Radiation therapy is a repetitive procedure given to patients daily for about 30 days. Setting patients up on the treatment couch and daily alignment of the beam is a complex process. Beyond positional complications, the therapy team has to leave the room when the beam is on, so if anything happens during delivery, problem-solving tools are very limited. National statistics show that incidents of incorrect delivery might occur on a level of about 1%. In a busy clinic, this could mean one patient per week. "Normally the treatments are just fine," says Pogue. "However, if you cannot see where the beam is, then it is a blind treatment, and the interaction between patient and therapy team is just less natural than it could be if the treatment was visual."

NCCC is currently the only cancer center in the world with regular use of Cherenkov imaging in all radiotherapy treatments, and was uniquely positioned for clinical research teams to test out these cameras for the planned study. Cherenkov imaging cameras have been installed in most linear accelerators within Dartmouth-Hitchcock, providing an extra level of safety during each patient's therapy session. "Cherenkov cameras mounted inside the radiotherapy treatment rooms give us the ability to simply see the treatment and provide an intuitive guide to therapists that we otherwise wouldn't have had," says Pogue. "This is a terrific tool for tracking what happens each day and in each treatment, and for improving the quality of radiotherapy delivery."


DoseOptics' technology was developed through research at Dartmouth by Dartmouth faculty, who then licensed the product to the company. Pioneered at Dartmouth-Hitchcock, it is now expanding to other cancer centers. Since DoseOptics, LLC, received FDA clearance to market BeamSite in December of 2020, the team hopes all radiation oncology clinics will introduce the technology to their programs. "Clinics should have all the tools available to them to ensure that each treatment for each patient is accurate, and to be able to quickly notice issues and fix them," says Pogue.

Brian W. Pogue, PhD, is Co-Director of the Translational Engineering in Cancer Research Program at Dartmouth's and Dartmouth-Hitchcock's Norris Cotton Cancer Center, MacLean Professor of Engineering at Dartmouth Engineering, Professor of Surgery at Geisel School of Medicine at Dartmouth, and President and Co-Founder of DoseOptics, LLC, which develops camera systems and software for radiotherapy imaging of Cherenkov light for dosimetry. His research interests include optics in medicine, biomedical imaging to guide cancer therapy, molecular-guided surgery, dose imaging in radiation therapy, Cherenkov light imaging, image-guided spectroscopy of cancer, photodynamic therapy, and modeling of tumor pathophysiology and contrast.

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