A GAMOS plug-in for GEANT4 based Monte Carlo simulation of radiation-induced light transport in biological media

Cherenkov light emission in external beam radiation therapy of the larynx

Significance

Cherenkov light emitted in the tissue during radiation therapy enables unprecedented approaches to tumor functional imaging for early treatment assessment. Cherenkov light-based tomographic imaging requires image reconstruction algorithms based on internal light sources that, in turn, require knowledge about the characteristics of the Cherenkov light within the patient.

Aim

We aim to investigate the spatial and spectral characteristics of Cherenkov light within the patient and at the patient's surface, and the origin within the tissue of light reaching the surface, to provide insight for the development of image reconstruction algorithms for Cherenkov light-based tomographic imaging.

Approach

Numerical experiments using clinical patient data and Monte Carlo simulations are performed for the radiation therapy of laryngeal cancer for intensity-modulated radiation therapy and volumetric-modulated arc radiation therapy.

Results

The emitted Cherenkov light is concentrated in regions of high delivered dose, with the spatial distribution within the patient and at the patient's surface depending on the treatment type and patient anatomy. The Cherenkov light at the patient's surface is dominant in the near-infrared spectral region. Light emitted within the tumor emerges at the patient's surface on a well-defined radiation beam-independent region. The distribution within the patient of the emitted light that emerges on reduced areas on the patient's surface containing this region is similar to that of the light that emerges across the entire patient's surface.

Conclusions

Detailed information about the spectral and spatial characteristics of Cherenkov light is provided. In addition, these results suggest that surface light measurements restricted to smaller areas containing the region where the light emitted in the tumor emerges (that can be determined through simulations prior to the treatment) could enable probing the tumor while being easier to integrate with the radiotherapy system and while the effect of measurement data incompleteness on image reconstruction may not be too strong.

Hybrid Monte Carlo model for efficient tissue Cherenkov emission estimation to assess changes from beam size, energy and incidence

PURPOSE

Cherenkov imaging in radiation therapy provides key knowledge of the delivery of treatment plans, but light-tissue interactions alter the emitted spectral signal and cause the modeling of emission relative to dose in highly modulated treatment plans to be complex.

METHODS

A 2-stage Monte Carlo approach to modeling Cherenkov emission was developed that leverages a traditional treatment planning system with an optical Monte Carlo simulation to provide a widely useable and efficient tool for modeling every beam control point for delivery interpretation of highly-modulated treatment plans. The emitted optical spectra were estimated for 6, 10, 15MV photon beams, 6 MeV electron beams, beam incidence in tissue, and square field sizes from 1 cm to 20 cm. The model was validated through comparison of measured Cherenkov emission from a blood and intralipid optical phantom.

RESULTS

The resulting hybrid model provides an efficient method of estimating Cherenkov emission for linac beams, showing a clear trend of decreasing emission intensity with increasing beam energy and strong emission intensity variation with beam type. The largest change in observed intensity was from altering field size, with a 76 % intensity decrease when going from 20 cm down to 1 cm square. The model showed agreement with experimental detected Cherenkov with an average percent difference of 6.2 % with the largest difference at the very smallest beam sizes.

CONCLUSION

The model potentially allows for modeling entire modulated treatment plans with high computational efficiency and is a key step to translate delivered dose and observed Cherenkov in highly modulated situations.

Evaluation of TOPAS MC tool performance in optical photon transport and radioluminescence-based dosimetry

Radiation therapy plays a pivotal role in modern cancer treatment, demanding precise and accurate dose delivery to tumor sites while minimizing harm to surrounding healthy tissues. Monte Carlo simulations have emerged as indispensable tools for achieving this precision, offering detailed insights into radiation transport and interaction at the subatomic level. As the use of scintillation and luminescence dosimetry becomes increasingly prevalent in radiation therapy, there arises a need for validated Monte Carlo tools tailored to optical photon transport applications. In this paper, an evaluation process of the TOPAS (TOol for PArticle Simulation) Monte Carlo tool for Cerenkov light generation, optical photon transport and radioluminescence based dosimetry is presented. Three distinct sources of validation data are utilized: one from a published set of experimental results and two others from simulations performed with the Geant4 code. The methodology employed for evaluation includes the selection of benchmark experiments, making use of opt3 and opt4 Geant4 physics models and simulation setup, with observed slight discrepancies within the calculation uncertainties. Additionally, the complexities and challenges associated with modeling optical photons generation through luminescence or Cerenkov radiation and their transport are discussed. The results of our evaluation suggests that TOPAS can be used to reliably predict Cerenkov generation, luminescence phenomenon and the behavior of optical photons in common dosimetry scenarios.

