The FLASH effect holds significant potential in improving radiotherapy treatment outcomes. Very high energy electrons (VHEEs) with energies in the range of 50-250 MeV can effectively target tumors deep in the body and can be accelerated to achieve ultra-high dose rates (UHDR), making them a promising modality for delivering FLASH radiotherapy in the clinic. However, apart from suitable VHEE sources, clinical translation requires accurate dosimetry, which is challenging due to the limitation of standard dosimeters under UHDR conditions. Water-equivalent and real-time plastic scintillation dosimeters (PSDs) may offer a viable solution. 
Purpose & Methods: In this study, a 4-channel PSD, consisting of polystyrene-based BCF12 and Medscint proprietary scintillators, polyvinyltoluene (PVT)-based EJ-212 and a blank plastic fiber channel for Cherenkov subtraction was exposed to the 200 MeV VHEE UHDR beam at the CLEAR CERN facility. The Hyperscint RP200 platform was used to assess linearity to dose pulses of up to 90 Gy and dose rates up to 4.6×109Gy/s, and to investigate radiation damage and recovery after dose accumulation of 37.2 kGy. 
Results: While blank fiber response was linear across the entire dose range studied, light output saturated above 45 Gy/pulse for scintillators. Despite radiation damage, linearity was preserved, though it resulted in a decrease of scintillator and blank fiber light output of <1.87 %/kGy and a shift in spectra towards longer wavelengths. Short-term recovery (<100h) of these changes was observed and depended on rest duration and accumulated dose. After long-term rest (<172 days), light output recovery was partial, with 6-22% of residual permanent damage remaining, while spectral recovery was complete. 
Conclusions: We showed that PSDs are sensitive to radiation damage, but maintain dose linearity even after a total accumulated dose of 37.2 kGy, and exhibit significant response recovery. This work highlights the potential of PSDs for dosimetry in UHDR conditions.
Read full abstract