A back-projection algorithm in the presence of an extra attenuating medium: towards EPID dosimetry for the MR-Linac

In external beam radiotherapy, electronic portal imaging devices (EPIDs) are frequently used for pre-treatment and for in vivo dose verification. Currently, various MR-guided radiotherapy systems are being developed and clinically implemented. Independent dosimetric verification is highly desirable. For this purpose we adapted our EPID-based dose verification system for use with the MR-Linac combination developed by Elekta in cooperation with UMC Utrecht and Philips. In this study we extended our back-projection method to cope with the presence of an extra attenuating medium between the patient and the EPID. Experiments were performed at a conventional linac, using an aluminum mock-up of the MRI scanner housing between the phantom and the EPID. For a 10 cm square field, the attenuation by the mock-up was 72%, while 16% of the remaining EPID signal resulted from scattered radiation. 58 IMRT fields were delivered to a 20 cm slab phantom with and without the mock-up. EPID re...

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