Image reconstruction in non-reciprocal broken-ray tomography

Optical methods of biomedical tomographic imaging are of considerable interest due to their non-invasive nature and sensitivity to physiologically important markers. Similarly to other imaging modalities, optical methods can be enhanced by utilizing extrinsic contrast agents. Typically, these are fluorescent molecules, which can aggregate in regions of interest due to various mechanisms. In the current approaches to imaging, the intrinsic (related to the tissue) and extrinsic (related to the contrast agent) optical parameters are determined separately. This can result in errors, in particular, due to using simplified heuristic models for the spectral dependence of the optical parameters. Recently, we have developed the theory of non-reciprocal broken-ray tomography (NRBRT) for fluorescence imaging of weakly scattering systems. NRBRT enables simultaneous reconstruction of the fluorophore concentration as well as of the intrinsic optical attenuation coefficient at both the excitation and the emission wavelengths. Importantly, no assumption about the spectral dependence of the tissue optical properties is made in NRBRT. In this study, we perform numerical validation of NRBRT under realistic conditions using the Monte Carlo method to generate forward data. We demonstrate that NRBRT can be used for tomographic imaging of samples of up to four scattering lengths in size. The effects of physical characteristics of the detectors such as the area and the acceptance angle are also investigated.

Meshless Monte Carlo radiation transfer method for curved geometries using signed distance functions

SIGNIFICANCE

Monte Carlo radiation transfer (MCRT) is the gold standard for modeling light transport in turbid media. Typical MCRT models use voxels or meshes to approximate experimental geometry. A voxel-based geometry does not allow for the precise modeling of smooth curved surfaces, such as may be found in biological systems or food and drink packaging. Mesh-based geometry allows arbitrary complex shapes with smooth curved surfaces to be modeled. However, mesh-based models also suffer from issues such as the computational cost of generating meshes and inaccuracies in how meshes handle reflections and refractions.

AIM

We present our algorithm, which we term signedMCRT (sMCRT), a geometry-based method that uses signed distance functions (SDF) to represent the geometry of the model. SDFs are capable of modeling smooth curved surfaces precisely while also modeling complex geometries.

APPROACH

We show that using SDFs to represent the problem's geometry is more precise than voxel and mesh-based methods.

RESULTS

sMCRT is validated against theoretical expressions, and voxel and mesh-based MCRT codes. We show that sMCRT can precisely model arbitrary complex geometries such as microvascular vessel network using SDFs. In comparison with the current state-of-the-art in MCRT methods specifically for curved surfaces, sMCRT is more precise for cases where the geometry can be defined using combinations of shapes.

CONCLUSIONS

We believe that SDF-based MCRT models are a complementary method to voxel and mesh models in terms of being able to model complex geometries and accurately treat curved surfaces, with a focus on precise simulation of reflections and refractions. sMCRT is publicly available at https://github.com/lewisfish/signedMCRT.

Cherenkov light emission in molecular radiation therapy of the thyroid and its application to dosimetry

Numerical experiments based on Monte Carlo simulations and clinical CT data are performed to investigate the spatial and spectral characteristics of Cherenkov light emission and the relationship between Cherenkov light intensity and deposited dose in molecular radiotherapy of hyperthyroidism and papillary thyroid carcinoma. It is found that Cherenkov light is emitted mostly in the treatment volume, the spatial distribution of Cherenkov light at the surface of the patient presents high-value regions at locations that depend on the symmetry and location of the treatment volume, and the surface light in the near-infrared spectral region originates from the treatment site. The effect of inter-patient variability in the tissue optical parameters and radioisotope uptake on the linear relationship between the dose absorbed by the treatment volume and Cherenkov light intensity at the surface of the patient is investigated, and measurements of surface light intensity for which this effect is minimal are identified. The use of Cherenkov light measurements at the patient surface for molecular radiation therapy dosimetry is also addressed.

