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Evaluating the Clinical Utility of Cherenkov Imaging in Radiotherapy

R Hachadorian1*, D Alexander1, I Tendler1, M Jermyn1,2, B Pogue1,2,3, L Jarvis3, (1) Dartmouth College, Hanover, NH, (2) DoseOptics LLC, Lebanon, NH, (3) Dartmouth-Hitchcock Med. Ctr., Lebanon, NH

Presentations

(Sunday, 7/12/2020)   [Eastern Time (GMT-4)]

Room: AAPM ePoster Library

Purpose
In the last decade, Cherenkov imaging has been translated and integrated into clinical radiation therapy workflow in several academic radiotherapy centers. It has provided the treatment care team with a real-time view of the beam as it treats the patient, thereby adding a unique layer of safety and quality of the treatment. Using Cherenkov imaging, it is possible to ensure that healthy anatomy remains clear of the treating beam, and that the treatment site remains consistent in appearance at each fraction of treatment.

Methods:
All patients were consented in this IRB-approved, non-clinical trial, passive imaging study. Each fraction of treatment was recorded using a time-gated intensified CMOS camera (C-Dose Research, DoseOptics LLC, Lebanon, NH). The treatment field each day was tested for consistency relative to both Day 1 of treatment and the treatment plan. Metrics used include the mean distance to conformity (MDC, average distance that pixels which are only in one beam shape must be moved to be in both beam shapes).

Results:
Thirty-four patients receiving radiotherapy at sites including (but not limited to) breast, skin, and head/neck were imaged, yielding data over 187 total fractions— the largest Cherenkov imaging cohort to date. It was found that Cherenkov imaging lends valuable positioning insight for cases with nonconventional setup, such as a breast patient treated with arm immobilized at side body, revealing contralateral breast falling into the treating beam. In a separate breast case, it was found in some fractions the bolus did not sufficiently cover the entire treatment site.

Conclusion:
Monitoring patients in real time as they are treated provides an unparalleled layer of safety and security to the patient treatment. This study analyzes the largest Cherenkov imaging patient data cohort to date, and has revealed several important utilities of real-time monitoring in the clinic.

Download ePoster [PDF]

Funding Support, Disclosures, and Conflict of Interest: Authors Prof. Brian Pogue, Prof. Michael Jermyn and Dr. Lesley Jarvis M.D. have competing interests with DoseOptics LLC, a company that manufactures Cherenkov cameras used to monitor radiation therapy.

Keywords

Optical Imaging, Quality Control

Taxonomy

IM- Optical : Quality Control and Image Quality Assessment

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