A method for direct conversion of EPID images to incident fluence for dose reconstruction

A direct incident fluence measurement method based on amorphous silicon electronic portal imaging device (a-Si EPID) has been developed for pretreatment verification of intensity-modulated radiation therapy (IMRT). The EPID-based incident fluence conversion method deconvolves EPID images to the primary response distribution based on measured lateral scatter kernels in the EPID detector using Conjugate Gradient algorithm. The primary response is converted to the incident fluence based on measured fluence conversion matrix which corrects for off-axis position dependence of the a-Si EPID response and the "horn" beam profile caused by flatting filter. To verify feasibility and accuracy of this method, square fields of various sizes and two IMRT plans were delivered. The dose distributions computed based on EPID-derived incident fluence were compared with the measurement data. For all square field sizes except the smallest field (2 cm), the mean dose differences in cross-line dose profiles were within 1% excluding the penumbra region, and gamma passing percentages with a 2%/2 mm criterion were about 99%. For two IMRT plans, the least gamma passing percentage for all eight IMRT fields was 98.14% with 2%/3 mm criteria. It can be concluded that our direct EPID-based incident fluence conversion method is accurate and capable of being applied to pretreatment dose verification in clinical routines.