Skip to main content Accessibility help

Dosimetric verification and quality assurance for intensity-modulated radiation therapy using Gafchromic® EBT3 film

  • Khalid Iqbal (a1) (a2), Muhammad Mazhar Iqbal (a3), Muhammad Akram (a2), Saima Altaf (a1) (a2) and Saeed Ahmad Buzdar (a2)...



This study aimed to examine the dosimetric properties of Gafchromic® EBT3 film and intensity-modulated radiation therapy quality assurance (IMRT QA).

Materials and methods

Beams characteristics dosimetric properties and 20 IMRT plans were created and irradiated on Varian dual-energy DHX-S Linac for 6 and 15 MV energies. EBT3 films were analysed using ‘film Pro QA 2014’ software.


The dosimetric comparison of EBT3 film (for red channel dosimetry) and ionisation ion chamber measurement showed that average deviations of symmetry, flatness, central axis, penumbra (left) and penumbra (right) of dose profile were 0·18, 1·34, 0·49%, 3·68 and 3·61 mm for 6 MV and 0·10, 1·3, 0·45, 2·65 and 2·71 mm for 15 MV, respectively. The blue and green channels dosimetry showed greater dose deviation as compared with red channel. IMRT QA verification plan complied about 95% at all different criteria. Reproducibility, stability and face orientation of film were within 1·4% for red channel.


The results advocate that the film can be used not only for dosimetric assessment but also as a reliable IMRT QA tool.


Corresponding author

Correspondence to: Khalid Iqbal, Department of Radiation Oncology, Shaukat Khanum Cancer Hospital & Research Center, Lahore 54000, Pakistan. Tel: +924235905000. Fax: +924235945206. E-mail:


