In patient dose reconstruction using a cine acquisition for dynamic arc radiation therapy.

An amorphous silicon (a-Si) electronic portal imaging device (EPID) was implemented to perform transit in vivo dosimetry for dynamic conformal arc therapy (DCAT). A set of images was acquired for each arc irradiation using the EPID cine acquisition mode, that supplies a frame acquisition rate of one image every 1.66 s, with a monitor unit rate equal to 100 UM/min. In these conditions good signal stability, +/-1% (2SD) evaluated during 3 months, signal reproducibility within +/-0.8% (2SD) and linearity with dose and dose rate within +/-1% (2SD) were obtained. The transit signal, S (t), due to the transmitted radiotherapy beam below a solid phantom, measured by the EPID cine acquisition mode was used to determine, (1) a set of correlation functions, F(w, L), defined as the ratio between S (t) and the dose at half thickness, D (m), measured in solid water phantoms of different thicknesses, w and with square fields of side L, (2) a set of factors, f(d, L), that take into account the different x-ray scatter contribution from the phantom to the S (t) signal as a function of the variation, d, of the air gap between the phantom and the EPID. The reconstruction of the isocenter dose, D (iso), for DCAT was obtained convolving the transit signal values, obtained at different gantry angles, with the respective reconstruction factors determined by a house-made software. The method was applied to a first patient and the results show that the reconstructed D (iso) values can be obtained with an accuracy within +/-5%. In conclusion, it was assessed that an a-Si EPID with the cine acquisition mode is suitable to perform transit in vivo dosimetry for the DCAT therapy.