Physica Medica 30 (2014) 708e712

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Technical notes

Analysis of the EBT3 Gafchromic film irradiated with 6 MV photons

and 6 MeV electrons using reflective mode scanners
Nicolas Farah a, b, Ziad Francis a, c, *, Marie Abboud a
a
Physics Department, Faculty of Science, Saint Joseph University, B.P. 11-514 Riad El Solh, Beirut 1107 2050, Lebanon
b
Department of Radiation-Oncology, Hôtel-Dieu de France Hospital, PO Box HDF 166830, Beirut, Lebanon
c
The Open University, Faculty of Science, Department of Physical Sciences, Walton Hall, MK7 6AA Milton Keynes, United Kingdom

a r t i c l e i n f o a b s t r a c t

Article history: We explore in our study the effects of electrons and X-rays irradiations on the newest version of the
Received 30 January 2014 Gafchromic EBT3 film. Experiments are performed using the Varian “TrueBeam 1.6” medical accelerator
Received in revised form delivering 6 MV X-ray photons and 6 MeV electron beams as desired. The main interest is to compare the
4 April 2014
responses of EBT3 films exposed to two separate beams of electrons and photons, for radiation doses
Accepted 25 April 2014
Available online 29 May 2014
ranging up to 500 cGy. The analysis is done on a flatbed EPSON 10000 XL scanner and cross checked on a
HP Scanjet 4850 scanner. Both scanners are used in reflection mode taking into account landscape and
portrait scanning positions. After thorough verifications, the reflective scanning method can be used on
Keywords:
Gafchromic EBT3
EBT3 as an economic alternative to the transmission method which was also one of the goals of this
Film dosimetry study. A comparison is also done between single scan configuration including all samples in a single A4
Radiotherapy (HP) or A3 (EPSON) format area and multiple scan procedure where each sample is scanned separately
on its own. The images analyses are done using the ImageJ software. Results show significant influence of
the scanning configuration but no significant differences between electron and photon irradiations for
both single and multiple scan configurations. In conclusion, the film provides a reliable relative dose
measurement method for electrons and photons irradiations in the medical field applications.
! 2014 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Introduction
In the past years, using radiochromic films for dose assessment
went through noticeable progress, and studies were emphasized on
this type of measurements in the medical field for radiation
dosimetry and radiotherapy control. Gafchromic film irradiation is
seen today as a simple and quick method for dose profiling in
different irradiation situations. However some properties should be
considered for more reliable results taking into account the sensi-
tivity of such type of films to several parameters e.g. radiation type
and energy. Studies on the effect of read out light sources and
ambient light on previous versions of Gafchromic films, e.g. MD-55-
1 and MD-55-2 [1], showed an interesting color modification after
few hours of exposure especially for fluorescent light sources, and
* Corresponding author. Physics Department, Faculty of Science, Saint Joseph
University, B.P. 11-514 Riad El Solh, Beirut 1107 2050, Lebanon. Tel.: þ961 1 421
000ext3450; fax: þ961 4 532 657.
E-mail addresses: ziad.francis@gmail.com (Z. Francis), marie.abboud@usj.edu.lb
(M. Abboud).
thus care should be taken during film handling and storage.
Another study by Ref. [2] revealed a 9% post-irradiation coloration
increase of MD-55-2 films up to 20 h after the irradiation, sug-
gesting that films should be scanned for read out at least 6 h after
exposure. The properties of EBT Gafchromic films exposed to X-rays
radiation were also investigated by other authors e.g. Ref. [3] and
the energy response of the EBT2 films was found to be independent
of the incident photon energy over a wide range from 15 keV to
w2.5 MeV for doses ranging between 25 cGy and 500 cGy. The
absorption spectra variations during read out scanning of the EBT
film showed a clear increase in net optical density for frequencies
around 636 nm in comparison with older versions of Gafchromic
films [4]. The improvements applied on the EBT made this type of
films a powerful candidate for several applications like measuring
solar UV radiation [5], and as a potential dosimeter for ion beams
therapy [6], underlining the precision that can be achieved in
practical cases like medical tomotherapy [7]. A detailed review by
Ref. [8] summarizes the improvement of Gafchromic films through
the recent years and underlines the importance of precision in
dosimetry for medical applications. However, some performance
issues were still reported for the EBT2 version, e.g., the

http://dx.doi.org/10.1016/j.ejmp.2014.04.010
1120-1797/! 2014 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.
 N. Farah et al. / Physica Medica 30 (2014) 708e712
inhomogeneity of the film response [9], showing the importance of
the repetitive and complementary verification studies that are re-
ported in the literature for the different types of Gafchromic films.
In fact, comparisons between different versions of the EBT are of
extreme importance, especially when it comes to assessing the
improvements that are made for the medical applications dosim-
etry. Moreover, the analysis protocols that are reported in the
literature can differ easily one from another leading to differences
in the obtained results. Here comes the importance of reporting as
much details as possible when it comes to analysis methods.
In our study we use the most recent version of the EBT series
namely the EBT3 film. The EBT3 is an improved version of the EBT2
film; it is made by laminating an active layer between two identical
polyester layers [10]. Studies published in the literature showed
some of the characteristics of the EBT3 e.g., energy dependence of
the film reaction after X-rays irradiation [11], particle type depen-
dence [12], specific IMRT applications [10] and comparisons with its
predecessor the EBT2 in medical irradiation applications [13]. One
of the advantages of the EBT3 is that the analysis is independent
from the film scan orientation which was not the case for the EBT2.
Here in this work, our interest lies mostly in comparing the
response of the films to doses delivered by X-ray and electron
beams, and using different analysis configurations with two flatbed
reflective scanners. In fact, transmission scanners are more costly
than reflective scanners and might be more difficult to acquire in
some cases. One of the issues we also wanted to verify here is the
reliability of the reflective analysis method comparing a relatively
expensive scanner to the results obtained by a cheaper scanner
model.
Materials and methods
Gafchromic film EBT3
The Gafchromic EBT3 (lot number A 01231202, Ashland Spe-
cialty Ingredients, NJ, USA) radiochromic film is available in sheets
of 20.32 " 25.4 cm2. It consists of an active layer of w28 mm of
thickness coated on both sides by a protective polyester layer of
100 mm. Samples are cut into pieces of 5 " 6 cm2 before the irra-
diation. This size order is acceptable and common to several studies
in the literature [7,12]; it covers an area that is wide enough to limit
statistical uncertainties during irradiation and analysis. Handling
the samples from cutting phase to the scanning and folding is done
using latex gloves to avoid stains and marks that can affect the
scanning results. The samples are folded with care in a dark en-
velope whenever not in use in order to avoid ambient light and
other sources effects during storage.
Irradiation procedure
The irradiations are accomplished using a Varian “TrueBeam
1.6” accelerator providing electron beams of 6 MeV average energy
and photon beams of 6 MV acceleration potential. Relatively low
energies are chosen and phantoms are used in order to achieve the
best dose absorption rate and to minimize the irradiation time,
without altering the quality of the results. The considered config-
uration is thus compatible with our study since the dose response
of the film is independent of the depth in the phantom between 2
and 25 cm [14]. The irradiation field is considered uniform and
limited within 10 " 10 cm2. The films are positioned between two
water equivalent phantom layers of polystyrene; the build-up
phantom (1.5 cm thickness as in Ref. [4]) is placed between the
source field and the irradiated sample and the support phantom
(10 cm thickness) laying behind the sample in the beam propaga-
tion direction. Additionally, no significant influence is observed
709
between low and high field sizes ranging from 3 " 3 cm2 up to
25 " 25 cm2 [14] on dose response so only the mentioned
10 " 10 cm2 configuration is adopted. The irradiation procedure is
performed for doses ranging from 0 to 500 cGy with a step of
50 cGy for both electron and photon beams. The relative uncer-
tainty of the delivered dose is around 2%; this is the standard
conventional value that is clinically used when continuous quality
control procedures are implemented using the ionization chamber
methods.
Scan procedure
The irradiated films were folded in dark envelopes at least for
24 h to ensure the darkening effect stabilization. The scanning is
performed in landscape and portrait positions using two different
scanners: HP scanjet 4850 and EPSON 10000 XL with a resolution of
300 dots per inch (dpi) producing 48 bit RGB colored images in tiff
format. When HP scanner is used, five blank scans are performed in
order to warm up the lamp of the scanner and the sixth scan is
saved for analysis. In the case of Epson 10000 XL scanner, an
average of 2e3 preview scans was considered sufficient at the
beginning of the scanning procedure to take into account the
warm-up effect. According to Ref. [14] the impact of these effects on
the results does not exceed 0.1%. We consider two approaches of
scanning: (i) a single scan configuration where all the samples are
placed according to increasing, decreasing or random dose order
from left to right in order to ensure that the position on the scanner
bed does not affect the results and then scanned at once fitting in an
A4 or A3 format area for the HP and the EPSON scanners respec-
tively and (ii) a ‘multiple scan’ configuration where every sample is
placed in the center of the scanner bed and scanned on its own. The
comparison between single and multiple scans approaches would
show the effect of the scanning phase parameter on the results. As
advised by the manufacturer, for the scanning, no filters or color
correction functions are applied to raw pixel value results.
Scan analysis
Image measurement and analysis are performed on a region of
interest (ROI) of 480 " 480 pixels2 around the film samples center.
Three values are taken to obtain the mean pixel value with its
standard deviation in the ROI. The scanned images are then
analyzed using ImageJ [15] software. The RGB and the red
component of the color are taken into account [5,16].
The net reflective optical density “net ROD” is calculated using
the pixels values from the scanned images according to the
following expression
! "
Iu
Net ROD ¼ log (1)
Ii
where Iu and Ii are the average pixel values of the reflected in-
tensities through non irradiated and irradiated films respectively
[17].
Results and discussion
As already mentioned, we consider in our study several analysis
configurations. The combination of different setups and approaches
would lead to a high number of similar results that would be
cumbersome to show at once, thus, for the sake of clarity only the
interesting selection is displayed in this section. Furthermore, the
error bars on experimental values represent less than 0.1% and they
do not appear on the figures as they are smaller than the symbols.
710 N. Farah et al. / Physica Medica 30 (2014) 708e712

