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Experiments were conducted to characterize the prototype's imaging performance relative to a standard commercialEPID<\/jats:styled-content>and Monte Carlo (MC<\/jats:styled-content>) simulations were performed to quantify the impact of several detector parameters on image quality and to inform the design of a proposed next\u2010generation prototype.<\/jats:p><\/jats:sec>Methods<\/jats:title>The prototypeEPID<\/jats:styled-content>utilizes an array of 3 cm long plastic\u2010scintillating fibers in place of the metal plate\/phosphor screen in standardEPID<\/jats:styled-content>s. Using a clinical 6MV<\/jats:styled-content>photon beam, the prototype's modulation transfer function (MTF<\/jats:styled-content>), noise power spectrum (NPS<\/jats:styled-content>), and detective quantum efficiency (DQE<\/jats:styled-content>) were measured and compared to measurements taken using a standard commercialEPID<\/jats:styled-content>. A sensitivity analysis was then performed using theMC<\/jats:styled-content>model by quantifying these metrics while varying the values of several geometrical and optical transport parameters that were unspecified by the prototype manufacturer. Finally, theMC<\/jats:styled-content>model was used to quantify the imaging performance of a proposed next\u2010generation prototype incorporating 1.5 cm long fibers that is better suited for integration with clinical portal imaging and dosimetry systems.<\/jats:p><\/jats:sec>Results<\/jats:title>The prototypeEPID<\/jats:styled-content>'s zero spatial frequencyDQE<\/jats:styled-content>exceeded 3%, more than doubling that measured with the standardEPID<\/jats:styled-content>(1.25%). This increasedDQE<\/jats:styled-content>was a consequence of using a prototype array detector with a greater equivalent thickness than the combined copper plate and phosphor screen in a standardEPID<\/jats:styled-content>. The increased thickness of our prototype decreased spatial resolution relative to the standardEPID<\/jats:styled-content>; however, the prototypeEPID NPS<\/jats:styled-content>was also lower than that measured with the standardEPID<\/jats:styled-content>across all spatial frequencies. The sensitivity analysis demonstrated that theNPS<\/jats:styled-content>was strongly affected by the roughness of the boundaries between fiber core and cladding regions. By comparison, theMTF<\/jats:styled-content>was most sensitive to beam divergence and the presence of air between the fiber array and underlying photodiode panel. Simulations demonstrated that by optimizing these parameters,DQE<\/jats:styled-content>(0)><\/jats:italic>4% may be achievable with the proposed next\u2010generation prototype design.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>The first measurements characterizing the imaging performance of a novel water\u2010equivalentEPID<\/jats:styled-content>for imaging and dosimetry in radiotherapy demonstrated aDQE<\/jats:styled-content>(0) more than double that of a standardEPID<\/jats:styled-content>.MC<\/jats:styled-content>simulations further demonstrated the potential for developing a next\u2010generation prototype better suited for clinical translation with even higherDQE<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mp.12882","type":"journal-article","created":{"date-parts":[[2018,3,26]],"date-time":"2018-03-26T01:37:34Z","timestamp":1522028254000},"page":"2154-2168","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["A highDQE<\/scp>water\u2010equivalentEPID<\/scp>employing an array of plastic\u2010scintillating fibers for simultaneous imaging and dosimetry in radiotherapy"],"prefix":"10.1002","volume":"45","author":[{"given":"Samuel J.","family":"Blake","sequence":"first","affiliation":[{"name":"Institute of Medical Physics School of Physics University of Sydney Sydney NSW 2006 Australia"},{"name":"Ingham Institute for Applied Medical Research Sydney NSW 2170 Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhangkai","family":"Cheng","sequence":"additional","affiliation":[{"name":"Institute of Medical Physics School of Physics 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