Abstract
Imaging Cherenkov emission during radiation therapy cancer treatments can provide a real-time, non-contact sampling of the entire dose field. The emitted Cherenkov signal generated is proportional to deposited dose, however, it is affected by attenuation from the intrinsic tissue optical properties of the patient, which in breast, ranges from primarily adipose to fibroglandular tissue. Patients being treated with whole-breast X-ray radiotherapy (n = 13) were imaged for 108 total fractions, to establish correction factors from the linear relationships between Cherenkov light and CT number (HU). This study elucidates this relationship in vivo, and a correction factor approach is used to scale each image to improve the linear correlation between Cherenkov emission intensity and dose (R_{6X}^2 = 0.85,,R_{10X}^2 = 0.95). This study provides a major step towards direct quantitative radiation dose imaging in humans by utilizing non-contact camera sensing of Cherenkov emission during the radiation therapy treatment.
Highlights
Imaging Cherenkov emission during radiation therapy cancer treatments can provide a realtime, non-contact sampling of the entire dose field
Cherenkov imaging has enabled both the relative mapping of the radiotherapy beam shape as it is delivered in real time, and has illustrated that the time-integrated Cherenkov field outline matches the planned dose delivery[3]
This study presents a major step in a multi-part solution to the most limiting aspect of in vivo dosimetry
Summary
Imaging Cherenkov emission during radiation therapy cancer treatments can provide a realtime, non-contact sampling of the entire dose field. It is well known that various tissue types have specific blood volumes and optical scattering[8,9,10], it seems plausible that internal tissue characterization using X-ray CT attenuation values (HU, Hounsfield units) might be used as a way to calibrate for the heterogeneous optical transport of subsurface Cherenkov photons This relevant correction takes advantage of the ability to measure breast tissue densities across a spectrum of compositions from adipose to fibroglandular, readily separated by CT number[11,12,13], and that these two tissue types are known to have very different optical properties[10,14,15]. Therapeutic X-rays are the most common treatment modality for cancer, with over 50% of all patients receiving it, it is estimated that approximately 11 million women being treated for invasive breast cancer in the United States alone could benefit from to continued exploration of imaging in vivo dosimetry
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