Leaf trajectory verification during dynamic intensity modulated radiotherapy using an amorphous silicon flat panel imager.

An independent verification of the leaf trajectories during each treatment fraction improves the safety of IMRT delivery. In order to verify dynamic IMRT with an electronic portal imaging device (EPID), the EPID response should be accurate and fast such that the effect of motion blurring on the detected moving field edge position is limited. In the past, it was shown that the errors in the detected position of a moving field edge determined by a scanning liquid-filled ionization chamber (SLIC) EPID are negligible in clinical practice. Furthermore, a method for leaf trajectory verification during dynamic IMRT was successfully applied using such an EPID. EPIDs based on amorphous silicon (a-Si) arrays are now widely available. Such a-Si flat panel imagers (FPIs) produce portal images with superior image quality compared to other portal imaging systems, but they have not yet been used for leaf trajectory verification during dynamic IMRT. The aim of this study is to quantify the effect of motion distortion and motion blurring on the detection accuracy of a moving field edge for an Elekta iViewGT a-Si FPI and to investigate its applicability for the leaf trajectory verification during dynamic IMRT. We found that the detection error for a moving field edge to be smaller than 0.025 cm at a speed of 0.8 cm/s. Hence, the effect of motion blurring on the detection accuracy of a moving field edge is negligible in clinical practice. Furthermore, the a-Si FPI was successfully applied for the verification of dynamic IMRT. The verification method revealed a delay in the control system of the experimental DMLC that was also found using a SLIC EPID, resulting in leaf positional errors of 0.7 cm at a leaf speed of 0.8 cm/s.