SU-E-T-62: A Preliminary Experience of Using EPID Transit Dosimetry for Monitoring Daily Dose Variations in Radiation Treatment Delivery




To investigate the use of EPID transit dosimetry for monitoring daily dose variations in radiation treatment delivery.


A patient with head and neck cancer treated using nine field IMRT beams was used in this study. The prescription was 45 Gy in 25 fractions. A KV CBCT was acquired before each treatment on a Varian NTX linear accelerator. Integrated images using MV EPID were acquired for each treatment beam. Planning CT images, treatment plan, and daily integrated images were imported into a commercial QA software Dosimetry Check (v4r4 Math Resolutions, LLC, Columbia, MD) to calculate 3D dose of the day assuming 25 fractions treatment. Planning CT images were deformed and registered to each daily CBCT using Varian SmartAdapt (v11.MR2). ROIs were then propagated from planning CT to daily CBCT. The correlation between maximum, average dose of ROIs and ROI volume, center of mass shift, Dice Similarity Coefficient (DSC) were investigated.


Not all parameters investigated showed strong correlations. For PTV and CTV, the average dose has inverse correlation with their volume change (correlation coefficient −0.52, −0.50, respectively) and DSC (−0.59, −0.59, respectively). The average dose of right parotid has correlation with its volume change (0.56). The maximum dose of spinal cord has correlation with the center of mass superior-inferior shift (0.52) and inverse correlation with the center of mass anterior-posterior shift (−0.73).


Transit dosimetry using EPID images collected during treatment delivery offers great potential to monitor daily dose variations due to patient anatomy change, motion, and setup errors in radiation treatment delivery. It can provide a patient-specific QA tool valuable for adaptive radiation therapy. Further work is needed to validate the technique.