Dose verification and plan conformity with three different dosimeters for intensity-modulated radiation therapy plans

Background: The intensity-modulated radiotherapy (IMRT) enables personalized treatment; the complexity of this technique increased the need for patient-specific quality assurance (QA). Objective: Comparing three dosimeters that common for patient-specific QA of IMRT. Material and Method: cases were planned at Eclipse treatment planning system (TPS) to receive radiotherapy at Unique VARIAN linear accelerator LINAC; Patient-specific QA was performed with three independent dosimeters: Gafchromic films EPT2, Electronic Portal Image Device (EPID), and PTW 2D array. The absolute dose was measured and analysis of 2D gamma index was performed, then compared with the plan calculated in TPS. Results: Analysis of absolute dose measured have highest difference from dose in Gafchromic film (89.1±4) % while EPID had a lower range (96.6 ± 1.2) and 2Darray showed an agreement up to (99±1.2) for patient specific QA both EBT2 and EPID enable to compare the measured map with TPS calculations, for plan conformity the gafchromic film enable measurement with lower accuracy even with localized brain tumor, the heterogeneity in lung case slightly affect the EPID measurement, this found also with irregular surface of head and neck and increased depth within pelvic case examine. Measurement with 2D array found to be the optimum dosimeter within different conditions. Conclusion: different parameters might affect the accuracy of gafchromic film including film scanning, storing, and calibration curve. EPID has an average deviation appears in beam fluence and 2D array as a 2D ion chamber found to have the most accurate dosimeter, but still time consuming when compared to EPID.