Department of Medicine, Geisel School of Medicine at Dartmouth College, Hanover, New Hampshire; Norris Cotton Cancer Center at the Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
Department of Physics and Astronomy, Dartmouth College, Hanover, New Hampshire.
Int J Radiat Oncol Biol Phys. 2014 Jul 1;89(3):615-22. doi: 10.1016/j.ijrobp.2014.01.046. Epub 2014 Mar 28.
To determine whether Cherenkov light imaging can visualize radiation therapy in real time during breast radiation therapy.
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).
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.
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.
确定切伦科夫光成像是如何在乳腺癌放射治疗过程中实时可视化放射治疗的。
将增强型电荷耦合器件（CCD）相机与强度器设置为×100 的临床直线加速器的 3.25μs 辐射脉冲同步。在分次全乳房照射过程中连续采集切伦科夫图像（2.8 帧/秒），每帧积累 100 个辐射脉冲（约 5 个监测单位）。
使用首例患者图像来说明，即使在复杂的治疗计划、混合能量和调制治疗野的情况下，切伦科夫发射也可以在典型的乳腺癌放射治疗条件下作为视频可视化。图像是根据患者接受的表面剂量生成的，并且可能与皮肤反应的位置相关。图像中可以看到主要血管，这为使用这些血管作为提高几何精度的生物标志物提供了可能性。该系统检测放射治疗误操作的潜力，这些误操作可能是由于硬件故障或患者在单个分次中的定位设置错误导致的。
切伦科夫镜检术是一种可视化表面剂量的独特方法，可实现实时质量控制。我们提出，该系统可以在日常临床实践中检测放射治疗错误，从而在这些错误可以得到纠正的情况下，提高放射治疗的安全性和质量。