Analysis of corrected Cerenkov emission during electron radiotherapy by Monte Carlo method

Cerenkov emission during electron radiotherapy had been emerging as a new dose assessment approach for clinical radiotherapy and could be imaged through a standard commercial camera. The purpose of this work aimed to study the accuracy of corrected Cerenkov emission method during electron radiotherapy by Monte Carlo (MC) method. GAMOS MC software was used to model the physics of electron therapy and calculated dose and Cerenkov photon distribution in water phantom. Compared to ionization chamber and diode measurement, MC simulated dose discrepancy was less than 1% in percentage depth dose (PDD) curves and less than. 2% in crossline profile curves, which was acceptable for clinical criterion. Compared to ionization chamber dose measurement, MC simulated Cerenkov discrepancy was less than 2% in crossline profile distribution, which was acceptable for clinical criterion. However, the Cerenkov PDD curves tended to overestimate the dose at the build-up region and underestimate the dose at the remaining attenuation region. After increasing the Cerenkov distribution depth to 2-3 mm, the discrepancy became well within 1% at the remaining attenuation region, which was acceptable for clinical criterion. Therefore, corrected Cerenkov emission could be used to assess PDD accuracy and crossline profile accuracy during electron radiotherapy.

Review of in vivo optical molecular imaging and sensing from x-ray excitation

SIGNIFICANCE

Deep-tissue penetration by x-rays to induce optical responses of specific molecular reporters is a new way to sense and image features of tissue function in vivo. Advances in this field are emerging, as biocompatible probes are invented along with innovations in how to optimally utilize x-ray sources.

AIM

A comprehensive review is provided of the many tools and techniques developed for x-ray-induced optical molecular sensing, covering topics ranging from foundations of x-ray fluorescence imaging and x-ray tomography to the adaptation of these methods for sensing and imaging in vivo.

APPROACH

The ways in which x-rays can interact with molecules and lead to their optical luminescence are reviewed, including temporal methods based on gated acquisition and multipoint scanning for improved lateral or axial resolution.

RESULTS

While some known probes can generate light upon x-ray scintillation, there has been an emergent recognition that excitation of molecular probes by x-ray-induced Cherenkov light is also possible. Emission of Cherenkov radiation requires a threshold energy of x-rays in the high kV or MV range, but has the advantage of being able to excite a broad range of optical molecular probes. In comparison, most scintillating agents are more readily activated by lower keV x-ray energies but are composed of crystalline inorganic constituents, although some organic biocompatible agents have been designed as well. Methods to create high-resolution structured x-ray-optical images are now available, based upon unique scanning approaches and/or a priori knowledge of the scanned x-ray beam geometry. Further improvements in spatial resolution can be achieved by careful system design and algorithm optimization. Current applications of these hybrid x-ray-optical approaches include imaging of tissue oxygenation and pH as well as of certain fluorescent proteins.

CONCLUSIONS

Discovery of x-ray-excited reporters combined with optimized x-ray scan sequences can improve imaging resolution and sensitivity.

Using Cherenkov imaging to monitor the match line between photon and electron radiation therapy fields on biological tissue phantoms

SIGNIFICANCE

Due to patients' respiratory movement or involuntary body movements during breast cancer radiotherapy, the mismatched adjacent fields in surface exposure regions could result in insufficient dosage or overdose in these regions, which would lead to tissue injury, excessive skin burns, and potential death. Cherenkov luminescence imaging (CLI) could be used to effectively detect the matching information of adjacent radiation fields without extra radiation or invasive imaging.

AIM

Our objective was to provide a biological experimental basis for monitoring matching of adjacent radiation fields between photon and electron fields due to introduced shifts during radiotherapy by CLI technique.