Scan orientation comparison

Figures 1 and 2 show the landscape and portrait scan orienta-

tion comparison for 6 MV photon and 6 MeV electron irradiations
respectively, for doses between 0 and 500 cGy. The Epson 10000 XL
scanner is used in reflective mode and the analysis is made in 2
different ways taking into account the complete RGB scanned im-
age for one analysis and only the RED channel for the other. The
landscape and portrait configurations lead to the same results for
the RGB and the Red channel analyses; the differences of the ROD
values are below 0.03% for the whole spectrum with an exception
reaching 0.07% for doses above 400 cGy for electrons irradiations.
Differences of around 0.45%e1.1% were reported in the literature
for a dose range reaching up to 10 Gy [12]. In the previous EBT
versions (EBT2) the scanning results showed noticeable differences
between landscape and portrait scan positions, which is not the
case for the EBT3 where the difference is negligible as mentioned
by the manufacturer and verified by Ref. [13]. Furthermore, in
previous studies on previous EBT films, the red channel showed a
higher sensitivity than the RGB [18] and this tendency is still valid
for the particular conditions applied in our study.
Figure 2. Dose response of EBT3 Gafchromic film irradiated with 6 MeV electrons. The
analysis details are the same as for Fig. 1.
Particle type and energy dependence

In order to verify the effect of the particle type on the EBT3
coloring, samples are irradiated using 2 different particles, photons
and electrons. The scan of the films is done in a landscape config-
uration and a comparison between RGB and red channel analyses is
conducted. Figure 3 shows a comparison of the net ROD for electron
and photon irradiations. The obtained results show very close re-
sults for both radiation types and for the same doses. Discrepancies
remain less than 0.07% for doses below 350 cGy and increase
slightly up to 0.1% for doses around 500 cGy. These findings are in
agreement with previous results from the literature where the
EBT3 film was used for IMRT energy range e.g., 6 MVe15 MV and
the energy dependence was proven to be negligible [10]. For high
energy photon beams generally used in radiotherapy energy
dependence of the EBT3 coloring is also weak [11] and the
dependence on the particle type was also reported to be non-
significant by Refs. [12] and [19] for the EBT3 predecessors (The
EBT2 and the EBT versions).
Single versus multiple scan comparison
As the results can vary according to the scanning details e.g. scan
lamp temperature reference [20] and other parameters, we
compare two scan configurations. In a multiple scan approach, each
irradiated sample is scanned together with the non-irradiated one
consecutively from the lower dose to the higher one, then in a
decreasing order of dose and finally in a random order. In all three
cases, the analyses of the scanned images yield to the same result.
In a single scan approach, all the samples are placed in an A3 format
area and scanned at once using the EPSON 10000 XL scanner.

