The physics of imaging with metal/phosphor (Gd2O2S:Tb on brass) screens at megavoltage energies has been investigated using Monte Carlo simulation. It has been found that pair production is a significant contributor to energy deposition for Bremsstrahlung beams with energies greater than 6 MV. The effects of different thicknesses of phosphor and metal have been studied, and it is shown that the metal plays a significant role in establishing electronic equilibrium in the phosphor. The transport of optical photons through the phosphor has been modeled, and was found that only 10% to 20% of the light created in the phosphor escapes from the surface, with much of the loss being due to total internal reflection at the surface. Calculated results have been compared with experimental measurements of screen brightness for different phosphor and metal thicknesses. The SNR of a video electronic portal imaging device (VEPID) has been calculated as a function of x-ray and optical photon detection efficiency. The non-Poisson distribution of energy deposition in the phosphor is an important contributor to the SNR. The results of this paper should serve as a useful guide to the engineering design of future electronic portal imaging systems.

Studies were conducted to determine the optimal metal/phosphor screen for on-line video verification of radiation treatment portals. Screens were evaluated for luminance and spatial resolution as a function of composition and thickness at 6- and 23-MV x-ray energies. A new video technique was used to determine modulation transfer functions. Gd2O2S was found to be the most efficient (brightest) phosphor for this application. Luminance was found to vary linearly with phosphor thickness up to a thickness of 500 mg/cm2. Metal plates made of iron, brass, copper, lead, and sintered tungsten of various thicknesses were also tested for luminance and resolution with Gd2O2S phosphor. Brightness peaked at about 2-mm thickness for most metals. Significant contributions to the brightness were found to come from x rays interacting with the phosphor itself.

Video-based systems for on-line portal imaging utilize a metal plate coated with Gd2O2S phosphor at a typical thickness of 500 mg/cm2. A new screen design is proposed wherein the conventional flat phosphor coating is replaced by a much thicker phosphor layer (1000-2000 mg/cm2) penetrated by either lineal grooves or pyramidal holes comparable to the system pixel size. By increasing the surface area of the phosphor, the grooves or holes allow light from deep layers of the phosphor to escape by a process of internal reflection. In addition, the escaping light is strongly forward peaked, improving optical coupling to the video camera. The processes by which grooved screens intensify light output have been modeled in a simple computer program that gives approximate agreement with experiment. Prototype screens have been constructed that provide several times the forward light output of flat screens, and that improve DQE(f) in light photon limited systems for spatial frequencies below 0.4 mm-1.

Gd2O2S phosphor screens between 250 and 1000 mg/cm2 thick were evaluated for use in megavoltage imaging systems. The phosphor layers were placed on brass plates ranging from 1 to 5 mm thick, each with and without an optical back reflector (white paint). Light output and spatial resolution were measured at 6- and 23-MV x-ray energies. Light output was found to increase linearly with phosphor thickness up to 500 mg/cm2, reaching a plateau at 1000 mg/cm2. Spatial resolution [modulation transfer function (MTF)] decreased exponentially with phosphor thickness up to 750 mg/cm2, where a minimum was reached. The variation of MTF with phosphor thickness was found to obey a simple empirical relation.