APPROACH

A medical accelerator was used to generate photon and electron fields. An industrial camera system was adopted to image the excited CLI signal during irradiation of chicken tissue with yellow (group A and group C experiments) or black color (group B experiment). The following introduced shifts were tested: 10, 5, 2, and 0 mm toward superior or inferior direction. A model was introduced to deal with matching error analysis of adjacent radiation fields due to introduced shifts with adapted plans used to treat neoplasms of the right breast with supraclavicular nodes or internal mammary lymph node.

RESULTS

The matching values between photon and electron fields were consistent with the tested introduced shifts during yellow chicken irradiation. In group A, average discrepancies were 0.59  ±  0.35  mm and 0.68  ±  0.37  mm for photon fields and electron fields in anterior/posterior (AP) direction, with 87% and 75% of measurement within 1 mm, respectively. In group C, average discrepancies were 0.80  ±  0.65  mm and 1.07  ±  0.57  mm for oblique photon field with gantry angles of 330 deg and 150 deg, with 66% and 65% of measurement within 1 mm, respectively. The average discrepancies were 0.44  ±  0.30  mm for electron field in the AP direction, with 94% of measurement within 1 mm. The matching error introduced by the proposed method was less than 1.5 mm for AP fields and 2 mm for oblique incidence fields. However, the field matching could not be monitored with black chicken tissue irradiation due to a weak CLI signal that could hardly be extracted from background noise in group B.

CONCLUSIONS

CLI is demonstrated for the quantitative monitoring of the field match line on light biological tissue phantoms and has potential for monitoring of field matching in surface tissue during breast cancer radiotherapy.

Theoretical lateral and axial sensitivity limits and choices of molecular reporters for Cherenkov-excited luminescence in tissue during x-ray beam scanning

PURPOSE

Unlike fluorescence imaging utilizing an external excitation source, Cherenkov emissions and Cherenkov-excited luminescence occur within a medium when irradiated with high-energy x-rays. Methods to improve the understanding of the lateral spread and axial depth distribution of these emissions are needed as an initial step to improve the overall system resolution.

METHODS

Monte Carlo simulations were developed to investigate the lateral spread of thin sheets of high-energy sources and compared to experimental measurements of similar sources in water. Additional simulations of a multilayer skin model were used to investigate the limits of detection using both 6- and 18-MV x-ray sources with fluorescence excitation for inclusion depths up to 1 cm.

RESULTS

Simulations comparing the lateral spread of high-energy sources show approximately 100  ×   higher optical yield from electrons than photons, although electrons showed a larger penumbra in both the simulations and experimental measurements. Cherenkov excitation has a roughly inverse wavelength squared dependence in intensity but is largely redshifted in excitation through any distance of tissue. The calculated emission spectra in tissue were convolved with a database of luminescent compounds to produce a computational ranking of potential Cherenkov-excited luminescence molecular contrast agents.

CONCLUSIONS

Models of thin x-ray and electron sources were compared with experimental measurements, showing similar trends in energy and source type. Surface detection of Cherenkov-excited luminescence appears to be limited by the mean free path of the luminescence emission, where for the given simulation only 2% of the inclusion emissions reached the surface from a depth of 7 mm in a multilayer tissue model.

Holistic Monte-Carlo optical modelling of biological imaging

The invention and advancement of biological microscopy depends critically on an ability to accurately simulate imaging of complex biological structures embedded within complex scattering media. Unfortunately no technique exists for rigorous simulation of the complete imaging process, including the source, instrument, sample and detector. Monte-Carlo modelling is the gold standard for the modelling of light propagation in tissue, but is somewhat laborious to implement and does not incorporate the rejection of scattered light by the microscope. On the other hand microscopes may be rigorously and rapidly modelled using commercial ray-tracing software, but excluding the interaction with the biological sample. We report a hybrid Monte-Carlo optical ray-tracing technique for modelling of complete imaging systems of arbitrary complexity. We make the software available to enable user-friendly and rigorous virtual prototyping of biological microscopy of arbitrary complexity involving light scattering, fluorescence, polarised light propagation, diffraction and coherence. Examples are presented for the modelling and optimisation of representative imaging of neural cells using light-sheet and micro-endoscopic fluorescence microscopy and imaging of retinal vasculature using confocal and non-confocal scanning-laser ophthalmoscopes.

