Radiotherapy Treatment Verification

During a radiotherapy treatment, a dosimetric verification or a geometric localization can be done, in order to assess the quality of the treatment. The dosimetric verification is generally performed measuring the dose at some points inside (natural cavities) or outside the patient, and comparing it to the dose at the same points calculated and predicted by the treatment planning system. This can be done either with thermoluminescent or diodes dosimeters or with ionization chambers. The geometric localization can be done acquiring a portal image of the patient. Portal imaging can be performed either with films placed between metallic screens, or with an electronic portal imaging device such as fluoroscopic systems, solid state devices or matrix ionization chamber systems. In order to assess possible field placement errors, the portal images have to be compared with images obtained with the simulator in the same geometric conditions and/or with the digitally reconstructed radiograph (DRR) obtained with the treatment planning system. In particular, when using matrix ionization chamber systems, the portal images contain also information regarding the exit dose. This means that this kind of imaging device can be used both for geometric localization and for dosimetric verification. In this case, the exit dose measured by the portal image can be compared with the exit dose calculated and predicted by the treatment planning system. Some “in-vivo” applications of this methodology are presented.