The purpose of the study was evaluating accuracy and reproducibility of a radiochromic film-based protocol to measure computer tomography dose index (CTDI) as a part of annual QA on CT scanners and kV-CBCT systems attached to linear accelerators.
Energy dependence of Gafchromic XR-QA2 ® film model was tested over imaging beam qualities (50 – 140 kVp). Film pieces were irradiated in air to known values of air-kerma (up to 10 cGy). Calibration curves for each beam quality were created (Film reflectance change Vs. Air-kerma in air). Film responses for same air-kerma values were compared. Film strips were placed into holes of a CTDI phantom and irradiated for several clinical scanning protocols. Film reflectance change was converted into dose to water and used to calculate CTDIvol values. Measured and tabulated CTDIvol values were compared.
Average variations of ±5.2% in the mean film reflectance change were observed in the energy range of 80 to 140 keV, and 11.1% between 50 and 140 keV. Measured CTDI values were in average 10% lower than tabulated CTDI values for CT-simulators, and 44% higher for CBCT systems. Results presented a mean variation for the same machine and protocol of 2.6%. Variation of film response is within ±5% resulting in ±15% systematic error in dose estimation if a single calibration curve is used. Relatively large discrepancy between measured and tabulated CTDI values strongly support the trend towards replacing CTDI value with equilibrium dose measurement in the center of cylindrical phantom, as suggested by TG- 111.