Space-variant deconvolution of Cerenkov light images acquired from a curved surface

PURPOSE

Cerenkov photons are generated by high-energy radiation used in external beam radiation therapy (EBRT). This study expands upon the Cerenkov light dosimetry formula previously developed to relate an image of Cerenkov photons to the primary beam fluence. Extension of this formulation allows for deconvolution to be performed on images acquired from curved geometries.

METHODS

The integral equation, which represented the formation of Cerenkov photon image from an incident high-energy photon beam, was expanded to allow for space-variance of the convolution kernel called as the Cerenkov scatter function (CSF). The GAMOS (Geant4-based Architecture for Medicine-Oriented Simulations) Monte Carlo (MC) particle simulation software was used to obtain the CSF for different incident beam angles. The image of a curved surface was first projected to a flat plane by using a perspective correction method. Then, the planar image was partitioned into small segments (or blocks), where a CSF corresponding to a specific beam incident angle was applied for deconvolution. The block size and the margin around the block were optimized by studying the effects of those parameters on the deconvolution accuracy for a test image. We evaluated three deconvolution techniques: Richardson-Lucy, Blind, and Total Variation minimization (TV/L2) algorithms, to select the most accurate method for the current applications.

RESULTS

Analysis of deconvolution algorithms showed that the TV/L2 method provided the most accurate solution to the deconvolution problem for Cerenkov imaging. Optimization of space-variant deconvolution parameters showed that including a margin that is at least 42.9% of the image width provided the most accurate product image. There was no optimal size for the deconvolution area and should be chosen based on the presence of unique CSF kernels within an image. Space-variant deconvolution improved measured field size in Cerenkov photon images by 7.37%, as compared with 1.74% by space-invariant deconvolution. Space-variant deconvolution improved measured penumbra by 99.3%, as compared with 76.7% by space-invariant deconvolution. Space-variant deconvolution introduced artifacts in flat regions of the beam. Artifacts were avoided through selective space-variant deconvolution in only the penumbra region.

CONCLUSIONS

Primary photon fluence distributions of a curved surface can be obtained by using space-variant deconvolution methods in Cerenkov light dosimetry. The TV/L2 algorithm is the best method for deconvolution of Cerenkov photon images from an open-field beam derived from either a flat or curved surface. The partition size chosen for space-variant deconvolution should be at least six times the full width at half maximum (FWHM) of the corresponding scatter kernel used in deconvolution. Space-variant deconvolution is necessary if the incident beam angle difference is larger than 6 ∘ between regions of an image.

Modeling PpIX effective light fluence at depths into the skin for PDT dose comparison

BACKGROUND

Daylight-activated PDT has seen increased support in recent years as a treatment method for actinic keratosis and other non-melanoma skin cancers. The inherent variability observed in broad-spectrum light used in this methodology makes it difficult to plan and monitor light dose, or compare to lamp light doses.

METHODS

The present study expands on the commonly used PpIX-weighted effective surface irradiance metric by introducing a Monte Carlo method for estimating effective fluence rates into depths of the skin. The fluence rates are compared between multiple broadband and narrowband sources that have been reported in previous studies, and an effective total fluence for various treatment times is reported. A dynamic estimate of PpIX concentration produced during pro-drug incubation and treatment is used with the fluence estimates to calculate a photodynamic dose.

RESULTS

Even when there is up to a 5x reduction between the effective surface irradiance of the broadband light sources, the effective fluence below 250 μm depth is predicted to be relatively equivalent. An effective threshold fluence value (0. 70Jeff/cm2) is introduced based on a meta-analysis of previously published ALA-PpIX induced cell death. This was combined with a threshold PpIX concentration (50 nM) to define a threshold photodynamic dose of 0.035 u M Jeff/cm2.

CONCLUSIONS

The threshold was used to generate lookup tables to prescribe minimal treatment times to achieve depth-dependent cytotoxic effect based on incubation times and irradiance values for each light source.

