This work validates the use of an amorphous-silicon, flat-panel electronic portal imaging device (a-Si EPID) for use as a gauge of patient or phantom radiological thickness, as an alternative to dosimetry. The response of the a-Si EPID is calibrated by adapting a technique previously applied to scanning liquid ion chamber EPIDs, and the stability, accuracy and reliability of this calibration are explored in detail. We find that the stability of this calibration, between different linacs at the same centre, is sufficient to justify calibrating only one of the EPIDs every month and using the calibration data thus obtained to perform measurements on all of the other linacs. Radiological thickness is shown to provide a reliable means of relating experimental measurements to the results of BEAMnrc Monte Carlo simulations of the linac-phantom-EPID system. For these reasons we suggest that radiological thickness can be used to verify radiotherapy treatment delivery and identify changes in the treatment field, patient position and target location, as well as patient physical thickness.
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