Modeling dose distributions from portal dose images using the convolution/superposition method.

Post-treatment dose verification refers to the process of reconstructing delivered dose distributions internal to a patient from information obtained during the treatment. The exit dose is commonly used to describe the dose beyond the exit surface of the patient from a megavoltage photon beam. Portal imaging provides a method of determining the dose in a plane distal to a patient from a megavoltage therapeutic beam. This exit dose enables reconstruction of the dose distribution from external beam radiation throughout the patient utilizing the convolution/superposition method and an extended phantom. An iterative convolution/superposition algorithm has been created to reconstruct dose distributions in patients from exit dose measurements during a radiotherapy treatment. The method is based on an extended phantom that includes the patient CT representation and an electronic portal imaging device (EPID). The convolution/superposition method computes the dose throughout the extended phantom, which allows the portal dose image to be predicted in the EPID. The process is then reversed to take the portal dose measurement and infer what the dose distribution must have been to produce the measured portal dose. The dose distribution is modeled without knowledge of the incident intensity distribution, and includes the effects of scatter in the computation. The iterative method begins by assuming that the primary energy fluence (PEF) at the portal image plane is equal to the portal dose image, the PEF is then back-projected through the extended phantom and convolved with the dose deposition kernel to determine a new prediction of the portal dose image. The image of the ratio of the computed PEF to the computed portal dose is then multiplied by the measured portal dose image to produce a better representation of the PEF. Successive iterations of this process then converge to the exiting PEF image that would produce the measured portal dose image. Once convergence is established, the dose distribution is determined by back-projecting the PEF and convolving with the dose deposition kernel. The method is accurate, provided the patient representation during treatment is known. The method was used on three phantoms with a photon energy of 6 MV to verify convergence and accuracy of the algorithm. The reconstructed dose volumes agree to within 3% of the forward computation dose volumes. Furthermore, this technique assumes no prior knowledge of the incident fluence and therefore may better represent the dose actually delivered.