Developing a novel method to analyse Gafchromic EBT2 films in intensity modulated radiation therapy quality assurance

Recently individual intensity modulated radiation therapy quality assurances (IMRT QA) have been more and more performed with Gafchromic (TM) EBT series films processed in red-green-blue (R-G-B) channel due to their extremely high spatial resolution. However, the efficiency of this method is relatively low, as for each box of film, a calibration curve must be established prior to the film being used for measurement. In this study, the authors find a novel method to process the Gafchromic (TM) EBT series, that is, to use the 16-bit greyscale channel to process the exposed film rather than the conventional 48-bit R-G-B channel, which greatly increases the efficiency and even accuracy of the whole IMRT procedure. The main advantage is that when processed in greyscale channel, the Gafchromic (TM) EBT2 films exhibits a linear relationship between the net pixel value and the dose delivered. This linear relationship firstly reduces the error in calibration-curve fitting, and secondly saves the need of establishing a calibration curve for each box of films if it is only to be used for relative measurements. Clinical testing for this novel method was carried out in two radiation therapy centres that involved a total of 743 IMRT cases, and 740 cases passed the 3 mm 3 % gamma analysis criteria. The cases were also tested with small ionization chambers (cc-13) and the results were convincing. Consequently the authors recommend the use of this novel method to improve the accuracy and efficiency of individual IMRT QA procedure using Gafchromic EBT2 films.