For the first time, it is possible to directly visualize a radiation beam incident upon a patient's tissue in real time, using Cerenkov emission imaging. This imaging could transform the ease for verifying delivery in radiation oncology, and allow on the fly reporting, recording and correction of replanning needs or delivery errors. In a field wher there is an incredibly high number of new technologies for delivery, the verification of delivery and recording of adverse incidents will become more and more critical and yet the ease of implementation must be improved. A recent discovery that gated intensified imaging allows video-rate passive detection of Cherenkov emission during radiation therapy with the room lights on, and so the delivery process is unaffected by the imaging system. This opens up a new important paradigm in radiation oncology verification. This work has been invented and patented at Dartmouth, and DoseOptics LLC is a company spin-off of this research program, with the goal to advance video-rate Cerenkov imaging as a dose delivery visualization & verification tool. The feasibility of the system has been proven through the technological refinement and pilot clinical trial at Dartmouth. The next phase of this work involves the DoseOptics prototype development as a C-Dose OnBoard verification tool for imaging patients during treatment from the view of the LINAC gantry. The system will be developed with a unique proprietary moderate cost design, which will then be tested in phantoms and with patient treatment plans delivered to water tanks. The system will have capabilities for video-rate capture of IMRT/VMAT data, tracking MLC movements in real time, and allowing analysis of treatment plans on a beam to beam basis. The competing technologies using ionization chambers or diode arrays are low resolution devices with limitations that they cannot eventually translate to direct on-patient imaging. The work carried out in the company is augmented by a plan to evaluate the system in Clinical Physics at Dartmouth, and be further evaluated at Stanford and UPenn. The technology patent protected as developed by this group, and for this start up, the team of developers includes a substantial number of experts in Cerenkov imaging, medical physics and new venture creation.

Public Health Relevance

For the first time, it is possible to directly visualize a radiation beam incident upon a patient's tissue during therapy, with high resolution imaging, using Cerenkov emission imaging. This application will develop an alpha prototype system to image radiation therapy treatment plans in real time as a delivery verification tool.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Small Business Innovation Research Grants (SBIR) - Phase II (R44)
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Special Emphasis Panel (ZRG1-SBIB-T (10))
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Narayanan, Deepa
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Doseoptics, LLC
United States
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Miao, Tianshun; Bruza, Petr; Pogue, Brian W et al. (2018) Cherenkov imaging for linac beam shape analysis as a remote electronic quality assessment verification tool. Med Phys :
Bruza, Petr; Gollub, Sarah L; Andreozzi, Jacqueline M et al. (2018) Time-gated scintillator imaging for real-time optical surface dosimetry in total skin electron therapy. Phys Med Biol 63:095009
Snyder, Clare; Pogue, Brian W; Jermyn, Michael et al. (2018) Algorithm development for intrafraction radiotherapy beam edge verification from Cherenkov imaging. J Med Imaging (Bellingham) 5:015001