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Wahabi JM, Ung NM, Mahdiraji GA, Wong JHD. Development and characterisation of a plastic scintillator dosemeter in high-energy photon beams. RADIATION PROTECTION DOSIMETRY 2024; 200:264-273. [PMID: 38123475 DOI: 10.1093/rpd/ncad303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 10/22/2023] [Accepted: 11/15/2023] [Indexed: 12/23/2023]
Abstract
The radioluminescent (RL) dosemeter is excellent for real-time radiation measurement and can be used in various applications. A plastic scintillator is often the choice sensor because of its size and tissue equivalency. This study aims to characterise a novel plastic scintillator irradiated with high-energy photon beams. An RL dosimetry system was developed using the plastic scintillator. The RL dosimetry system was irradiated using a linear accelerator to characterise the dose linearity, dose rate, energy dependency and depth dose. The developed system showed a linear response toward the dose and dose rate. An energy dependency factor of 1.06 was observed. Depth dose measurement showed a mean deviation of 1.21% from the treatment planning system. The response and characteristics of the plastic scintillator show that it may be used as an alternative in an RL dosimetry system.
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Affiliation(s)
- Janatul M Wahabi
- Department of Biomedical Imaging, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia
- Ministry of Health Malaysia, Putrajaya 62590, Malaysia
| | - N M Ung
- Clinical Oncology Unit, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia
| | | | - Jeannie H D Wong
- Department of Biomedical Imaging, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia
- Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW 2522, Australia
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2
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Lucido JJ, Penoncello GP, Laughlin BS, Armstrong MD, Lo SG, Rivera JN, Tang X, Chungbin SJ, Breen WG, Mangold AR, Comfere NI, Lester SC, Rule WG, Deufel CL, Foster MG. Development and Dosimetric Characterization of a Customizable Shield for Subtotal Skin Electron Beam Therapy. Adv Radiat Oncol 2023; 8:101289. [PMID: 37457824 PMCID: PMC10344686 DOI: 10.1016/j.adro.2023.101289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 06/08/2023] [Indexed: 07/18/2023] Open
Abstract
Purpose Purpose: Subtotal skin electron beam therapy may be an option for patients with cutaneous lymphoma receiving radiation therapy to treat large areas of their skin but may benefit from sparing specific areas that may have had previous radiation therapy, are of specific cosmetic concern, and/or show no evidence of disease. We report here on the design, implementation, and dosimetric characteristics of a reusable and transparent customizable shield for use with the large fields used to deliver total skin electron beam therapy at extended distance with a conventional linear accelerator. Methods and Materials A shield was designed and manufactured consisting of acrylic blocks that can be mounted on a steel frame to allow patient-specific shielding. The dosimetry of the device was measured using radiochromic film. Results The shield is easy to use and well-tolerated for patient treatment, providing minimal electron transmission through the shield with a sharp penumbra at the field edge, with no increase in x-ray dose. We report on the dosimetry of a commercial device that has been used to treat more than 30 patients to date. Conclusions The customizable shield is well suited to providing patient-specific shielding for subtotal skin electron beam therapy.
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Affiliation(s)
- J. John Lucido
- Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota
| | | | | | | | - Stephanie G. Lo
- Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota
| | - Judith N. Rivera
- Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota
| | - Xueyan Tang
- Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota
| | | | - William G. Breen
- Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota
| | | | | | - Scott C. Lester
- Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota
| | - William G. Rule
- Department of Radiation Oncology, Mayo Clinic, Phoenix, Arizona
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Total Skin Treatment with Helical Arc Radiotherapy. Int J Mol Sci 2023; 24:ijms24054492. [PMID: 36901922 PMCID: PMC10002962 DOI: 10.3390/ijms24054492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 02/19/2023] [Accepted: 02/20/2023] [Indexed: 03/02/2023] Open
Abstract
For widespread cutaneous lymphoma, such as mycosis fungoides or leukemia cutis, in patients with acute myeloid leukemia (AML) and for chronic myeloproliferative diseases, total skin irradiation is an efficient treatment modality for disease control. Total skin irradiation aims to homogeneously irradiate the skin of the entire body. However, the natural geometric shape and skin folding of the human body pose challenges to treatment. This article introduces treatment techniques and the evolution of total skin irradiation. Articles on total skin irradiation by helical tomotherapy and the advantages of total skin irradiation by helical tomotherapy are reviewed. Differences among each treatment technique and treatment advantages are compared. Adverse treatment effects and clinical care during irradiation and possible dose regimens are mentioned for future prospects of total skin irradiation.
