For small fields of size 1.6 × 1.6 cm or less, it was clarified that the volume averaging and density perturbation were the dominant effects responsible for the variation in the RPLD response. Moreover, perturbation correction is required when measuring a field size 1.0 × 1.0 cm or less. Under the IMRT conditions, the difference in the responses of the RPLD between the reference conditions and the PTV region calculated by Monte Carlo simulation did not exceed 0.8%. These results indicate that it is feasible to measure IMRT dosage using an RPLD at the PTV region.