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2. Retrospective Evaluation of an Always-on Cherenkov Imaging System for Radiotherapy Quality Improvement

Author

Alexander, Daniel A., Jermyn, Michael, Bruza, Petr, Zhang, Rongxiao, Chen, Erli, Decker, Savannah M., McGlynn, Tatum L., Rosselot, Rory A., Lee, Jae, Rose, Melanie L., Williams, Benjamin B., Pogue, Brian W., Gladstone, David J., and Jarvis, Lesley A.

Subjects
Physics - Medical Physics
Abstract

Purpose: Cherenkov imaging is now clinically available to track the course of radiation therapy as a treatment verification tool. The aim of this work was to discover the benefits of always-on Cherenkov images as a novel incident detection and quality improvement system through retrospective review of imaging in our center. Methods: Continuous imaging of all patients was attempted during a 12-month period by automating the acquisition of Cherenkov imaging using an always-on commercial system. Multi-camera systems were installed in two treatment bunkers in the radiation oncology clinic at our center and one bunker in an affiliated satellite clinic. Images were acquired as part of normal treatment procedure and reviewed retrospectively with potential incidents flagged for evaluation by the physician and medical physics teams. Results: In total, 622 patients were imaged as part of this study. In this summary, 9 patients were identified with incidents occurring during their course of treatment that were detected only with Cherenkov imaging. Incidents were found relating to issues during simulation, planning, pre-treatment review, and treatment delivery, however none of the incidents were detected prior to treatment delivery. Primary areas of improvement identified in this study are dose to unintended areas in planning, dose to unintended areas due to positioning, and non-ideal bolus placement during setup. Case studies are presented highlighting the detection of these issues using Cherenkov imaging. Conclusions: All detected events were deemed below the threshold for reporting, but their observation could lead to quality improvement in practice. Perhaps most importantly, the imaging was seamless with no effort required by the radiotherapy team and provided both real-time and permanent records of what was delivered in each fraction., Comment: 22 pages, 1 table, 12 figures

Published
2021

11. Initial Clinical Experience of Cherenkov Imaging in External Beam Radiation Therapy Identifies Opportunities to Improve Treatment Delivery

Author

Jarvis, Lesley A., primary, Hachadorian, Rachael L., additional, Jermyn, Michael, additional, Bruza, Petr, additional, Alexander, Daniel A., additional, Tendler, Irwin I., additional, Williams, Benjamin B., additional, Gladstone, David J., additional, Schaner, Philip E., additional, Zaki, Bassem I., additional, and Pogue, Brian W., additional

Published
2021
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13. Computer animation body surface analysis of total skin electron radiation therapy dose homogeneity via Cherenkov imaging

Author

Miao, Tianshun, primary, Petroccia, Heather, additional, Xie, Yunhe, additional, Jermyn, Michael, additional, Perroni-Scharf, Maxine, additional, Kapoor, Namit, additional, Mahoney, James M., additional, Zhu, Timothy C., additional, Bruza, Petr, additional, Williams, Benjamin B., additional, Gladstone, David J., additional, and Pogue, Brian W., additional

Published
2020
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16. Experimentally Observed Cherenkov Light Generation in the Eye During Radiation Therapy

Author

Tendler, Irwin I., primary, Hartford, Alan, additional, Jermyn, Michael, additional, LaRochelle, Ethan, additional, Cao, Xu, additional, Borza, Victor, additional, Alexander, Daniel, additional, Bruza, Petr, additional, Hoopes, Jack, additional, Moodie, Karen, additional, Marr, Brian P., additional, Williams, Benjamin B., additional, Pogue, Brian W., additional, Gladstone, David J., additional, and Jarvis, Lesley A., additional

Published
2020
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26. Mesoscopic characterization of prostate cancer using Raman spectroscopy: potential for diagnostics and therapeutics

Author

Aubertin, Kelly, primary, Trinh, Vincent Quoc, additional, Jermyn, Michael, additional, Baksic, Paul, additional, Grosset, Andrée-Anne, additional, Desroches, Joannie, additional, St-Arnaud, Karl, additional, Birlea, Mirela, additional, Vladoiu, Maria Claudia, additional, Latour, Mathieu, additional, Albadine, Roula, additional, Saad, Fred, additional, Leblond, Frédéric, additional, and Trudel, Dominique, additional

Published
2018
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29. A new method using Raman spectroscopy for in vivo targeted brain cancer tissue biopsy

