Characterization and use of EBT radiochromic film for IMRT dose verification.

We present an evaluation of a new and improved radiochromic film, type EBT, for its implementation to IMRT dose verification. Using a characterized flat bed color CCD scanner, the film's dose sensitivity, uniformity, and speed of development post exposure were shown to be superior to previous types of radiochromic films. The film's dose response was found to be very similar to ion chamber scans in water through comparisons of depth dose and lateral dose profiles. The effect of EBT film polarization with delivered dose and film scan orientation was shown to have a significant effect on the scanner's OD readout. In addition, the film's large size, flexibility, and the ability to submerge it in water for relatively short periods of time allowed for its use in both water and solid water phantoms to verify TomoTherapy IMRT dose distributions in flat and curved dose planes. Dose verification in 2D was performed on ten IMRT plans (five head and neck and five prostate) by comparing measured EBT dose distributions to TomoTherapy treatment planning system calculated dose. The quality of agreement was quantified by the gamma index for four sets of dose difference and distance to agreement criteria. Based on this study, we show that EBT film has several favorable features that allow for its use in routine IMRT patient-specific QA.