: The aim of this study is to reduce the uncertainty associated with determining dose-to-water using an amorphous silicon electronic portal imaging detector (EPID) under reference conditions by developing a direct calibration formalism based on radiochromic film measurements made within the EPID panel and detailed Monte Carlo simulations. To our knowledge, this is the first EPID-based dosimetry study reporting an uncertainty budget
. Methods: Pixel sensitivity and relative off-axis response was mapped by simultaneously irradiating film contained within the imager panel and acquiring an EPID image set. The detector panel was disassembled for the purpose of modeling the EPID in detail using the EGSnrc DOSXYZnrc usercode, which was in turn used to calculate dose-to-film in EPID to dose-to-water in water conversion factors
. Results: A direct comparison of the two correction methodologies investigated in this work, the previously established empirical method and the proposed simultaneous measurement approach involving in-EPID film dosimetry, produced an agreement with an RMS deviation of 1.4 % overall. A combined standard relative uncertainty of 3.3 % (k = 1) was estimated for the determination of absorbed dose to water at the position of the EPID using the proposed calibration methodology
. Conclusions: This work describes a direct method of calibrating EPID response in terms of absorbed dose to water requiring fewer measurements than other empirical approaches, and without 2D spatial interpolation of correction factors.
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