Author

Desroches, Joannie, Jermyn, Michael, Pinto, Michael, Picot, Fabien, Tremblay, Marie-Andrée, Obaid, Sami, Marple, Eric, Urmey, Kirk, Trudel, Dominique, Soulez, Gilles, Guiot, Marie-Christine, Wilson, Brian C., Petrecca, Kevin, Leblond, Frédéric, Desroches, Joannie, Jermyn, Michael, Pinto, Michael, Picot, Fabien, Tremblay, Marie-Andrée, Obaid, Sami, Marple, Eric, Urmey, Kirk, Trudel, Dominique, Soulez, Gilles, Guiot, Marie-Christine, Wilson, Brian C., Petrecca, Kevin, and Leblond, Frédéric

Abstract

Modern cancer diagnosis requires histological, molecular, and genomic tumor analyses. Tumor sampling is often achieved using a targeted needle biopsy approach. Targeting errors and cancer heterogeneity causing inaccurate sampling are important limitations of this blind technique leading to non-diagnostic or poor quality samples, and the need for repeated biopsies pose elevated patient risk. An optical technology that can analyze the molecular nature of the tissue prior to harvesting could improve cancer targeting and mitigate patient risk. Here we report on the design, development, and validation of an in situ intraoperative, label-free, cancer detection system based on high wavenumber Raman spectroscopy. This optical detection device was engineered into a commercially available biopsy system allowing tumor analysis prior to tissue harvesting without disrupting workflow. Using a dual validation approach we show that high wavenumber Raman spectroscopy can detect human dense cancer with >60% cancer cells in situ during surgery with a sensitivity and specificity of 80% and 90%, respectively. We also demonstrate for the first time the use of this system in a swine brain biopsy model. These studies set the stage for the clinical translation of this optical molecular imaging method for high yield and safe targeted biopsy.

Published
2018

30. A new method using Raman spectroscopy for in vivo targeted brain cancer tissue biopsy

Author

Desroches, Joannie, primary, Jermyn, Michael, additional, Pinto, Michael, additional, Picot, Fabien, additional, Tremblay, Marie-Andrée, additional, Obaid, Sami, additional, Marple, Eric, additional, Urmey, Kirk, additional, Trudel, Dominique, additional, Soulez, Gilles, additional, Guiot, Marie-Christine, additional, Wilson, Brian C., additional, Petrecca, Kevin, additional, and Leblond, Frédéric, additional

Published
2018
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35. Technical Note: Quality assurance and relative dosimetry testing of a 60Co total body irradiator using optical imaging.

Author

Tendler, Irwin I., Bredfeldt, Jeremy S., Zhang, Rongxiao, Bruza, Petr, Jermyn, Michael, Pogue, Brian W., and Gladstone, David J.

Subjects
OPTICAL images, TOTAL body irradiation, QUALITY assurance, SCINTILLATORS, IONIZATION chambers, RADIATION dosimetry
Abstract

Purpose: The aim of this study was to create an optical imaging‐based system for quality assurance (QA) testing of a dedicated Co‐60 total body irradiation (TBI) machine. Our goal is to streamline the QA process by minimizing the amount time necessary for tests such as verification of dose rate and field homogeneity. Methods: Plastic scintillating rods were placed directly on the patient treatment couch of a dedicated TBI 60Co irradiator. A tripod‐mounted intensified camera was placed directly adjacent to the couch. Images were acquired over a 30‐s period once the cobalt source was fully exposed. Real‐time image filtering was used; cumulative images were flatfield corrected as well as background and darkfield subtracted. Scintillators were used to measure light‐radiation field correspondence, dose rate, field homogeneity, and symmetry. Dose rate effects were measured by modifying the height of the treatment couch and scintillator response was compared to ionization chamber (IC) measurements. Optically stimulated luminesce detector (OSLD) used as reference dosimeters during field symmetry and homogeneity testing. Results: The scintillator‐based system accurately reported changes in dose rate. When comparing normalized output values for IC vs scintillators over a range of source‐to‐surface distances, a linear relationship (R2 = 0.99) was observed. Normalized scintillator signal matched OSLD measurements with <1.5% difference during field homogeneity and symmetry testing. Beam symmetry across both axes of the field was within 2%. The light field was found to correspond to 90 ± 3% of the isodose maximum along the longitudinal and latitudinal axis, respectively. Scintillator imaging output results using a single image stack requiring no postexposure processing (needed for OSLD) or repeat manual measurements (needed for IC). Conclusion: Imaging of scintillation light emission from plastic rods is a viable and efficient method for carrying out TBI 60Co irradiator QA. We have shown that this technique can accurately measure field homogeneity, symmetry, light‐radiation field correspondence, and dose rate effects. [ABSTRACT FROM AUTHOR]