Characterization of the Cerenkov scatter function: a convolution kernel for Cerenkov light dosimetry

Cerenkov light is created in clinical applications involving high-energy radiation such as in radiation therapy. There is considerable interest in using Cerenkov light as a means to perform in vivo dosimetry during radiation therapy; however, a better understanding of the light-to-dose relationship is needed. One such method to solve this relationship is that of a deconvolution formulation, which relies on the Cerenkov scatter function (CSF). The CSF describes the creation of Cerenkov photons by a pencil beam of high-energy radiation, and the subsequent scattering that occurs before emission from the irradiated medium surface. This study investigated the dependence of the CSF on common radiation beam parameters (beam energy and incident angle) and the type of irradiated medium. An analytical equation with fitting coefficients of the CSF was obtained for common beam energies in a stratified skin model and optical phantom. Perturbation analysis was performed to investigate the dependence of the deconvolved Cerenkov images on the full-width at half-maximum and amplitude of the CSF. The irradiated material and beam angle had a large impact on the deconvolution process, whereas the beam energy had little effect.

Theoretical investigation of ultrasound-modulated Cerenkov luminescence imaging for higher-resolution imaging in turbid media

Cerenkov luminescence imaging (CLI) is an optical technique for imaging radiolabeled molecules in vivo. It has demonstrated utility in both the clinical and preclinical settings and can serve as a substitute for nuclear imaging instrumentation in some cases. However, optical scattering fundamentally limits the resolution and depth of imaging that can be achieved with this modality. In this Letter, we report the numerical results that support the potential for ultrasound-modulated Cerenkov luminescence imaging (USCLI), a new imaging modality that can mitigate optical scattering. The technique uses an acoustic field to modulate the refractive index of the medium and, thus, the intensity of Cerenkov luminescence in a spatially precise manner. This mechanism of contrast has not been reported previously. For a physiologically compatible ultrasound peak pressure of 1 MPa, ∼0.1% of the Cerenkov signal can be modulated. Furthermore, our simulations show that USCLI can overcome the scattering limit of resolution for CLI and provide higher-resolution imaging. For an F18 point source centered in a 1  cm³ simulated tissue phantom with a scattering coefficient of μs'=10  cm^-1, <2  mm full width at half-maximum lateral spatial resolution is possible, a resolution three times finer than the same phantom imaged with CLI.

Technical Note: On maximizing Cherenkov emissions from medical linear accelerators

PURPOSE

Cherenkov light during MV radiotherapy has recently found imaging and therapeutic applications but is challenged by relatively low fluence. Our purpose is to investigate the feasibility of increasing Cherenkov light production during MV radiotherapy by increasing photon energy and applying specialized beam-hardening filtration.

METHODS

GAMOS 5.0.0, a GEANT4-based framework for Monte Carlo simulations, was used to model standard clinical linear accelerator primary photon beams. The photon source was incident upon a 17.8 cm³ cubic water phantom with a 94 cm source to surface distance. Dose and Cherenkov production was determined at depths of 3-9 cm. Filtration was simulated 15 cm below the photon beam source. Filter materials included aluminum, iron, and copper with thicknesses of 2-20 cm. Histories used depended on the level of attenuation from the filter, ranging from 100 million to 2 billion. Comparing average dose per history also allowed for evaluation of dose-rate reduction for different filters.

RESULTS

Overall, increasing photon beam energy is more effective at improving Cherenkov production per unit dose than is filtration, with a standard 18 MV beam yielding 3.3-4.0× more photons than 6 MV. Introducing an aluminum filter into an unfiltered 2400 cGy/min 10 MV beam increases the Cherenkov production by 1.6-1.7×, while maintaining a clinical dose rate of 300 cGy/min, compared to increases of ~1.5× for iron and copper. Aluminum was also more effective than the standard flattening filter, with the increase over the unfiltered beam being 1.4-1.5× (maintaining 600 cGy/min dose rate) vs 1.3-1.4× for the standard flattening filter. Applying a 10 cm aluminum filter to a standard 18 MV, photon beam increased the Cherenkov production per unit dose to 3.9-4.3× beyond that of 6 MV (vs 3.3-4.0× for 18 MV with no aluminum filter).

CONCLUSIONS

Through a combination of increasing photon energy and applying specialized beam-hardening filtration, the amount of Cherenkov photons per unit radiotherapy dose can be increased substantially.