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Di X, Geng C, Guo C, Shang Y, Fu H, Han H, Tang X. Enhanced Cherenkov imaging for real-time beam visualization by applying a novel carbon quantum dot sheeting in radiotherapy. Med Phys 2023; 50:1215-1227. [PMID: 36433734 DOI: 10.1002/mp.16121] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 11/10/2022] [Accepted: 11/10/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Cherenkov imaging can be used to visualize the placement of the beam directly on the patient's surface tissue and evaluate the accuracy of treatment planning. However, Cherenkov emission intensity is lower than ambient light. At present, time gating is the only way to realize Cherenkov imaging with ambient light. PURPOSE This study proposes preparing a novel carbon quantum dot (cQD) sheeting to adjust the wavelength of Cherenkov emission to obtain the optimal wavelength meeting the sensitive detection region of the camera, meanwhile the total optical signal is also increased. By combining a specific filter, this approach might help in using lower-cost camera systems without intensifier-coupled to accomplish in vivo monitoring of the surface beam profile on patients with ambient light. METHODS The cQD sheetings were prepared by spin coating and UV curing with different concentrations. All experiments were performed on the Varian VitalBeam system and optical emission was captured using an electron multiplying charge-coupled device (EMCCD) camera. To quantify the optical characteristics and certify the improvement of light intensity as well as signal-to-noise ratio (SNR) of cQD sheeting, the first part of the study was carried out on solid water with 6 and 10 MV photon beams. The second part was carried out on an anthropomorphic phantom to explore the applicability of sheeting when using different radiotherapy materials and the imaging effect of sheeting with the impact of ambient light sources. Additionally, thanks to the narrow emission spectrum of the cQD, a band-pass filter was tested to reduce the effect from environmental lights. RESULTS The experimental results show that the optical intensity collected with sheeting has an excellent linear relationship (R2 > 0.99) with the dose for 6 and 10 MV photons. The full-width half maximum (FWHM) in x and y axis matched with the measured EBT film image, with accuracy in the range of ±1.2 and ±2.7 mm standard deviation, respectively. CQD sheeting can significantly improve the light intensity and SNR of optical images. Using 0.1 mg/ml sheeting as an example, the signal intensity is increased by 209%, and the SNR is increased by 147.71% at 6 MV photons. The imaging on the anthropomorphic phantom verified that cQD sheeting could be applied to different radiotherapy materials. The average optical intensity increased by about 69.25%, 63.72%, and 61.78%, respectively, after adding cQD sheeting to bolus, mask sample and the combination of bolus and mask. Corresponding SNR is improved by about 62.78%, 56.77%, and 68.80%, respectively. Through the sheeting, optical images with SNR > 5 can be obtained in the presence of ambient light and it can be improved through combining with a band-pass filter. When red ambient lights are on, the SNR is increased by about 98.85% after adding a specific filter. CONCLUSION Through a combination of cQD sheeting and corresponding filter, light intensity and SNR of optical images can be increased significantly, and it shed new light on the promotion of the clinical application of optical imaging to visualize the beam in radiotherapy.
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Affiliation(s)
- Xing Di
- Department of Nuclear Science and Technology, Nanjing University of Aeronautics and Astronautics, Nanjing, People's Republic of China
| | - Changran Geng
- Department of Nuclear Science and Technology, Nanjing University of Aeronautics and Astronautics, Nanjing, People's Republic of China.,Joint International Research Laboratory on Advanced Particle Therapy, Nanjing University of Aeronautics and Astronautics, Nanjing, People's Republic of China
| | - Chang Guo
- Department of Radiation Oncology, Jiangsu Cancer Hospital, Nanjing, People's Republic of China
| | - Yufen Shang
- Department of Radiation Physics, Dezhou Second People's Hospital, Dezhou, People's Republic of China
| | - Hongtao Fu
- Department of Radiation Physics, Dezhou Second People's Hospital, Dezhou, People's Republic of China
| | - Haonan Han
- Department of Nuclear Science and Technology, Nanjing University of Aeronautics and Astronautics, Nanjing, People's Republic of China
| | - Xiaobin Tang
- Department of Nuclear Science and Technology, Nanjing University of Aeronautics and Astronautics, Nanjing, People's Republic of China.,Joint International Research Laboratory on Advanced Particle Therapy, Nanjing University of Aeronautics and Astronautics, Nanjing, People's Republic of China
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Alexander DA, Certa O, Haertter A, Li T, Taunk N, Zhu TC. Comparison of surface dose during whole breast radiation therapy on Halcyon and TrueBeam using Cherenkov imaging. PROCEEDINGS OF SPIE--THE INTERNATIONAL SOCIETY FOR OPTICAL ENGINEERING 2023; 12371:1237108. [PMID: 37101538 PMCID: PMC10128868 DOI: 10.1117/12.2652588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
The emergence of the Halcyon linear accelerator has allowed for increased patient throughput and improved treatment times for common treatment sites in radiation oncology. However, it has been shown that this can lead to increased surface dose in sites like breast cancer compared with treatments on conventional machines with flattened radiation beams. Cherenkov imaging can be used to estimate surface dose by detection of Cherenkov photons emitted in proportion to energy deposition from high energy electrons in tissue. Phantom studies were performed with both square beams in reference conditions and with clinical treatments, and dosimeter readings and Cherenkov images report higher surface dose (25% for flat phantom entrance dose, 5.9% for breast phantom treatment) from Halcyon beam deliveries than for equivalent deliveries from a TrueBeam linac. Additionally, the first Cherenkov images of a patient treated with Halcyon were acquired, and superficial dose was estimated.
