Ultrahigh-resolution Cerenkov-light imaging system for positron radionuclides: potential applications and limitations

A review of recent and emerging approaches for the clinical application of Cerenkov luminescence imaging

Cerenkov luminescence (CL) is a blue-weighted emission of light produced by a vast array of clinically approved radioisotopes and LINAC accelerators. When β particles (emitted during the decay of radioisotopes) are present in a medium such as water or tissue, they are able to travel faster than the speed of light in that medium and in doing so polarize the molecules around them. Once the particle has left the local area, the polarized molecules relax and return to their baseline state releasing the additional energy as light (luminescence). This blue glow has commonly been used to determine the output of nuclear power plant cores and, in recent years, has found traction in the preclinical and clinical imaging field. This brief review will discuss the technology which has enabled the emergence of the biomedical Cerenkov imaging field, recent pre-clinical studies with potential clinical translation of Cerenkov luminescence imaging (CLI) and the current clinical implementations of the method. Finally, an outlook is given as to the direction in which the field is heading.

Comparison of the distributions of bremsstrahlung X-rays, Cerenkov light, and annihilation radiations for positron emitters

Positron emission tomography (PET) is a powerful tool because we can acquire functional information of tissue from the images with high sensitivity and relatively high spatial resolution. However, high-spatial-resolution PET imaging for high-energy positron emitters is difficult because the positrons have a long range and annihilation radiations are emitted at the endpoints of the positrons' trajectories. Along the trajectories, Cerenkov light (CL) is also emitted in advance of the emission of annihilation radiations. Hence, CL can be used for the imaging of high-energy positron emitters. Bremsstrahlung X-rays are also emitted along the trajectories of positrons, and imaging is possible. However, the differences in the spatial distributions of these three types of radiations are not obvious. Because CL and bremsstrahlung X-rays are produced before the endpoint of the positron, high-spatial-resolution imaging may be possible for high-energy positrons. In this study, to clarify this point, we simulated the spatial distribution of CL, bremsstrahlung X-rays, and annihilation radiations using Monte Carlo simulation and compared the distributions. The distributions of the bremsstrahlung X-rays and CL were smaller than those of the annihilation radiations in case of high energy positrons, and we found that the distributions of bremsstrahlung X-rays nearly matched those of CL for high-energy positron emitters. We concluded that CL and bremsstrahlung X-ray imaging have higher spatial resolution than annihilation radiation imaging for MeV ordered positron emitters, and thus they are promising for high-spatial-resolution imaging of high-energy positron emitters such as O-15 for ion therapy and Ga-68 for PET imaging.

Energy spread estimation of radioactive oxygen ion beams using optical imaging

Radioactive ion (RI) beams combined with in-beam positron emission tomography enable accurate in situ beam range verification in heavy ion therapy. However, the energy spread of the radioactive beams generated as secondary beams is wider than that of conventional stable heavy ion beams which causes Bragg peak region and distal falloff region broadening. Therefore, the energy spread of the RI beams should be measured carefully for their quality control. Here, we proposed an optical imaging technique for the energy spread estimation of radioactive oxygen ion beams. A polymethyl methacrylate phantom (10.0 × 10.0 × 9.9 cm3) was irradiated with an 15O beam (mean energy = 247.7 MeV u−1, standard deviation = 6.8 MeV u−1) in the Heavy Ion Medical Accelerator in Chiba. Three different momentum acceptances of 1%, 2% and 4% were used to get energy spreads of 1.9 MeV u−1, 3.4 MeV u−1 and 5.5 MeV u−1, respectively. The in-beam luminescence light and offline beam Cerenkov light images were acquired with an optical system consisting of a lens and a cooled charge-coupled device camera. To estimate the energy spread of the 15O ion beams, we proposed three optical parameters: (1) distal-50% falloff length of the prompt luminescence signals; (2) full-width at half maximum of the Cerenkov light signals in the beam direction; and (3) positional difference between the peaks of the Cerenkov light and the luminescence signals. These parameters estimated the energy spread with the respective mean squared errors of 2.52 × 10−3 MeV u−1, 5.91 × 10−3 MeV u−1, and 0.182 MeV u−1. The distal-50% falloff length of the luminescence signals provided the lowest mean squared error among the optical parameters. From the findings, we concluded optical imaging using luminescence and Cerenkov light signals offers an accurate energy spread estimation of 15O ion beams. In the future, the proposed optical parameters will be used for energy spread estimation of other RI beams as well as stable ion beams.

Discovery of the luminescence of water during irradiation of radiation at a lower energy than the Cherenkov light threshold

It is widely believed that light is not emitted in water during irradiation of radiation at energies lower than the Cherenkov light threshold. Contrary to this consensus, we discovered that light (luminescence) is emitted in water during irradiation of radiation, and imaging of this luminescence was possible. In this review, the author describes the optical images obtained for various types of radiation, their characteristics and origins, and potential applications of the luminescence of water during irradiation at a lower energy than the Cherenkov light threshold. The author also describes the luminescence of other transparent materials and future prospects of the discovered luminescence.

Estimation of the fractions of luminescence of water at higher energy than Cerenkov-light threshold for various types of radiation

Although the luminescence of water at a lower energy than the Cerenkov-light (CL) threshold has been found for various types of radiation, the fractions of the luminescence of water to the total produced light have not been obvious for radiations at a higher energy than the CL threshold because it is difficult to separate these two types of light. Thus, we used a Monte Carlo simulation to estimate the fractions of the luminescence of water for various types of radiation at a higher energy than the CL threshold to confirm the major component of the produced light. After we confirmed that the estimated light production of the luminescence of water could adequately simulate the experimental results, we calculated the produced light photons of this luminescence and the CL from water for protons (170 MeV), carbon ions (330 MeV/n), high-energy x-ray (6 MV) from a linear accelerator (LINAC), high-energy electrons (9 MeV) from LINAC, positrons (F-18, C-11, O-15, and N-13), and high-energy gamma photon radionuclides (Co-60). For protons, the major fraction of the produced light was the luminescence of water in addition to the CL from the prompt gamma photons produced by the nuclear interactions. For carbon ions, the major fraction of the produced light was the luminescence of water and the CL produced by the secondary electrons in addition to the prompt gamma photons produced by the nuclear interactions. For high-energy x-ray and electrons from LINAC, the fractions of luminescence of water were ∼0.1  %   to 0.2%. The fractions of luminescence of water for positrons were 0.2% to 1.5% and that for Co-60 was 0.4%. We conclude that the major fractions of light produced from x-ray and electrons from LINAC, positron radionuclides, and the Co-60 source are CL, with fractions of the luminescence of water from <0.1  %   to 1.5%.