Consequences of the spectral response of an a-Si EPID and implications for dosimetric calibration.

One of the attractive features of amorphous silicon electronic portal imaging devices (a-Si EPIDs) as dosimetric tools is that for open fields they are known to exhibit a generally linear relation between pixel value and incident energy fluence as measured by an ion chamber. It has also been established that a-Si EPIDs incorporating high atomic number phosphors such as Gd2O2S:Tb exhibit a disproportionately large response to low-energy (<1 MeV) photons. The present work examines the consequences of this hypersensitivity in a commercially available EPID, the Varian aS500, with respect to energy fluence calibration in a 6 MV radiotherapy beam. EPIDs may be deployed in situations where the spectrum of the incident beam is modified by passing through a compensator or through a patient or phantom. By examining the specific case of a beam hardened by passage through compensator material, we show that the discrepancy between open and attenuated beam calibration curves can be as high as 8%. A Monte Carlo study using a comprehensive model of the aS500 shows that this difference can be explained by spectral changes, and further suggests that it can be reduced by the addition of an external copper plate. We consider configurations with the plate placed directly on top of the EPID cassette and 15 cm above the cassette, supported by Styrofoam. In order to reduce the maximum discrepancy to <4%, it was found that a copper thickness of approximately 0.7 cm was required in the elevated configuration. Improvement was minimal with the copper in the contact configuration. Adding 0.7 cm of copper in the elevated configuration reduced the contrast-to-noise ratio by 19% and the modulation transfer for a given spatial frequency by 30%.