Development of EPID-based real time dose verification for dynamic IMRT

An electronic portal image device (EPID) has become a method of patient-specific IMRT dose verification for radiotherapy. Research studies have focused on pre and post-treatment verification, however, there are currently no interventional procedures using EPID dosimetry that measure the dose in real time as a mechanism to ensure that overdoses do not occur and underdoses are detected as soon as is practically possible. As a result, an EPID-based real time dose verification system for dynamic IMRT was developed and was implemented with MATLAB/Simulink. The EPID image acquisition was set to continuous acquisition mode at 1.4 images per second. The system defined the time constraint gap, or execution gap at the image acquisition time, so that every calculation must be completed before the next image capture is completed. In addition, the γ-evaluation method was used for dose comparison, with two types of comparison processes; individual image and cumulative dose comparison monitored. The outputs of the system are the γ-map, the percent of γ<1, and mean-γ versus time, all in real time. Two strategies were used to test the system, including an error detection test and a clinical data test. The system can monitor the actual dose delivery compared with the treatment plan data or previous treatment dose delivery that means a radiation therapist is able to switch off the machine when the error is detected.