Reduction of the effect of non-uniform backscatter from an E-type support arm of a Varian a-Si EPID used for dosimetry

Backscatter from the metallic components in the support arm is one of the sources of inaccuracy in dosimetry with Varian amorphous silicon electronic portal imaging devices (a-Si EPIDs). In this study, the non-uniform arm backscatter is blocked by adding lead sheets between the EPID and an E-type support arm. By comparing the EPID responses on and off the arm, with and without lead and considering the extra weight on the imager, 2 mm of lead was determined as the optimum thickness for both 6 and 18 MV beam energies. The arm backscatter at the central axis with the 2 mm lead in place decreased to 0.1% and 0.2% for the largest field size of 30x30 cm(2) using 6 and 18 MV beams, from 2.3% and 1.3% without lead. Changes in the source-to-detector distance (SDD) did not affect the backscatter component more than 1%. The symmetry of the in-plane profiles improved for all field sizes for both beam energies. The addition of lead decreased the contrast-to-noise ratio and resolution by 1.3% and 0.84% for images taken in 6 MV and by 0.5% and 0.38% for those in 18 MV beams. The displacement of the EPID central pixel was measured during a 360 degrees gantry rotation with and without lead which was 1 pixel different. While the backscatter reduces with increasing lead thickness, a 2 mm lead sheet seems sufficient for acceptable dosimetry results without any major degradation to the routine performance of the imager. No increase in patient skin dose was detected.