Rongxiao Zhang

Projection imaging of photon beams by the Čerenkov effect

PURPOSE A novel technique for beam profiling of megavoltage photon beams was investigated for the first time by capturing images of the induced Čerenkov emission in water, as a potential surrogate for the imparted dose in irradiated media. METHODS A high-sensitivity, intensified CCD camera (ICCD) was configured to acquire 2D projection images of Čerenkov emission from a 4 × 4 cm(2) 6 MV linear accelerator (LINAC) x-ray photon beam operating at a dose rate of 400 MU∕min incident on a water tank with transparent walls. The ICCD acquisition was gated to the LINAC sync pulse to reduce background light artifacts, and the measurement quality was investigated by evaluating the signal to noise ratio and measurement repeatability as a function of delivered dose. Monte Carlo simulations were used to derive a calibration factor for differences between the optical images and deposited dose arising from the anisotropic angular dependence of Čerenkov emission. Finally, Čerenkov-based beam profiles were compared to a percent depth dose (PDD) and lateral dose profile at a depth of d(max) from a reference dose distribution generated from the clinical Varian ECLIPSE treatment planning system (TPS). RESULTS The signal to noise ratio was found to be 20 at a delivered dose of 66.6 cGy, and proportional to the square root of the delivered dose as expected from Poisson photon counting statistics. A 2.1% mean standard deviation and 5.6% maximum variation in successive measurements were observed, and the Monte Carlo derived calibration factor resulted in Čerenkov emission images which were directly correlated to deposited dose, with some spatial issues. The dose difference between the TPS and PDD predicted by Čerenkov measurements was within 20% in the buildup region with a distance to agreement (DTA) of 1.5-2 mm and ±3% at depths beyond d(max). In the lateral profile, the dose difference at the beam penumbra was within ±13% with a DTA of 0-2 mm, ±5% in the central beam region, and 2%-3% in the beam umbra. CONCLUSIONS The results from this initial study demonstrate the first documented use of Čerenkov emission imaging to profile x-ray photon LINAC beams in water. The proposed modality has several potential advantages over alternative methods, and upon future refinement may prove to be a robust and novel dosimetry method.

Optical dosimetry of radiotherapy beams using Cherenkov radiation: the relationship between light emission and dose

Recent studies have proposed that light emitted by the Cherenkov effect may be used for a number of radiation therapy dosimetry applications. There is a correlation between the captured light and expected dose under certain conditions, yet discrepancies have also been observed and a complete examination of the theoretical differences has not been done. In this study, a fundamental comparison between the Cherenkov emission and absorbed dose was explored for x-ray photons, electrons, and protons using both a theoretical and Monte Carlo-based analysis. Based on the findings of where dose correlates with Cherenkov emission, it was concluded that for x-ray photons the light emission would be optimally suited for narrow beam stereotactic radiation therapy and surgery validation studies, for verification of dynamic intensity-modulated and volumetric modulated arc therapy treatment plans in water tanks, near monoenergetic sources (e.g., Co-60 and brachy therapy sources) and also for entrance and exit surface imaging dosimetry of both narrow and broad beams. For electron use, Cherenkov emission was found to be only suitable for surface dosimetry applications. Finally, for proton dosimetry, there exists a fundamental lack of Cherenkov emission at the Bragg peak, making the technique of little use, although post-irradiation detection of light emission from radioisotopes could prove to be useful.

Cherenkov Video Imaging Allows for the First Visualization of Radiation Therapy in Real Time

PURPOSE To determine whether Cherenkov light imaging can visualize radiation therapy in real time during breast radiation therapy. METHODS AND MATERIALS An intensified charge-coupled device (CCD) camera was synchronized to the 3.25-μs radiation pulses of the clinical linear accelerator with the intensifier set × 100. Cherenkov images were acquired continuously (2.8 frames/s) during fractionated whole breast irradiation with each frame an accumulation of 100 radiation pulses (approximately 5 monitor units). RESULTS The first patient images ever created are used to illustrate that Cherenkov emission can be visualized as a video during conditions typical for breast radiation therapy, even with complex treatment plans, mixed energies, and modulated treatment fields. Images were generated correlating to the superficial dose received by the patient and potentially the location of the resulting skin reactions. Major blood vessels are visible in the image, providing the potential to use these as biological landmarks for improved geometric accuracy. The potential for this system to detect radiation therapy misadministrations, which can result from hardware malfunction or patient positioning setup errors during individual fractions, is shown. CONCLUSIONS Cherenkoscopy is a unique method for visualizing surface dose resulting in real-time quality control. We propose that this system could detect radiation therapy errors in everyday clinical practice at a time when these errors can be corrected to result in improved safety and quality of radiation therapy.