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Affiliation(s)
- Daniel A. Alexander
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA 19104
| | - Olivia Certa
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA 19104
| | - Allison Haertter
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA 19104
| | - Taoran Li
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA 19104
| | - Neil Taunk
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA 19104
| | - Timothy C. Zhu
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA 19104
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Miao T, Zhang R, Jermyn M, Bruza P, Zhu T, Pogue BW, Gladstone DJ, Williams BB. Computational dose visualization & comparison in total skin electron treatment suggests superior coverage by the rotational versus the Stanford technique. J Med Imaging Radiat Sci 2022; 53:612-622. [PMID: 36045017 PMCID: PMC10152509 DOI: 10.1016/j.jmir.2022.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 07/16/2022] [Accepted: 08/11/2022] [Indexed: 12/24/2022]
Abstract
INTRODUCTION/BACKGROUND The goal of Total Skin Electron Therapy (TSET) is to achieve a uniform surface dose, although assessment of this is never really done and typically limited points are sampled. A computational treatment simulation approach was developed to estimate dose distributions over the body surface, to compare uniformity of (i) the 6 pose Stanford technique and (ii) the rotational technique. METHODS The relative angular dose distributions from electron beam irradiation was calculated by Monte Carlo simulation for cylinders with a range of diameters, approximating body part curvatures. These were used to project dose onto a 3D body model of the TSET patient's skin surfaces. Computer animation methods were used to accumulate the dose values, for display and analysis of the homogeneity of coverage. RESULTS The rotational technique provided more uniform coverage than the Stanford technique. Anomalies of under dose were observed in lateral abdominal regions, above the shoulders and in the perineum. The Stanford technique had larger areas of low dose laterally. In the rotational technique, 90% of the patient's skin was within ±10% of the prescribed dose, while this percentage decreased to 60% or 85% for the Stanford technique, varying with patient body mass. Interestingly, the highest discrepancy was most apparent in high body mass patients, which can be attributed to the loss of tangent dose at low angles of curvature. DISCUSSION/CONCLUSION This simulation and visualization approach is a practical means to analyze TSET dose, requiring only optical surface body topography scans. Under- and over-exposed body regions can be found, and irradiation could be customized to each patient. Dose Area Histogram (DAH) distribution analysis showed the rotational technique to have better uniformity, with most areas within 10% of the umbilicus value. Future use of this approach to analyze dose coverage is possible as a routine planning tool.
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Affiliation(s)
- Tianshun Miao
- Thayer School of Engineering, Dartmouth College, Hanover NH, 03755, USA
| | - Rongxiao Zhang
- Thayer School of Engineering, Dartmouth College, Hanover NH, 03755, USA; Department of Medicine, Radiation Oncology, Norris Cotton Cancer Center, Dartmouth Hitchcock Medical Center, Lebanon, NH 03766, USA
| | - Michael Jermyn
- Thayer School of Engineering, Dartmouth College, Hanover NH, 03755, USA; DoseOptics, LLC, Lebanon NH 03755 USA
| | - Petr Bruza
- Thayer School of Engineering, Dartmouth College, Hanover NH, 03755, USA; DoseOptics, LLC, Lebanon NH 03755 USA
| | - Timothy Zhu
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia PA, 19104 USA
| | - Brian W Pogue
- Thayer School of Engineering, Dartmouth College, Hanover NH, 03755, USA; DoseOptics, LLC, Lebanon NH 03755 USA; Department of Medical Physics, University of Wisconsin-Madison, Wisconsin WI 53705 USA.
