LEBANON, NH - Dartmouth's and Dartmouth-Hitchcock's Norris Cotton Cancer Center (NCCC) is the first cancer center in the world to install BeamSite Cherenkov imaging cameras in its radiotherapy treatment rooms. The camera system, invented, validated and commercialized by entrepreneurs from NCCC and Dartmouth spinoff biomed tech company, DoseOptics, LLC, captures imaging and real-time video of the beam directly on the patient, allowing the radiation oncology team to visualize treatment delivery.

Cherenkov imaging makes radiation treatment a visual process. The Cherenkov effect occurs when photon or electron radiation beams interact with tissue, such as skin, producing a small light emission from the surface. BeamSite cameras can capture images of the treatment-beam shapes in real time, as well as show levels of intensity that are proportional to the radiation dose. These visual data can be used to verify both accuracy of dose and of beam delivery at each daily treatment, a verification not possible using standard quality assurance measures.

"Cherenkov imaging provides visualization of the radiation therapy treatment, so that the treatment team can see everything, and make adjustments when unexpected things happen," explains Brian Pogue, PhD, co-director of the Translational Engineering in Cancer Research Program at NCCC, MacLean Professor of Engineering Sciences at Dartmouth Engineering and co-founder of DoseOptics, LLC. A joint engineering and oncology team reviewed events recorded in their Cherenkov imaging study over the course of a few years, during which they documented incidents when radiotherapy delivery was not ideal and the adjustments made to rectify. Their findings, "Initial Clinical Experience of Cherenkov Imaging in External Beam Radiation Therapy Identifies Opportunities to Improve Treatment Delivery," have been published in The International Journal of Radiation Oncology, Biology, Physics.
There were a total of 64 patients in the study, under the supervision of radiation oncologist and lead author Lesley Jarvis, MD, PhD, Member of NCCC's Translational Engineering in Cancer Research Program and Associate Professor of Medicine at the Geisel School of Medicine at Dartmouth. The patients were receiving treatment for breast cancer, sarcoma, lymphoma and other cancers. Six patients were found to indicate that adjustments would have improved treatment, such as stray radiation dose exposure to the opposite breast, arm or chin during breast cancer treatments. The imaging system was also used to identify when inadvertent dose was not an issue, such as confirming no unintended exposure of the opposite leg during an extremity sarcoma treatment.

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