The proposed local NPS (r-square values) showed superior sensitivity to the noise level variations of individual subpanels compared with global quantitative metrics such as MTF, NPS, and DQE. Wavelet analysis was effective in detecting isolated defective pixels and inter-subpanel flat-fielding artifacts. The proposed methods are promising for the early detection of imaging artifacts of EPIDs.

Purpose: As EPIDs are increasingly used for IMRT QA and real‐time treatment verification, comprehensive quality assurance (QA) of EPIDs becomes critical. Current QA with phantoms such as the Las Vegas and PIPSpro™ can fail in the early detection of EPID artifacts. Beyond image quality assessment, we propose a quantitative methodology using local noise power spectrum (NPS) to characterize image noise and wavelet transform to identify bad pixels and inter‐subpanel flat‐fielding artifacts. Methods: A total of 93 image sets including bar‐pattern images and open exposure images were collected from four iViewGT a‐Si EPID systems over three years. Quantitative metrics such as modulation transform function (MTF), NPS and detective quantum efficiency (DQE) were computed for each image set. Local 2D NPS was calculated for each subpanel. A 1D NPS was obtained by radial averaging the 2D NPS and fitted to a power‐law function. R‐square and slope of the linear regression analysis were used for panel performance assessment. Haar wavelet transformation was employed to identify pixel defects and non‐uniform gain correction across subpanels. Results: Overall image quality was assessed with DQE based on empirically derived area under curve (AUC) thresholds. Using linear regression analysis of 1D NPS, panels with acceptable flat fielding were indicated by r‐square between 0.8 and 1, and slopes of −0.4 to −0.7. However, for panels requiring flat fielding recalibration, r‐square values less than 0.8 and slopes from +0.2 to −0.4 were observed. The wavelet transform successfully identified pixel defects and inter‐subpanel flat fielding artifacts. Standard QA with the Las Vegas and PIPSpro phantoms failed to detect these artifacts. Conclusion: The proposed QA methodology is promising for the early detection of imaging and dosimetric artifacts of EPIDs. Local NPS can accurately characterize the noise level within each subpanel, while the wavelet transforms can detect bad pixels and inter‐subpanel flat fielding artifacts.