Stereo Cherenkov imaging as 3D absolute dose monitoring tool for total skin electron therapy (TSET)

Cherenkov imaging provides a non-contact method for monitoring surface dose delivery during total skin electron therapy (TSET), where patients are treated in six postures using the Stanford standing technique. In this study, a multi-view Cherenkov imaging framework combined with patient-specific correction factors was investigated to improve quantitative three-dimensional (3D) surface dose estimation. Cherenkov emission was recorded during treatment using three synchronized time-gated cameras providing anterior and lateral coverage. Patient-specific anatomical models reconstructed from 3D surface scans were used to generate Monte Carlo (MC) reference dose distributions. Cherenkov images were corrected for background, camera response, and geometric distortions before conversion to pseudo-dose using in-vivo dosimetry calibration. Vertical Cherenkov intensity profiles were compared with MC dose profiles to derive patient-specific correction factors. Results showed that uncorrected Cherenkov-derived dose underestimated dose in distal and lateral body regions, while applying patient-specific corrections and multi-view imaging improved agreement with MC reference dose, supporting enhanced surface dose monitoring for TSET.