| | - David J Gladstone
- Thayer School of Engineering, Dartmouth College, Hanover NH, 03755, USA; Department of Medicine, Radiation Oncology, Norris Cotton Cancer Center, Dartmouth Hitchcock Medical Center, Lebanon, NH 03766, USA
| | - Benjamin B Williams
- Thayer School of Engineering, Dartmouth College, Hanover NH, 03755, USA; Department of Medicine, Radiation Oncology, Norris Cotton Cancer Center, Dartmouth Hitchcock Medical Center, Lebanon, NH 03766, USA
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7
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Bianfei S, Fang L, Zhongzheng X, Yuanyuan Z, Tian Y, Tao H, Jiachun M, Xiran W, Siting Y, Lei L. Application of Cherenkov radiation in tumor imaging and treatment. Future Oncol 2022; 18:3101-3118. [PMID: 36065976 DOI: 10.2217/fon-2022-0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Cherenkov radiation (CR) is the characteristic blue glow that is generated during radiotherapy or radioisotope decay. Its distribution and intensity naturally reflect the actual dose and field of radiotherapy and the location of radioisotope imaging agents in vivo. Therefore, CR can represent a potential in situ light source for radiotherapy monitoring and radioisotope-based tumor imaging. When used in combination with new imaging techniques, molecular probes or nanomedicine, CR imaging exhibits unique advantages (accuracy, low cost, convenience and fast) in tumor radiotherapy monitoring and imaging. Furthermore, photosensitive nanomaterials can be used for CR photodynamic therapy, providing new approaches for integrating tumor imaging and treatment. Here the authors review the latest developments in the use of CR in tumor research and discuss current challenges and new directions for future studies.
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Affiliation(s)
- Shao Bianfei
- Department of Head and Neck Oncology, West China Hospital, Sichuan University, Chengdu, China
| | - Liu Fang
- Department of Head and Neck Oncology, West China Hospital, Sichuan University, Chengdu, China.,Department of Radiation Oncology, Henan Cancer Hospital, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Xiang Zhongzheng
- Department of Head and Neck Oncology, West China Hospital, Sichuan University, Chengdu, China
| | - Zeng Yuanyuan
- Department of Head and Neck Oncology, West China Hospital, Sichuan University, Chengdu, China
| | - Yang Tian
- Department of Head and Neck Oncology, West China Hospital, Sichuan University, Chengdu, China
| | - He Tao
- Department of Head and Neck Oncology, West China Hospital, Sichuan University, Chengdu, China
| | - Ma Jiachun
- Department of Head and Neck Oncology, West China Hospital, Sichuan University, Chengdu, China
| | - Wang Xiran
- Department of Head and Neck Oncology, West China Hospital, Sichuan University, Chengdu, China
| | - Yu Siting
- Department of Head and Neck Oncology, West China Hospital, Sichuan University, Chengdu, China
| | - Liu Lei
- Department of Head and Neck Oncology, West China Hospital, Sichuan University, Chengdu, China
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8
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Zhong W, Ong Y, Miao T, Pogue BW, Zhu TC. Monte Carlo simulation of Cherenkov imaging for Total Skin Electron Treatment with CT DICOM realistic patient geometry. PROCEEDINGS OF SPIE--THE INTERNATIONAL SOCIETY FOR OPTICAL ENGINEERING 2022; 11940:1194009. [PMID: 35506008 PMCID: PMC9060570 DOI: 10.1117/12.2609027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
This Monte Carlo (MC) simulation study provides an evaluation of dose uniformity in a patient and the difference between dose and Cherenkov distributions, which is invaluable in developing conversion factors to relate observed Cherenkov images to actual dose distributions for TSET patients. This MC simulations with TOPAS is performed using realistic patient geometries obtained with a 3D scanner during total skin electron treatments (TSET) at UPenn. For each treatment posture in the Stanford technique, the differences between Cherenkov photon distributions and dose distributions produced in MC are consistent with the differences observed between a Cherenkov imaging camera and in-vivo dose measurement with OSLD on patient skin. According to MC studies of a flat rectangular PVC board, the difference between Cherenkov and dose is mostly due to the spoiler. This is confirmed by observing consistent dose and Cherenkov distributions in clinical measurements on a PVC board without the spoiler. The accumulated dose and Cherenkov distributions for each patient are obtained by projecting the MC output of the 6 postures of the TSET treatment together onto a finite element model of the patient.
