Digital illustration of stylized human body with radiation beams, representing precision in cancer treatment.

Are You Getting the Right Radiation Dose? How Daily Checks Can Improve Your Cancer Treatment

Avery Sinclair in Health & Wellness December 2025 • 4 min read.

"A new study highlights how daily monitoring with EPID technology can ensure precision and reduce errors in IMRT radiation therapy, potentially improving outcomes for cancer patients."

In the fight against cancer, precision is everything. Modern radiation therapy, especially Intensity-Modulated Radiation Therapy (IMRT), has become a powerful tool for targeting tumors while sparing healthy tissues. IMRT delivers radiation in carefully shaped beams, maximizing the dose to the tumor and minimizing the impact on surrounding organs.

However, the complexity of IMRT also introduces the potential for errors. From slight shifts in patient positioning to variations in the equipment, many factors can affect whether the radiation is delivered exactly as planned. That's why researchers are constantly looking for ways to improve the accuracy and reliability of radiation therapy.

A groundbreaking study published in the journal 'Reports of Practical Oncology and Radiotherapy' explores the use of daily checks with EPID (Electronic Portal Imaging Device) technology to ensure the reproducibility of IMRT treatments. This method offers a way to catch potential errors in real-time, helping to ensure that patients receive the intended dose of radiation with every session. Let's break down this research and understand why it could change how we approach radiation therapy.

What is EPID and How Does It Improve Radiation Accuracy?

Digital illustration of stylized human body with radiation beams, representing precision in cancer treatment.

An EPID is an imaging system integrated into radiation therapy machines. It captures images of the radiation beam after it has passed through the patient. By comparing these images to a reference image of the planned treatment, doctors can verify if the radiation is being delivered accurately.

The study focused on using EPID to monitor the daily reproducibility of IMRT plans. Researchers used an anthropomorphic phantom (a model that mimics the human body) to develop a method for collecting data and detecting positioning errors. They then applied this method to 23 patients undergoing IMRT for pelvic and head and neck cancers.

Daily Monitoring: EPID images were collected daily for each IMRT subfield.
Gamma Method: These images were compared to reference images using the gamma method, a statistical test to assess the agreement between two radiation dose distributions.
Error Detection: The goal was to identify any deviations from the planned treatment that could indicate errors in positioning or equipment function.

The results of the study were promising. The phantom study demonstrated the ability of EPID to detect shifts during radiotherapy. In the clinical setting, the researchers found that for most patients, the EPID measurements showed good reproducibility, with score values below 1% in a significant percentage of analyzed fields. The study also found relationships between treatment plan parameters, pre-verification results, and the repeatability of the collected images. This suggests that EPID-based daily verification can provide valuable information about the consistency of treatment delivery.

The Future of Precision in Radiation Therapy

The study concludes that EPID-based daily verification offers a valuable tool for ensuring the accuracy and consistency of IMRT treatments, without adding any additional dose to the patient. By catching potential errors in real-time, this approach can help to improve the effectiveness of radiation therapy and minimize the risk of side effects. As technology advances, we can expect EPID-based verification to become an increasingly important part of the radiation therapy process, helping to deliver more precise and personalized cancer care.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1016/j.rpor.2018.05.003, Alternate LINK

Title: Epid-Based Daily Verification Of Reproducibility Of Patients’ Irradiation With Imrt Plans

Subject: Radiology, Nuclear Medicine and imaging

Journal: Reports of Practical Oncology & Radiotherapy

Publisher: VM Media SP. zo.o VM Group SK

Authors: Marta Kruszyna-Mochalska

Published: 2018-09-01

Everything You Need To Know

What is IMRT, and why is precision so crucial in its application for cancer treatment?

IMRT, or Intensity-Modulated Radiation Therapy, is a sophisticated radiation therapy technique designed to target tumors with precisely shaped beams of radiation. The goal is to maximize the radiation dose delivered to the tumor while minimizing exposure to the surrounding healthy tissues and organs. Precision is paramount in IMRT because even small deviations in radiation delivery can significantly impact the effectiveness of the treatment and the patient's well-being. Inaccurate delivery can lead to underdosing the tumor, potentially allowing it to grow, or overdosing healthy tissues, increasing the risk of side effects. Ensuring the precise delivery of the radiation dose is, therefore, critical for achieving optimal outcomes in cancer treatment.

How does EPID technology work to improve the accuracy of IMRT treatments?

EPID, or Electronic Portal Imaging Device, is an imaging system integrated into radiation therapy machines. It functions by capturing images of the radiation beam after it has passed through the patient. These images are then compared to a reference image of the planned treatment. By comparing the images, doctors can verify whether the radiation is being delivered accurately. This process allows for real-time monitoring and detection of errors, such as slight shifts in patient positioning or equipment variations, which could affect the radiation dose. EPID enables daily verification of IMRT plans, thereby enhancing the accuracy and repeatability of treatments and ensuring patients receive the intended dose of radiation.

What methods were used in the study to assess the effectiveness of EPID in monitoring IMRT treatments?

The study utilized a multi-faceted approach to evaluate the efficacy of EPID in monitoring IMRT treatments. Firstly, researchers employed an anthropomorphic phantom, a model simulating the human body, to develop a method for collecting data and detecting potential positioning errors. Then, this method was applied to 23 patients undergoing IMRT for pelvic and head and neck cancers. Daily monitoring was conducted using EPID, capturing images for each IMRT subfield. These images were then compared to reference images using the gamma method, a statistical test designed to assess the agreement between two radiation dose distributions. The objective was to identify any deviations from the planned treatment that could indicate errors in positioning or equipment functionality, thereby ensuring the accuracy and consistency of IMRT delivery.

What were the key findings of the study regarding EPID-based daily verification in IMRT?

The study yielded promising results, demonstrating the effectiveness of EPID in enhancing IMRT treatment accuracy. The phantom study revealed the capacity of EPID to detect shifts during radiotherapy. In the clinical setting, EPID measurements indicated good reproducibility for most patients, with score values below 1% in a significant percentage of analyzed fields. Moreover, the study established relationships between treatment plan parameters, pre-verification results, and the repeatability of collected images. These findings underscore the value of EPID-based daily verification in providing valuable information about the consistency of treatment delivery, ensuring the radiation is delivered as planned, and ultimately improving patient outcomes.

How can EPID-based daily verification contribute to the future of cancer care, and what are its implications for patients?

EPID-based daily verification is poised to become an increasingly vital component of radiation therapy, contributing significantly to the advancement of cancer care. By enabling real-time detection of potential errors during IMRT treatments, EPID facilitates more precise and personalized cancer care. This proactive approach can improve the effectiveness of radiation therapy, ensuring the tumor receives the intended dose while minimizing the risk of side effects for the patient. As technology continues to evolve, the integration of EPID in radiation therapy is expected to grow, further refining the accuracy and consistency of treatments, thereby leading to enhanced outcomes and a better quality of life for cancer patients.