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Daily Cherenkov Imaging to Monitor for Unintended Field Overlap During Bilateral Breast Radiation Therapy
Diego A Hernandez1, Jaqueline M Andreozzi1, Savannah M Decker2
1Department of Physics, University of South Florida, Tampa, Florida; Department of Radiation Oncology, Moffitt Cancer Center, Tampa, Florida.
Practical Radiation Oncology
|March 21, 2026
Summary
Cherenkov imaging successfully verified the medial gap in bilateral breast radiotherapy, confirming treatment accuracy. This method offers real-time monitoring and reduces the need for other dosimetry techniques.
Area of Science:
- Medical Physics
- Radiation Oncology
- Medical Imaging
Background:
- Cherenkov imaging offers advanced radiotherapy treatment verification.
- Bilateral breast radiotherapy requires a planned medial gap to prevent beam overlap.
Purpose of the Study:
- To present the first in-vivo analysis of Cherenkov images in bilateral breast radiotherapy.
- To evaluate Cherenkov imaging for verifying the medial gap between opposing beams.
Main Methods:
- Patients received 3D conformal radiotherapy with a deep-inspiration breath hold technique.
- Cherenkov emissions were captured using a ceiling-mounted camera.
- Optical phantom experiments guided imaging threshold selection; gap size was measured in 3 patients over 23 fractions.
Main Results:
- Cherenkov imaging consistently showed a discernible medial gap across all fractions.
- Average minimum gap sizes in treatment plans were 1.1 cm, 1.0 cm, and 2.0 cm.
- In-vivo measurements showed average minimum gap sizes of 1.0 ± 0.4 cm, 0.9 ± 0.2 cm, and 2.0 ± 0.6 cm, with variability attributed to breath-hold differences.
Conclusions:
- Cherenkov imaging effectively verifies the daily medial field gap in bilateral breast radiotherapy.
- Offline review of Cherenkov images can provide feedback to prevent field overlap.
- This technique may reduce reliance on radiochromic film or in-vivo dosimetry.
