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Ionizing radiation acoustic beam localization: one step towards "proton surgery"
Wei Zhang1, Ibrahim Oraiqat2, Jiyeon Park3,4
1Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan.
Medrxiv : the Preprint Server for Health Sciences
|April 10, 2026
Summary
Researchers developed a novel radiation acoustic beam localization (iRABL) system to precisely track proton beams and map dose delivery in real-time during proton beam therapy (PBT). This breakthrough enables sub-millimeter accuracy for enhanced cancer treatment.
Area of Science:
- Medical Physics
- Radiation Oncology
- Biomedical Imaging
Background:
- Proton beam therapy (PBT) offers superior dose conformity for cancer treatment but faces limitations due to range uncertainties.
- Current PBT lacks real-time, pulse-by-pulse methods for tracking beam trajectory and mapping dose deposition within patients.
- Accurate localization is crucial for maximizing therapeutic efficacy and minimizing damage to healthy tissues during PBT.
Purpose of the Study:
- To develop and clinically demonstrate a novel radiation acoustic beam localization (iRABL) system for real-time monitoring of PBT.
- To enable precise tracking of pencil beam scanning (PBS) trajectories and mapping of dose deposition deep within patients.
- To address the fundamental limitations in current PBT monitoring for improved treatment accuracy and safety.
Main Methods:
- Development of a clinical-grade, compact iRABL system with high speed, super-resolution, and high sensitivity.
- Clinical feasibility validation through a first-in-human study on prostate cancer patients.
- Quantitative characterization of system performance using phantoms and clinical treatment plans, focusing on spatial resolution, imaging speed, and dosimetric accuracy.
Main Results:
- The iRABL system achieved sub-diffraction-limit displacement resolution (0.1 mm lateral, 0.2 mm axial), surpassing typical proton beam spot sizes.
- Enabled single-pulse detection at 1 kHz frame rate using GPU-accelerated reconstruction, matching PBS pulse repetition rates.
- Dosimetric validation demonstrated clinical accuracy with >90% gamma index passing rates (3 mm/3% tolerance) for M-shaped treatment plans.
Conclusions:
- The iRABL system provides the first real-time, pulse-by-pulse localization and dose mapping capability for PBS with clinical-grade accuracy.
- This technology overcomes fundamental limitations in PBT monitoring, offering sub-millimeter spatial resolution and high-speed imaging.
- The iRABL system holds significant promise for advancing PBT towards image-guided precision, akin to 'proton surgery'.
