Purpose: Lateral response artifact (LRA) is caused by the interaction between film and flatbed scanner in the direction perpendicular to the scanning direction. This can significantly affect the accuracy of patient-specific quality assurance (QA) in cases involving large irradiation fields. We hypothesized that by utilizing the central area of the flatbed scanner, where the magnitude of LRA is relatively small, the LRA could be mitigated effectively. This study proposes a practical solution using the image-stitching technique to correct LRA for patient-specific QA involving large irradiation fields.
Methods: Gafchromic™ EBT4 film and Epson Expression ES-G11000 flatbed scanner were used in this study. The image-stitching algorithm requires a spot between adjacent images to combine them. The film was scanned at three locations on a flatbed scanner, and these images were combined using the image-stitching technique. The combined film dose was then calculated and compared with the treatment planning system (TPS)-calculated dose using gamma analysis (3%/2 mm). Our proposed LRA correction was applied to several films exposed to 18 × 18 cm2 open fields at doses of 200, 400, and 600 cGy, as well as to four clinical Volumetric Modulated Arc Therapy (VMAT) treatment plans involving large fields.
Results: For doses of 200, 400, and 600 cGy, the gamma analysis values with and without LRA corrections were 95.7% versus 67.8%, 95.5% versus 66.2%, and 91.8% versus 35.9%, respectively. For the clinical VMAT treatment plan, the average pass rate ± standard deviation in gamma analysis was 94.1% ± 0.4% with LRA corrections and 72.5% ± 1.5% without LRA corrections.
Conclusions: The effectiveness of our proposed LRA correction using the image-stitching technique was demonstrated to significantly improve the accuracy of patient-specific QA for VMAT treatment plans involving large irradiation fields.
Keywords: film dosimetry; image‐stitching technique; lateral response artifact.
© 2024 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, LLC on behalf of The American Association of Physicists in Medicine.