Comparison of the epson expression 1680 flatbed and the vidar VXR-16 dosimetry PRO film scanners for use in IMRT dosimetry using gafchromic and radiographic film

Intensity-modulated radiotherapy (IMRT) treatment plan verification is often done using Kodak EDR2 film and a Vidar Dosimetry PRO film digitizer. However, since many hospitals are moving towards a filmless environment, access to a film processor may not be available. Therefore, we have investigated a newly available Gafchromic EBT film for IMRT dosimetry. Planar IMRT dose distributions are delivered to both EBT and EDR2 film and scanned with the Vidar VXR-16 as well as an Epson Expression 1680 flatbed scanner. The measured dose distributions are then compared to those calculated with a Pinnacle treatment planning system. The IMRT treatments consisted of 7-9 6 MV beams for treatment of prostate, head and neck, and a few other sites. The films were analyzed using FilmQATM (3cognition LLC) software. Comparisons between measured and calculated dose distributions are reported as dose difference (DD) (pixels within +/-5%), distance to agreement (DTA) (3 mm), as well as gamma values (y) (dose= +/-3%, dist. =2 mm). Using EDR2 with the Vidar scanner is an established technique and agreement between calculated and measured dose distributions was better than 90% in all indices (DD, DTA, and gamma). However, agreement with calculations deteriorated reaching the lower 80% for EBT film scans with the Vidar scanner in logarithmic mode. The EBT Vidar scans obtained in linear mode showed an improved agreement to the upper 80% range, but artifacts were still observed across the scan. These artifacts were very distinct in all EBT scans and can be attributed to the way the film is transported through the scanner. In the Epson scanner both films are rigidly immobilized and the light source scans over the film. It was found that the Epson scanner performed equally well with both types of film giving agreement to better than 90% in all indices.