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Affiliation(s)
- Weili Zhong
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA, PA 19104
| | - Yihong Ong
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA, PA 19104
| | - Tianshu Miao
- Yale School of Medicine, Yale University, New Haven, CT USA, 06520
| | - Brian W. Pogue
- Thayer School of Engineering, Dartmouth College, Hanover, NH USA, 03755
| | - Timothy C. Zhu
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA, PA 19104
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Rahman M, Bruza P, Hachadorian R, Alexander D, Cao X, Zhang R, Gladstone DJ, Pogue BW. Optimization of in vivo Cherenkov imaging dosimetry via spectral choices for ambient background lights and filtering. JOURNAL OF BIOMEDICAL OPTICS 2021; 26:JBO-210195RR. [PMID: 34643072 PMCID: PMC8510878 DOI: 10.1117/1.jbo.26.10.106003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 09/23/2021] [Indexed: 06/13/2023]
Abstract
SIGNIFICANCE The Cherenkov emission spectrum overlaps with that of ambient room light sources. Choice of room lighting devices dramatically affects the efficient detection of Cherenkov emission during patient treatment. AIM To determine optimal room light sources allowing Cherenkov emission imaging in normally lit radiotherapy treatment delivery rooms. APPROACH A variety of commercial light sources and long-pass (LP) filters were surveyed for spectral band separation from the red to near-infrared Cherenkov light emitted by tissue. Their effects on signal-to-noise ratio (SNR), Cherenkov to background signal ratio, and image artifacts were quantified by imaging irradiated tissue equivalent phantoms with an intensified time-gated CMOS camera. RESULTS Because Cherenkov emission from tissue lies largely in the near-infrared spectrum, a controlled choice of ambient light that avoids this spectral band is ideal, along with a camera that is maximally sensitive to it. An RGB LED light source produced the best SNR out of all sources that mimic room light temperature. A 675-nm LP filter on the camera input further reduced ambient light detected (optical density > 3), achieving maximal SNR for Cherenkov emission near 40. Reduction of the room light signal reduced artifacts from specular reflection on the tissue surface and also minimized spurious Cherenkov signals from non-tissue features such as bolus. CONCLUSIONS LP filtering during image acquisition for near-infrared light in tandem with narrow band LED illuminated rooms improves image quality, trading off the loss of red wavelengths for better removal of room light in the image. This spectral filtering is also critically important to remove specular reflection in the images and allow for imaging of Cherenkov emission through clear bolus. Beyond time-gated external beam therapy systems, the spectral separation methods can be utilized for background removal for continuous treatment delivery methods including proton pencil beam scanning systems and brachytherapy.
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Affiliation(s)
- Mahbubur Rahman
- Dartmouth College, Thayer School of Engineering, Hanover, New Hampshire, United States
| | - Petr Bruza
- Dartmouth College, Thayer School of Engineering, Hanover, New Hampshire, United States
| | - Rachael Hachadorian
- Dartmouth College, Thayer School of Engineering, Hanover, New Hampshire, United States
| | - Daniel Alexander
- Dartmouth College, Thayer School of Engineering, Hanover, New Hampshire, United States
| | - Xu Cao
- Dartmouth College, Thayer School of Engineering, Hanover, New Hampshire, United States
| | - Rongxiao Zhang
- Dartmouth College, Thayer School of Engineering, Hanover, New Hampshire, United States
- Dartmouth College, Geisel School of Medicine, Department of Radiation Oncology, Hanover, New Hampshire, United States
- Dartmouth-Hitchcock Medical Center, Norris Cotton Cancer Center, Lebanon, New Hampshire, United States
| | - David J. Gladstone
- Dartmouth College, Thayer School of Engineering, Hanover, New Hampshire, United States
- Dartmouth College, Geisel School of Medicine, Department of Radiation Oncology, Hanover, New Hampshire, United States
- Dartmouth-Hitchcock Medical Center, Norris Cotton Cancer Center, Lebanon, New Hampshire, United States
| | - Brian W. Pogue
- Dartmouth College, Thayer School of Engineering, Hanover, New Hampshire, United States
- Dartmouth-Hitchcock Medical Center, Norris Cotton Cancer Center, Lebanon, New Hampshire, United States
- Dartmouth College, Geisel School of Medicine, Department of Surgery, Hanover, New Hampshire, United States