Figure 1. Dose response of EBT3 Gafchromic film irradiated with 6 MV photon beam
and scanned in landscape and portrait configurations using an Epson 10000 XL Figure 3. Dose response curve for EBT3 Gafchromic film irradiated with 6 MV photons
scanner. The analyses are shown using separately the RGB and the Red channel and 6 MeV electrons, scanned in landscape orientation using an Epson 10000 XL
filtering. scanner and analyzed using RGB and red color filtering.
 N. Farah et al. / Physica Medica 30 (2014) 708e712
Figure 4. Superposition of red channel calibration curves for EBT3 Gafchromic film
irradiated with 6 MV photons and 6 MeV electrons, scanned in landscape orientation
in single and multiple scans procedure using an Epson 10000 XL scanner.
Results of multiple scan and single scan approaches are reported in
Fig. 4 for the red channel analysis. Differences between electron
and photon irradiations are less than 0.01%. Although these dis-
crepancies are insignificant, we recommend a single scan approach
for the whole measurements set, which allows for faster analysis
and avoids any potential doubts regarding the scan procedure as
discussed in Ref. [21] e.g. scan to scan differences, temperature
stability and other environmental issues.
Scanner type effect
In our study, two different scanners are used, the Epson 10000
XL which is commonly dedicated to this kind of analysis in the
medical field and a desktop flatbed HP scanner (Scanjet 4850). We
illustrate in Fig. 5 a comparison between both scanners. The dis-
played results are obtained for a landscape orientation and using a
red channel filtered analysis. Notwithstanding the significant var-
iations in sensitivity, both considered scanners exhibit good pre-
cision for Gafchromic film based dose measurements.
Although results show a higher sensitivity of the Epson scanner
reaching nearly 2 times the HP sensitivity for doses above 400 cGy,
one can use relatively old and cost saving scanners as long as a
suitable calibration is performed before use.
Conclusion
Based on our comparisons for the Gafchromic film dosimetry in
the range 0e500 cGy, and supported by the results from Ref. [11]
and those obtained by Ref. [12], this study suggests that the EBT3
film is suitable for reflective scanning analysis. Furthermore the
results showed no difference between landscape and portrait scan
orientation. In fact, the EBT3 properties should be investigated
more thoroughly in future studies in order to confirm the reliability
of the method described in this paper. Similarly to its predecessor
the EBT2, the EBT3 film reaches larger values of optical density for
the red channel, thus showing more sensitivity than with the RGB
spectrum analysis as revealed previously by Fig. 3. The differences
between photon and electron irradiation results can be neglected
showing that the EBT3 response is independent of the particle type
711
Figure 5. Dose response curve for EBT3 Gafchromic film irradiated with 6 MV photons
and 6 MeV electrons, scanned in landscape orientation using 2 different scanners the
EPSON 10000 XL and the HP Scanjet 4850. The analysis is done using a red channel
filtering.
in this case as previously confirmed by Ref. [10]. Although the
multiple and the single scan procedures did not show any signifi-
cant difference in the results, we recommend to proceed in a single
scan approach as long as the size and the number of the samples
still fit within the scanning area.
While comparing both scanners, the difference is relatively large
between the 2 scanners analysis. This may depend on many pa-
rameters, mainly related to the scanner state and its design.
Therefore it is impossible to compare results from different scan-
ners. Despite the observed significant variation of sensitivity, the
two scanners exhibit similar precision for Gafchromic film
measurements.
In conclusion, the EBT3 film is suitable for use as a dose control
method in the clinical field for different radiation types and
different doses. The analyses in reflective mode are reliable, and the
use of the red channel filtering leads to more ROD sensitivity
therefore to better dose measurement results. For a given system,
pertinent methods should be developed as part of the dosimetry
protocol during the calibration procedure.
Acknowledgments
Authors are grateful for the Research Council of the Saint Joseph
University for funding this project (Funding FS45), and would like
to thank the Department of Radiation-Oncology of the HDF for the
technical support.
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