TH-C-17A-09: Direct Visualization and Monitoring of Medical Radiation Beams in Air

Purpose: Radiation therapy errors are rare but potentially catastrophic. Recent fatal incidents could have been avoided by utilizing real-time methods of monitoring delivery of radiation during treatment. However, few existing methods are practical enough to be used routinely. The study presents the first experimental demonstration of a novel non-perturbing method of monitoring radiation therapy through the phenomena of air scintillation. Methods: Monitoring of radiation delivery was devised by leveraging the phenomena of nitrogen excitation in air by ionizing radiation. The excitation induced weak luminescence in the 300–400 nm range, a process called air scintillation. An electron-multiplication charge-coupled device camera (f/0.95 lens; 440 nm shortpass) was set-up in a clinical treatment vault and was used to capture air scintillation images of kilovoltage and megavoltage beams. Monte Carlo simulations were performed to determine the correlation of radiation dose to air scintillation. Results: Megavoltage beams from a Varian Clinac 21EX and kilovoltage beams from an orthovoltage unit (50 kVp, 30 mA) were visualized with a relatively short exposure time (10 s). Cherenkov luminescence produced in a plastic transparent phantom did not interfere with detection of air scintillation. The image intensity displayed an inverse intensity falloff (r2 = 0.89) along the central axis and was proportional to dose rate (r2 = 0.9998). As beam energy increased, the divergence of the imaged beam decreased. Last, air scintillation was visualized during a simulated total skin irradiation electron treatment. Conclusion: Air scintillation can be clinically detected to monitor a radiation beam in an inexpensive and non-perturbing manner. This new method is advantageous in monitoring for gross delivery and uniquely capable of wide area in a single acquisition, such as the case for online verification of total body / skin / lymphoid irradiation treatments.