Published
2019
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36. Raman Spectroscopy for Prostate Cancer Detection and Characterization

Author

Aubertin, Kelly, primary, Trinh, Vincent, additional, Jermyn, Michael, additional, Desroches, Joannie, additional, St-Pierre, Catherine, additional, Vladoiu, Maria-Claudia, additional, Grosset, Andrée-Anne, additional, Saad, Fred, additional, Trudel, Dominique, additional, and Leblond, Frédéric, additional

Published
2017
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40. A review of Raman spectroscopy advances with an emphasis on clinical translation challenges in oncology

Author

Jermyn, Michael, primary, Desroches, Joannie, additional, Aubertin, Kelly, additional, St-Arnaud, Karl, additional, Madore, Wendy-Julie, additional, De Montigny, Etienne, additional, Guiot, Marie-Christine, additional, Trudel, Dominique, additional, Wilson, Brian C, additional, Petrecca, Kevin, additional, and Leblond, Frederic, additional

Published
2016
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43. An intraoperative spectroscopic imaging system for quantification of Protoporphyrin IX during glioma surgery (Conference Presentation)

Author

Angulo-Rodríguez, Leticia M., primary, Laurence, Audrey, additional, Jermyn, Michael, additional, Sheehy, Guillaume, additional, Sibai, Mira, additional, Petrecca, Kevin, additional, Roberts, David W., additional, Paulsen, Keith D., additional, Wilson, Brian C., additional, and Leblond, Frédéric, additional

Published
2016
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45. Cherenkov imaging for linac beam shape analysis as a remote electronic quality assessment verification tool.

Author

Miao, Tianshun, Bruza, Petr, Pogue, Brian W., Jermyn, Michael, Krishnaswamy, Venkataramanan, Ware, William, Rafie, Frank, Gladstone, David J., and Williams, Benjamin B.

Subjects
CHERENKOV radiation, LINEAR accelerators, ACRYLONITRILE butadiene styrene resins, IMAGE quality analysis, IMAGING phantoms, PARTICLE emissions
Abstract

Purpose: A remote imaging system tracking Cherenkov emission was analyzed to verify that the linear accelerator (linac) beam shape could be quantitatively measured at the irradiation surface for Quality Audit (QA). Methods: The Cherenkov camera recorded 2D dose images delivered on a solid acrylonitrile butadiene styrene (ABS) plastic phantom surface for a range of square beam sizes, and 6 MV photons. Imaging was done at source to surface distance (SSD) of 100 cm and compared to GaF film images and linac light fields of the same beam sizes, ranging over 5 × 5 cm2 up to 20 × 20 cm2. Line profiles of each field were compared in both X and Y jaw directions. Each measurement was repeated on two different Clinac2100 machines. An interreader comparison of the beam width interpretation was completed using procedures commonly employed for beam to light field coincidence verification. Cherenkov measurements are also done for beams of complex treatment plan and isocenter QA. Results: The Cherenkov image widths matched with the measured GaF images and light field images, with accuracy in the range of ±1 mm standard deviation. The differences between the measurements were minor and within tolerance of geometrical requirement of standard linac QA procedures conducted by human setup verification, which had a similar error range. The measurement made by the remote imaging system allowed for beam shape extraction of radiation fields at the SSD location of the beam. Conclusions: The proposed Cherenkov image acquisition system provides a valid way to remotely confirm radiation field sizes and provides similar information to that obtained from the linac light field or GaF film estimates of the beam size. The major benefit of this approach is that with a fixed installation of the camera, testing could be done completely under software control with automated image analysis, potentially simplifying conventional QA procedures with appropriate calibration of boundary definitions, and the natural extension to capturing dynamic treatment beamlets at SSD could have future value, such as verification of beam plans with complex beam shapes, like IMRT or "star‐shot" QA for the isocenter. [ABSTRACT FROM AUTHOR]

Published
2019
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46. Improved sensitivity to fluorescence for cancer detection in wide-field image-guided neurosurgery

Author

Jermyn, Michael, primary, Gosselin, Yoann, additional, Valdes, Pablo A., additional, Sibai, Mira, additional, Kolste, Kolbein, additional, Mercier, Jeanne, additional, Angulo, Leticia, additional, Roberts, David W., additional, Paulsen, Keith D., additional, Petrecca, Kevin, additional, Daigle, Olivier, additional, Wilson, Brian C., additional, and Leblond, Frederic, additional

Published
2015
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