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10
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Cloutier E, Archambault L, Beaulieu L. Deformable scintillation dosimeter I: challenges and implementation using computer vision techniques. Phys Med Biol 2021; 66. [PMID: 34380116 DOI: 10.1088/1361-6560/ac1ca1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 08/11/2021] [Indexed: 01/18/2023]
Abstract
Plastic scintillation detectors are increasingly used to measure dose distributions in the context of radiotherapy treatments. Their water-equivalence, real-time response and high spatial resolution distinguish them from traditional detectors, especially in complex irradiation geometries. Their range of applications could be further extended by embedding scintillators in a deformable matrix mimicking anatomical changes. In this work, we characterized signal variations arising from the translation and rotation of scintillating fibers with respect to a camera. Corrections are proposed using stereo vision techniques and two sCMOS complementing a CCD camera. The study was extended to the case of a prototype real-time deformable dosimeter comprising an array of 19 scintillating fibers. The signal to angle relationship follows a gaussian distribution (FWHM = 52°) whereas the intensity variation from radial displacement follows the inverse square law. Tracking the position and angle of the fibers enabled the correction of these spatial dependencies. The detecting system provides an accuracy and precision of respectively 0.08 mm and 0.3 mm on the position detection. This resulted in an uncertainty of 2° on the angle measurement. Displacing the dosimeter by ±3 cm in depth resulted in relative intensities of 100 ± 10% (mean ± standard deviation) to the reference position. Applying corrections reduced the variations thus resulting in relative intensities of 100 ± 1%. Similarly, for lateral displacements of ±3 cm, intensities went from 98 ± 3% to 100 ± 1% after the correction. Therefore, accurate correction of the signal collected by a camera imaging the output of scintillating elements in a 3D volume is possible. This work paves the way to the development of real-time scintillator-based deformable dosimeters.
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Affiliation(s)
- E Cloutier
- Service de physique médicale et Axe Oncologie du Centre de recherche, CHU de Québec-Université Laval, Canada.,Département de physique, de génie physique et d'optique, et Centre de recherche sur le cancer, Université Laval, Québec, Canada
| | - L Archambault
- Service de physique médicale et Axe Oncologie du Centre de recherche, CHU de Québec-Université Laval, Canada.,Département de physique, de génie physique et d'optique, et Centre de recherche sur le cancer, Université Laval, Québec, Canada
| | - L Beaulieu
- Service de physique médicale et Axe Oncologie du Centre de recherche, CHU de Québec-Université Laval, Canada.,Département de physique, de génie physique et d'optique, et Centre de recherche sur le cancer, Université Laval, Québec, Canada
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11
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Mc Larney B, Skubal M, Grimm J. A review of recent and emerging approaches for the clinical application of Cerenkov luminescence imaging. FRONTIERS IN PHYSICS 2021; 9:684196. [PMID: 36845872 PMCID: PMC9957555 DOI: 10.3389/fphy.2021.684196] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Cerenkov luminescence (CL) is a blue-weighted emission of light produced by a vast array of clinically approved radioisotopes and LINAC accelerators. When β particles (emitted during the decay of radioisotopes) are present in a medium such as water or tissue, they are able to travel faster than the speed of light in that medium and in doing so polarize the molecules around them. Once the particle has left the local area, the polarized molecules relax and return to their baseline state releasing the additional energy as light (luminescence). This blue glow has commonly been used to determine the output of nuclear power plant cores and, in recent years, has found traction in the preclinical and clinical imaging field. This brief review will discuss the technology which has enabled the emergence of the biomedical Cerenkov imaging field, recent pre-clinical studies with potential clinical translation of Cerenkov luminescence imaging (CLI) and the current clinical implementations of the method. Finally, an outlook is given as to the direction in which the field is heading.
