A simple method to quantify the coincidence between portal image graticules and radiation field centers or radiation isocenter

Purpose: The aim of this study was to develop a computerized method to quantify the coincidence between portal image graticules and radiation field centers or radiation isocenter. Three types of graticules were included in this study: Megavoltage (MV) mechanical graticule, MV electronic portal imaging device digital graticule, and kilovoltage (kV) on-board imaging digital graticule. Methods: A metal ball bearing (BB) was imaged with MV and kV x-ray beams in a procedure similar to a Winston-Lutz test. The radiation fields, graticules, and BB were localized in eight portal images using Hough transform-based computer algorithms. The center of the BB served as a static reference point in the 3D space so that the distances between the graticule centers and the radiation field centers were calculated. The radiation isocenter was determined from the radiation field centers at different gantry angles. Results: Misalignments of MV and kV portal imaging graticules varied with the gantry or x-ray source angle as a result of mechanical imperfections of the linear accelerator and its imaging system. While the three graticules in this study were aligned to the radiation field centers and the radiation isocenter within 2.0 mm, misalignments of 1.5-2.0 mm were found at certain gantry angles. These misalignments were highly reproducible with the gantry rotation. Conclusions: A simple method was developed to quantify the alignments of portal image graticules directly against the radiation field centers or the radiation isocenter. The advantage of this method is that it does not require the BB to be placed exactly at the radiation isocenter through a precalibrated surrogating device such as room lasers or light field crosshairs. The present method is useful for radiation therapy modalities that require high-precision portal imaging such as image-guided stereotactic radiotherapy.