Remote dose imaging from cherenkov light using spatially-resolved CT calibration in breast radiotherapy

PURPOSE

Imaging Cherenkov light during radiotherapy allows the visualization and recording of frame-by-frame relative maps of the dose being delivered to the tissue at each control point used throughout treatment, providing one of the most complete real-time means of treatment quality assurance. In non-turbid media, the intensity of Cherenkov light is linear with surface dose deposited, however the emission from patient tissue is well-known to be reduced by absorbing tissue components such as hemoglobin, fat, water and melanin, and diffused by the scattering components of tissue. Earlier studies have shown that bulk correction could be achieved by using the patient planning CT scan for attenuation correction.

METHODS

In this study, CT maps were used for correction of spatial variations in emissivity. Testing was completed on Cherenkov images from radiotherapy treatments of post-lumpectomy breast cancer patients (n = 13), combined with spatial renderings of the patient radiodensity (CT number) from their planning CT scan.

RESULTS

The correction technique was shown to provide a pixel-by-pixel correction that suppressed many of the inter- and intra-patient differences in the Cherenkov light emitted per unit dose. This correction was established from a calibration curve that correlated Cherenkov light intensity to surface-rendered CT number (R_6MV ² = 0.70 and R_10MV ² = 0.72). The corrected Cherenkov intensity per unit dose standard error was reduced by nearly half (from ∼30% to ∼17%).

CONCLUSIONS

This approach provides evidence that the planning CT scan can mitigate some of the tissue-specific attenuation in Cherenkov images, allowing them to be translated into near surface dose images. This article is protected by copyright. All rights reserved.

Dose Imaging Detectors for Radiotherapy Based on Gas Electron Multipliers

New techniques in charged particle therapy and widespread use of modern dynamic beam delivery systems demand new beam monitoring devices as well as accurate 2D dosimetry systems to verify the delivered dose distribution. We are developing dose imaging detectors based on gas electron multipliers (GEM) with the goal of improving dose measurement linearity, position and timing resolution, and to ultimately allow pre-treatment verification of dose distributions and dose delivery monitoring employing scanning beam technology. A prototype 10×10 cm(2) double-GEM detector has been tested in the 205 MeV proton beam using electronic and optical readout modes. Preliminary results with electronic cross-strip readout demonstrate fast response and single-pixel (4 mm) position resolution. In optical readout mode, the line spread function of the detector was found to have σ=0.7 mm. In both readout modes, the detector response was linear up to dose rates of 50 Gy/min, with adequate representation of the Bragg peak in depth-dose profile measurements.