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Affiliation(s)
- Benedict Mc Larney
- Molecular Pharmacology Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Magdalena Skubal
- Molecular Pharmacology Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jan Grimm
- Molecular Pharmacology Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Pharmacology, Weill Cornell Medical College, New York, NY, USA
- Department of Radiology, Weill Cornell Medical College, New York, NY, USA
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12
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Jarvis LA, Hachadorian RL, Jermyn M, Bruza P, Alexander DA, Tendler II, Williams BB, Gladstone DJ, Schaner PE, Zaki BI, Pogue BW. Initial Clinical Experience of Cherenkov Imaging in External Beam Radiation Therapy Identifies Opportunities to Improve Treatment Delivery. Int J Radiat Oncol Biol Phys 2021; 109:1627-1637. [PMID: 33227443 PMCID: PMC10544920 DOI: 10.1016/j.ijrobp.2020.11.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 10/05/2020] [Accepted: 11/05/2020] [Indexed: 12/18/2022]
Abstract
PURPOSE The value of Cherenkov imaging as an on-patient, real-time, treatment delivery verification system was examined in a 64-patient cohort during routine radiation treatments in a single-center study. METHODS AND MATERIALS Cherenkov cameras were mounted in treatment rooms and used to image patients during their standard radiation therapy regimen for various sites, predominantly for whole breast and total skin electron therapy. For most patients, multiple fractions were imaged, with some involving bolus or scintillators on the skin. Measures of repeatability were calculated with a mean distance to conformity (MDC) for breast irradiation images. RESULTS In breast treatments, Cherenkov images identified fractions when treatment delivery resulted in dose on the contralateral breast, the arm, or the chin and found nonideal bolus positioning. In sarcoma treatments, safe positioning of the contralateral leg was monitored. For all 199 imaged breast treatment fields, the interfraction MDC was within 7 mm compared with the first day of treatment (with only 7.5% of treatments exceeding 3 mm), and all but 1 fell within 7 mm relative to the treatment plan. The value of imaging dose through clear bolus or quantifying surface dose with scintillator dots was examined. Cherenkov imaging also was able to assess field match lines in cerebral-spinal and breast irradiation with nodes. Treatment imaging of other anatomic sites confirmed the value of surface dose imaging more broadly. CONCLUSIONS Daily radiation therapy can be imaged routinely via Cherenkov emissions. Both the real-time images and the posttreatment, cumulative images provide surrogate maps of surface dose delivery that can be used for incident discovery and/or continuous improvement in many delivery techniques. In this initial 64-patient cohort, we discovered 6 minor incidents using Cherenkov imaging; these otherwise would have gone undetected. In addition, imaging provides automated, quantitative metrics useful for determining the quality of radiation therapy delivery.
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Affiliation(s)
- Lesley A Jarvis
- Department of Medicine, Section of Radiation Oncology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire.
| | | | - Michael Jermyn
- Thayer School of Engineering at Dartmouth, Hanover, New Hampshire
| | - Petr Bruza
- Thayer School of Engineering at Dartmouth, Hanover, New Hampshire
| | | | - Irwin I Tendler
- Thayer School of Engineering at Dartmouth, Hanover, New Hampshire
| | - Benjamin B Williams
- Department of Medicine, Section of Radiation Oncology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire; Thayer School of Engineering at Dartmouth, Hanover, New Hampshire
| | - David J Gladstone
- Department of Medicine, Section of Radiation Oncology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire; Thayer School of Engineering at Dartmouth, Hanover, New Hampshire
| | - Philip E Schaner
- Department of Medicine, Section of Radiation Oncology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
| | - Bassem I Zaki
- Department of Medicine, Section of Radiation Oncology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
| | - Brian W Pogue
- Thayer School of Engineering at Dartmouth, Hanover, New Hampshire
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13
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Zhong W, Ong YH, Zhu T. Monte Carlo (MC) study of dose distribution and Cherenkov imaging in total skin electron therapy (TSET) with TOPAS. PROCEEDINGS OF SPIE--THE INTERNATIONAL SOCIETY FOR OPTICAL ENGINEERING 2021; 11628. [PMID: 34083861 DOI: 10.1117/12.2583397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Malignant tissues can be effectively treated by Total Skin Electron Therapy (TSET) over the entire body surface using 6 MeV electron beams. During the radiation treatment, Cherenkov photons are emitted from the patient's skin, and can potentially be used for in-vivo imaging of the radiation dose distribution. A Monte Carlo (MC) simulation toolkit TOPAS is used to study the generation and propagation of Cherenkov photons that are generated from the interaction of electron radiation with human tissues, and to understand the relationship between the dose distributions and the Cherenkov photon distributions. Validation of MC simulations with experiments are performed at 100 SSD and 500 SSD, and simulations of a patient phantom in realistic clinical treatment setups have been done. These simulations with TOPAS show that the emitted Cherenkov distributions at phantom surfaces closely follow their corresponding dose distributions.
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Affiliation(s)
- Weili Zhong
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA USA, 19050
| | - Yi Hong Ong
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA USA, 19050
| | - Timothy Zhu
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA USA, 19050
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14
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Ding GX, Osmundson EC, Shinohara E, Newman NB, Price M, Kirschner AN. Monte Carlo study on dose distributions from total skin electron irradiation therapy (TSET). Phys Med Biol 2021; 66. [PMID: 33706289 DOI: 10.1088/1361-6560/abedd7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 03/11/2021] [Indexed: 11/11/2022]
Abstract
Total skin electron therapy (TSET) has been used to treat mycosis fungoides since the 1950s. Practitioners of TSET rely on relatively crude, phantom-based point measurements for commissioning and treatment plan dosimetry. Using Monte Carlo simulation techniques, this study presents whole-body dosimetry for a patient receiving rotational, dual-field TSET. The Monte Carlo codes, BEAMnrc/DOSXYZnrc, were used to simulate 6 MeV electron beams to calculate skin dose from TSET. Simulations were validated with experimental measurements. The rotational dual-field technique uses extended source-to-surface distance with an acrylic beam degrader between the patient and incident beams. Simulations incorporated patient positioning: standing on a platform that rotates during radiation delivery. Resultant patient doses were analyzed as a function of skin depth-dose coverage and evaluated using dose-volume-histograms (DVH). Good agreement was obtained between simulations and measurements. For a cylinder with a 30 cm diameter, the depths that dose fell to 50% of the surface dose was 0.66 cm, 1.15 cm and 1.42 cm for thicknesses of 9 mm, 3 mm and without an acrylic scatter plate, respectively. The results are insensitive to cylinder diameter. Relatively uniform skin surface dose was obtained for skin in the torso area although large dose variations (>25%) were found in other areas resulting from partial beam shielding of the extremities. To achieve 95% mean dose to the first 5 mm of skin depth, the mean dose to skin depth of 5-10 mm and depth of 10-15 mm from the skin surface was 74% (57%) and 50% (25%) of the prescribed dose when using a 3mm (9 mm) thickness scatter plate, respectively. As a result of this investigation on patient skin dose distributions we changed our patient treatments to use a 3 mm instead of a 9 mm thickness Acrylic scatter plate for clinically preferred skin depth dose coverage.
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Affiliation(s)
- George X Ding
- Department of Radiation Oncology , Vanderbilt University School of Medicine, Nashville, Tennessee, UNITED STATES
| | - Evan C Osmundson
- Department of Radiation Oncology , Vanderbilt University School of Medicine, Nashville, Tennessee, UNITED STATES
| | - Eric Shinohara
- Department of Radiation Oncology , Vanderbilt University School of Medicine, Nashville, Tennessee, UNITED STATES
| | - Neil B Newman
- Department of Radiation Oncology , Vanderbilt University School of Medicine, Nashville, Tennessee, UNITED STATES
| | - Michael Price
- Department of Radiation Oncology , Vanderbilt University School of Medicine, Nashville, Tennessee, UNITED STATES
| | - Austin N Kirschner
- Department of Radiation Oncology , Vanderbilt University School of Medicine, Nashville, Tennessee, UNITED STATES
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15
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Zhu TC, Ong Y, Sun H, Zhong W, Miao T, Dimofte A, Bruza P, Maity A, Plastaras JP, Paydar I, Dong L, Pogue BW. Cherenkov imaging for Total Skin Electron Therapy - an evaluation of dose uniformity. PROCEEDINGS OF SPIE--THE INTERNATIONAL SOCIETY FOR OPTICAL ENGINEERING 2021; 11628:116280R. [PMID: 34083857 PMCID: PMC8171222 DOI: 10.1117/12.2583939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Total Skin Electron Therapy (TSET) utilizes high-energy electrons to treat cancers on the entire body surface. The otherwise invisible radiation beam can be observed via the optical Cherenkov photons emitted from interaction between the high-energy electron beam and tissue. Cherenkov emission can be used to evaluate the dose uniformity on the surface of the patient in real-time using a time-gated intensified camera system. Each patient was monitored during TSET by in-vivo detectors (IVD) as well as Scintillators. Patients undergoing TSET in various conditions (whole body and half body) were imaged and analyzed. A rigorous methodology for converting Cherenkov intensity to surface dose as products of correction factors, including camera vignette correction factor, incident radiation correction factor, and tissue optical properties correction factor. A comprehensive study has been carried out by inspecting various positions on the patients such as vertex, chest, perineum, shins, and foot relative to the umbilicus point (the prescription point).
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Affiliation(s)
- Timothy C. Zhu
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA 19104
| | - Yihong Ong
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA 19104
| | - Hongjin Sun
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA 19104
| | - Weili Zhong
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA 19104
| | - Tianshun Miao
- Thayer School of Engineering, Dartmouth College, Hanover, NH 03755
| | - Andreea Dimofte
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA 19104
| | - Petr Bruza
- Thayer School of Engineering, Dartmouth College, Hanover, NH 03755
| | - Amit Maity
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA 19104
| | - John P. Plastaras
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA 19104
| | - Ima Paydar
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA 19104
| | - Lei Dong
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA 19104
| | - Brian W. Pogue
- Thayer School of Engineering, Dartmouth College, Hanover, NH 03755
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