Hide All
1. Xu, Y, Wuu, C S, Maryanski, M J. Performance of a commercial optical CT scanner and polymer gel dosimeters for 3-D dose verification. Med Phys 2004; 31: 30243033.
2. Oldham, M, Kim, L. Optical-CT gel-dosimetry. II: Optical artifacts and geometrical distortion. MedPhys 2004; 31: 10931104.
3. Maryanski, M J, Schulz, R J, Ibbott, G S et al. Magnetic resonance imaging of radiation dose distributions using a polymer-gel dosimeter. Phys Med Biol 1994; 39: 14371455.
4. McJury, M, Oldham, M, Leach, M O, Webb, S. Dynamics of polymerization in polyacrylamide gel (PAG) dosimeters: (I) aging and long-term stability. Phys Med Biol 1999; 44: 18631873.
5. Oldham, M. Optical-CT scanning of polymer gels. J Phys ConfSer 2004; 3: 122135.
6. Lynch, B, Kozelka, J, Ranade, M, Li, J, Simon, W, Dempsey, J F. Important consideration for radiochromic film dosimetry with flatbed CCD scanners and EBT GAFCHROMIC film. MedPhys 2006; 33: 45514556.
7. Hartmann, B, Martisikova, M, Jäkel, O. Homogeneity of Gafchromic EBT2 film. Med Phys 2010; 37: 17531756.
8. Zeidan, O A, Stephenson, S A, Meeks, S L et al. Characterization and use of EBT radiochromic film for IMRT dose verification. Med Phys 2006; 33: 40644072.
9. Saur, S, Frengen, J. GafChromic EBT film dosimetry with flatbed CCD scanner: a novel background correction method and full dose uncertainty analysis. Med Phys 2008; 35: 30943101.
10. Andres, C, Del Castillo, A, Tortosa, R, Alonso, D, Barquero, R. A comprehensive study of the Gafchromic EBT2 radiochromic film. A comparison with EBT. Med Phys 2010; 37: 62716278.
11. Fuss, M, Sturtewagen, E, De Wagter, C, Georg, D. Dosimetric characterization of GafChromic EBT film and its implication on film dosimetry quality assurance. Phys Med Biol 2007; 52: 42114225.
12. Meigooni, A S, Sanders, M F, Ibbott, G S, Szeglin, S R. Dosimetric characteristics of an improved radiochromic film. Med Phys 1996; 23: 18831888.
13. Chiu-Tsao, S C, Ho, Y, Shankar, R, Wang, L, Harrison, L B. Energy dependence of response of new high sensitivity radiochromic films for megavoltage and kilo voltage radiation energies. Med Phys 2005; 32: 33503354.
14. Cheung, T, Butson, M J, Yu, P K N. Post-irradiation colouration of Gafchromic EBT radiochromic film. Phys Med Biol 2005; 50: N281N285.
15. Devic, S, Aldelaijan, S, Mohammed, H et al. Absorption spectra time evolution of EBT-2 model Gafchromic film. Med Phys 2010; 37: 22072214.
16. Arjomandy, B, Tailor, R, Anand, A et al. Energy dependence and dose response of Gafchromic EBT2 film over a wide range of photon, electron and proton beam energies. Med Phys 2010; 37: 19421947.
17. Butson, MJ, Cheung, T, Yu, P K N, Alnawaf, H. Dose and absorption spectra response of EBT2 Gafchromic film to high energy x-rays. Australas Phys Eng Sci Med 2009; 32: 196202.
18. Ashland, K Y. Gafchromic radiotherapy films. Accessed on 10 June 2014.
19. Reinhardt, S, Hillbrand, M, Wilkens, JJ, Assmann, W. Comparison of Gafchromic EBT2 and EBT3 films for 24: clinical photon and proton beams. Med Phys 2012; 39: 52575262.
20. Iqbal, K, Gifford, K A, Ibbott, G, Grant, L R, Buzdar, S A. Comparison of an anthropomorphic PRESAGE® dosimeter and radiochromic film with a commercial radiation treatment planning system for breast IMRT: a feasibility study. J Appl Clin Med Phys 2014; 15: 363374.
21. Iqbal, K, Gillin, M, Summers, P A, Dhanesar, S, Gifford, K A, Buzdar, S A. Quality assurance evaluation of spot scanning beam proton therapy with an anthropomorphic prostate phantom. Br J Radiol 2013; 86 (1031): 20130390.
22. Paelinck, L, De Neve, W, De Wagter, C. “Precautions and strategies in using a commercial flatbed scanner for radiochromic film dosimetry. Phys Med Biol 2007; 52: 231242.
23. Todorovic, M, Fischer, M, Cremers, F, Thom, E, Schmidt, R. Evaluation of Gafchromic EBT prototype B for external beam dose verification. Med Phys 2006; 33: 13211328.
24. Fuss, M, Sturtewagen, E, DeWagter, C, Georg, D. Dosimetric characterization of Gafchromic EBT film and its implication on film dosimetry quality assurance. Phys Med Biol 2007; 52: 42114225.
25. Tsai, J S, Wazer, D E, Ling, M N et al. Dosimetric verification of the dynamic intensity-modulated radiation therapy of 92 patients. Int J Radiat Oncol Biol Phys 1998; 40: 12131230.
26. Low, D A, Harms, W B, Mutic, S, Purdy, J A. A technique for the quantitative evaluation of dose distributions. Med Phys 1998; 25: 656661.
27. Stock, M, Kroupa, B, Georg, D. Interpretation and evaluation of the γ index and the γ index angle for the verification of IMRT hybrid plans. Phys Med Biol 2005; 50: 399411.
28. Arjomandy, B, Tailor, R, Anand, A et al Radiochromic Film Dosimetry. AAPM TG55 Report No. 63. Madison, WI: Medical Physics Publishing, 1998.
29. Borca, V, Pasquino, M, Russo, G et al. Dosimetric characterisation and use of Gafchromic EBT3 film for IMRT dose verification. Med J Appl Clin Med Phys 2013; 14: 158171.
30. Klein, E E, Hanley, J, Bayouth, J et al. Task Group 142, American Association of Physicists in Medicine. Task Group 142 report: quality assurance of medical accelerators. Med Phys 2009; 36: 41974212.
31. Ferreira, B C, Lopes, M C, Capela, M. Evaluation of an Epson flatbed scanner to read Gafchromic EBT films for radiation dosimetry. Phys Med Biol 2009; 54: 10731085.
32. Almond, P R, Biggs, P J., Course, B M et al. AAPM’s TG-51 protocol for clinical reference dosimetry of high-energy photon and electron beams. Med Phys 1999; 26: 18471870.
33. Andreo, P, SaifulHuq, M, Westermark, M et al. Protocols for the dosimetry of high-energy photon and electron beams: a comparison of the IAEA TRS-398 and previous international Codes of Practice. Phys Med Biol 2002; 47: 3033.
34. Liu, H W, Gräfe, J, Khan, R et al. Role of in vivo dosimetry with radiochromic films for dose verification during cutaneous radiation therapy. Radiat Oncol 2015; 10: 12.
35. Chang, L, Ho, S Y, Lee, T F et al. Calibration of EBT2 film using a red-channel PDD method in combination with a modified three-channel technique. Med Phys 2015; 42 (10): 58385847.
36. Iqbal, K, Muhammad, I, Saeed, AB, Gifford, KA, Afzal, M. Treatment planning evaluation of sliding window and multiple static segments technique in intensity modulated radiotherapy. Rep Pract Oncol Radiother 2013; 18: 101106.
37. Asgharizadeh, S, Bekerat, H, Syme, A et al. Radiochromic film-based quality assurance for CT-based high-dose-rate brachytherapy. Brachytherapy 2015; 14 (4): 578585.



Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed