Can Gafchromic EBT3 films effectively characterize small fields of 6 MV unflattened photon beams of Cyberknife system?

Shielded silicon diodes are commonly employed in commissioning of Cyberknife 6 MV photon beams. This study aims to measure output factors, off centered ratio (OCR), percentage depth dose (PDD) of 6 MV photons using shielded and unshielded diodes and to compare with Gafchromic EBT3 film measurements to investigate whether EBT3 could effectively characterize small 6 MV photon beams. Output factors, OCR and PDD were measured with shielded and unshielded silicon detectors in a radiation field analyzer system at reference condition. Water equivalent solid phantom were used while irradiating EBT3 films. From multiuser data, diodes underestimated output factor by 3% for collimator fields ≤ 10 mm, while EBT3 underestimated the output factor by 3.9% for 5 mm collimator. 1D Gamma analysis of OCR between diode and film, results in gamma ≤ 1 for all measured points with 1 mm distance to agreement (DTA) and 1% relative dose difference (DD). Dose at surface is overestimated with diodes compared to EBT3. PDD results were within 2% relative dose values between diode and EBT3 except for 5 mm collimator. Except for small collimator fields of up to 10 mm, results of output factor, OCR, PDD of all detectors used in this study exhibited similar results. Relative dose measurements with Gafchromic EBT3 in this work show that EBT3 films can be used effectively as an independent tool to verify commissioning beam data of small fields only after careful verification of methodology for any systematic errors with appropriate readout procedure.