Superficial dosimetry imaging based on Čerenkov emission for external beam radiotherapy with megavoltage x-ray beam

PURPOSE Čerenkov radiation emission occurs in all tissue, when charged particles (either primary or secondary) travel at velocity above the threshold for the Čerenkov effect (about 220 KeV in tissue for electrons). This study presents the first examination of optical Čerenkov emission as a surrogate for the absorbed superficial dose for MV x-ray beams. METHODS In this study, Monte Carlo simulations of flat and curved surfaces were studied to analyze the energy spectra of charged particles produced in different regions near the surfaces when irradiated by MV x-ray beams. Čerenkov emission intensity and radiation dose were directly simulated in voxelized flat and cylindrical phantoms. The sampling region of superficial dosimetry based on Čerenkov radiation was simulated in layered skin models. Angular distributions of optical emission from the surfaces were investigated. Tissue mimicking phantoms with flat and curved surfaces were imaged with a time domain gating system. The beam field sizes (50 × 50-200 × 200 mm(2)), incident angles (0°-70°) and imaging regions were all varied. RESULTS The entrance or exit region of the tissue has nearly homogeneous energy spectra across the beam, such that their Čerenkov emission is proportional to dose. Directly simulated local intensity of Čerenkov and radiation dose in voxelized flat and cylindrical phantoms further validate that this signal is proportional to radiation dose with absolute average discrepancy within 2%, and the largest within 5% typically at the beam edges. The effective sampling depth could be tuned from near 0 up to 6 mm by spectral filtering. The angular profiles near the theoretical Lambertian emission distribution for a perfect diffusive medium, suggesting that angular correction of Čerenkov images may not be required even for curved surface. The acquisition speed and signal to noise ratio of the time domain gating system were investigated for different acquisition procedures, and the results show there is good potential for real-time superficial dose monitoring. Dose imaging under normal ambient room lighting was validated, using gated detection and a breast phantom. CONCLUSIONS This study indicates that Čerenkov emission imaging might provide a valuable way to superficial dosimetry imaging in real time for external beam radiotherapy with megavoltage x-ray beams.

Time-gated Cherenkov emission spectroscopy from linear accelerator irradiation of tissue phantoms

Radiation from a linear accelerator induces Cherenkov emission in tissue, which has recently been shown to produce biochemical spectral signatures that can be interpreted to estimate tissue hemoglobin and oxygen saturation or molecular fluorescence from reporters. The Cherenkov optical light levels are in the range of 10(-6) to 10(-9) W/cm2, which limits the practical utility of the signal in routine radiation therapy monitoring. However, due to the fact that the radiation is pulsed, gated-acquisition of the signal allows detection in the presence of ambient lighting, as is demonstrated here. This observation has the potential to significantly increase the value of Cherenkov emission spectroscopy during radiation therapy to monitor tissue molecular events.

Superficial dosimetry imaging of Čerenkov emission in electron beam radiotherapy of phantoms

Čerenkov emission is generated from ionizing radiation in tissue above 264 keV energy. This study presents the first examination of this optical emission as a surrogate for the absorbed superficial dose. Čerenkov emission was imaged from the surface of flat tissue phantoms irradiated with electrons, using a range of field sizes from 6 cm × 6 cm to 20 cm × 20 cm, incident angles from 0° to 50°, and energies from 6 to 18 MeV. The Čerenkov images were compared with the estimated superficial dose in phantoms from direct diode measurements, as well as calculations by Monte Carlo and the treatment planning system. Intensity images showed outstanding linear agreement (R(2) = 0.97) with reference data of the known dose for energies from 6 to 18 MeV. When orthogonal delivery was carried out, the in-plane and cross-plane dose distribution comparisons indicated very little difference (± 2-4% differences) between the different methods of estimation as compared to Čerenkov light imaging. For an incident angle 50°, the Čerenkov images and Monte Carlo simulation show excellent agreement with the diode data, but the treatment planning system had a larger error (OPT = ± 1~2%, diode = ± 2~3%, TPS = ± 6-8% differences) as would be expected. The sampling depth of superficial dosimetry based on Čerenkov radiation has been simulated in a layered skin model, showing the potential of sampling depth tuning by spectral filtering. Taken together, these measurements and simulations indicate that Čerenkov emission imaging might provide a valuable method of superficial dosimetry imaging from incident radiotherapy beams of electrons.

Three-dimensional Čerenkov tomography of energy deposition from ionizing radiation beams

Since its discovery during the 1930s the Čerenkov effect (light emission from charged particles traveling faster than the local speed of light in a dielectric medium) has been paramount in the development of high-energy physics research. The ability of the emitted light to describe a charged particles trajectory, energy, velocity, and mass has allowed scientists to study subatomic particles, detect neutrinos, and explore the properties of interstellar matter. However, to our knowledge, all applications of the process to date have focused on the identification of particles themselves, rather than their effect upon the surroundings through which they travel. Here we explore a novel application of the Čerenkov effect for the recovery of the spatial distribution of ionizing radiation energy deposition in a medium and apply it to the issue of dose determination in medical physics. By capturing multiple projection images of the Čerenkov light induced by a medical linear accelerator x-ray photon beam, we demonstrate the successful three-dimensional tomographic reconstruction of the imparted dose distribution.

A GAMOS plug-in for GEANT4 based Monte Carlo simulation of radiation-induced light transport in biological media

We describe a tissue optics plug-in that interfaces with the GEANT4/GAMOS Monte Carlo (MC) architecture, providing a means of simulating radiation-induced light transport in biological media for the first time. Specifically, we focus on the simulation of light transport due to the Čerenkov effect (light emission from charged particle’s traveling faster than the local speed of light in a given medium), a phenomenon which requires accurate modeling of both the high energy particle and subsequent optical photon transport, a dynamic coupled process that is not well-described by any current MC framework. The results of validation simulations show excellent agreement with currently employed biomedical optics MC codes, [i.e., Monte Carlo for Multi-Layered media (MCML), Mesh-based Monte Carlo (MMC), and diffusion theory], and examples relevant to recent studies into detection of Čerenkov light from an external radiation beam or radionuclide are presented. While the work presented within this paper focuses on radiation-induced light transport, the core features and robust flexibility of the plug-in modified package make it also extensible to more conventional biomedical optics simulations. The plug-in, user guide, example files, as well as the necessary files to reproduce the validation simulations described within this paper are available online at http://www.dartmouth.edu/optmed/research-projects/monte-carlo-software.

Real-time in vivo Cherenkoscopy imaging during external beam radiation therapy

Abstract. Cherenkov radiation is induced when charged particles travel through dielectric media (such as biological tissue) faster than the speed of light through that medium. Detection of this radiation or excited luminescence during megavoltage external beam radiotherapy (EBRT) can allow emergence of a new approach to superficial dose estimation, functional imaging, and quality assurance for radiation therapy dosimetry. In this letter, the first in vivo Cherenkov images of a real-time Cherenkoscopy during EBRT are presented. The imaging system consisted of a time-gated intensified charge coupled device (ICCD) coupled with a commercial lens. The ICCD was synchronized to the linear accelerator to detect Cherenkov photons only during the 3.25-μs radiation bursts. Images of a tissue phantom under irradiation show that the intensity of Cherenkov emission is directly proportional to radiation dose, and images can be acquired at 4.7  frames/s with SNR>30. Cherenkoscopy was obtained from the superficial regions of a canine oral tumor during planned, Institutional Animal Care and Use Committee approved, conventional (therapeutically appropriate) EBRT irradiation. Coregistration between photography and Cherenkoscopy validated that Cherenkov photons were detected from the planned treatment region. Real-time images correctly monitored the beam field changes corresponding to the planned dynamic wedge movement, with accurate extent of overall beam field, and expected cold and hot regions.

Video‐rate optical dosimetry and dynamic visualization of IMRT and VMAT treatment plans in water using Cherenkov radiation

PURPOSE A novel technique for optical dosimetry of dynamic intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT) plans was investigated for the first time by capturing images of the induced Cherenkov radiation in water. METHODS A high-sensitivity, intensified CCD camera (ICCD) was configured to acquire a two-dimensional (2D) projection image of the Cherenkov radiation induced by IMRT and VMAT plans, based on the Task Group 119 (TG-119) C-Shape geometry. Plans were generated using the Varian Eclipse treatment planning system (TPS) and delivered using 6 MV x-rays from a Varian TrueBeam Linear Accelerator (Linac) incident on a water tank doped with the fluorophore quinine sulfate. The ICCD acquisition was gated to the Linac target trigger pulse to reduce background light artifacts, read out for a single radiation pulse, and binned to a resolution of 512 × 512 pixels. The resulting videos were analyzed temporally for various regions of interest (ROI) covering the planning target volume (PTV) and organ at risk (OAR), and summed to obtain an overall light intensity distribution, which was compared to the expected dose distribution from the TPS using a gamma-index analysis. RESULTS The chosen camera settings resulted in 23.5 frames per second dosimetry videos. Temporal intensity plots of the PTV and OAR ROIs confirmed the preferential delivery of dose to the PTV versus the OAR, and the gamma analysis yielded 95.9% and 96.2% agreement between the experimentally captured Cherenkov light distribution and expected TPS dose distribution based upon a 3%/3 mm dose difference and distance-to-agreement criterion for the IMRT and VMAT plans, respectively. CONCLUSIONS The results from this initial study demonstrate the first documented use of Cherenkov radiation for video-rate optical dosimetry of dynamic IMRT and VMAT treatment plans. The proposed modality has several potential advantages over alternative methods including the real-time nature of the acquisition, and upon future refinement may prove to be a robust and novel dosimetry method with both research and clinical applications.