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Cherenkov Emissions Provide Dartmouth Investigators Real-Time Tool for Quality Assurance in Radiation Therapy

January 23, 2015
Lebanon, NH

Using a simple camera and water tank, investigators from Dartmouth-Hitchcock's Norris Cotton Cancer Center, led by Brian Pogue, PhD, and David J. Gladstone, ScD, demonstrated that induced Cherenkov light can be imaged and used to confirm that the complex spatial dose distribution imparted in dynamic treatment plans is being delivered correctly. Their paper "Video-rate optical dosimetry and dynamic visualization of IMRT and VMAT treatment plans in water using Cherenkov radiation," was recently published in Medical Physics.

"Cherenkov radiation is emitted and exists as a ‘free' optical signal that has not been previously utilized," explained Adam Glaser, lead PhD student on the project. "By imaging the light, we can improve the quality and accuracy of delivered plans to prevent radiation mistakes. This will ultimately improve the overall outcome for patients being treated."

The Cherenkov Effect is responsible for the characteristic blue glow of nuclear reactors. Although the phenomenon has been constructively utilized for decades in high-energy particle physics and astrophysics, only recently has there been investigation into its utility in radiation therapy. In that context, it is the only current method that can reveal dosimetric information while remaining completely non-invasive. Essentially, the signal comes directly from the water phantom being irradiated rather than introducing detector arrays.

To accomplish this work, a high-sensitivity, intensified CCD camera was set up to take a two-dimensional projected image during delivery of the Intensity-Modulated Radiation Therapy (IMRT) or Volumetric Modulated Arc Therapy (VMAT) plans. The camera focused on a water bath, and was gated to the Linear Accelerator to take a rapid series of photos that were connected to make an ersatz video and used to compare overall light distribution with the original dosing plan.

"Compared to conventional [quality assurance] methods, the advantages of this technique are video-rate, real-time data acquisition, two dimensional projection of 3-D dose distribution, and high spatial resolution that is limited only by the collection optics of the system," said Gladstone.

Next steps for the team at Norris Cotton Cancer Center are to extend the system to tomographic 3-D data recovery, as well as continuing clinical trials to investigate Cherenkov light imaged directly from a patient's tissue surface.

Drs. Pogue, Gladstone and their team work at Dartmouth-Hitchcock's Norris Cotton Cancer Center in Lebanon, New Hampshire and Dartmouth's Thayer School of Engineering in Hanover, NH. The NIH funded this work with grants RO1CA109558, R21EB017559, and P30CA23108.

About Norris Cotton Cancer Center at Dartmouth-Hitchcock

Norris Cotton Cancer Center combines advanced cancer research at Dartmouth and the Geisel School of Medicine with patient-centered cancer care provided at Dartmouth-Hitchcock Medical Center, at Dartmouth-Hitchcock regional locations in Manchester, Nashua, and Keene, NH, and St. Johnsbury, VT, and at 12 partner hospitals throughout New Hampshire and Vermont. It is one of 41 centers nationwide to earn the National Cancer Institute's "Comprehensive Cancer Center" designation. Learn more about Norris Cotton Cancer Center research, programs, and clinical trials online at cancer.dartmouth.edu.

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