Remote Cherenkov imaging-based quality assurance of a magnetic resonance image-guided radiotherapy system

PURPOSE

Tools to perform regular quality assurance of magnetic resonance image-guided radiotherapy (MRIgRT) systems should ideally be independent of interference from the magnetic fields. Remotely acquired optical Cherenkov imaging-based dosimetry measurements in water were investigated for this purpose, comparing measures of dose accuracy, temporal dynamics, and overall integrated IMRT delivery.

METHODS

A 40 × 30.5 × 37.5 cm3 water tank doped with 1 g/L of quinine sulfate was imaged using an intensified charge-coupled device (ICCD) to capture the Cherenkov emission while being irradiated by a commercial MRIgRT system (ViewRay™). The ICCD was placed down-bore at the end of the couch, 4 m from treatment isocenter and behind the 5-Gauss line of the 0.35-T MRI. After establishing optimal camera acquisition settings, square beams of increasing size (4.2 × 4.2 cm2 , 10.5 × 10.5 cm2 , and 14.7 × 14.7 cm2 ) were imaged at 0.93 frames per second, from an individual cobalt-60 treatment head, to develop projection measures related to percent depth dose (PDD) curves and cross beam profiles (CPB). These Cherenkov-derived measurements were compared to ionization chamber (IC) and radiographic film dosimetry data, as well as simulation data from the treatment planning system (TPS). An intensity-modulated radiotherapy (IMRT) commissioning plan from AAPM TG-119 (C4:C-Shape) was also imaged at 2.1 frames per second, and the single linear sum image from 509 s of plan delivery was compared to the dose volume prediction generated by the TPS using gamma index analysis.

RESULTS

Analysis of standardized test target images (1024 × 1024 pixels) yielded a pixel resolution of 0.37 mm/pixel. The beam width measured from the Cherenkov image-generated projection CBPs was within 1 mm accuracy when compared to film measurements for all beams. The 502 point measurements (i.e., pixels) of the Cherenkov image-based projection percent depth dose curves (pPDDs) were compared to pPDDs simulated by the treatment planning system (TPS), with an overall average error of 0.60%, 0.56%, and 0.65% for the 4.2, 10.5, and 14.7 cm square beams, respectively. The relationships between pPDDs and central axis PDDs derived from the TPS were used to apply a weighting factor to the Cherenkov pPDD, so that the Cherenkov data could be directly compared to IC PDDs (average error of -0.07%, 0.10%, and -0.01% for the same sized beams, respectively). Finally, the composite image of the TG-119 C4 treatment plan achieved a 95.1% passing rate using 4%/4 mm gamma index agreement criteria between Cherenkov intensity and TPS dose volume data.

CONCLUSIONS

This is the first examination of Cherenkov-generated pPDDs and pCBPs in an MR-IGRT system. Cherenkov imaging measurements were fast to acquire, and minimal error was observed overall. Cherenkov imaging also provided novel real-time data for IMRT QA. The strengths of this imaging are the rapid data capture ability providing real-time, high spatial resolution data, combined with the remote, noncontact nature of imaging. The biggest limitation of this method is the two-dimensional (2D) projection-based imaging of three-dimensional (3D) dose distributions through the transparent water tank.

A mathematical deconvolution formulation for superficial dose distribution measurement by Cerenkov light dosimetry

PURPOSE

Cerenkov photons are created by high-energy radiation beams used for radiation therapy. In this study, we developed a Cerenkov light dosimetry technique to obtain a two-dimensional dose distribution in a superficial region of medium from the images of Cerenkov photons by using a deconvolution method.

METHODS

An integral equation was derived to represent the Cerenkov photon image acquired by a camera for a given incident high-energy photon beam by using convolution kernels. Subsequently, an equation relating the planar dose at a depth to a Cerenkov photon image using the well-known relationship between the incident beam fluence and the dose distribution in a medium was obtained. The final equation contained a convolution kernel called the Cerenkov dose scatter function (CDSF). The CDSF function was obtained by deconvolving the Cerenkov scatter function (CSF) with the dose scatter function (DSF). The GAMOS (Geant4-based Architecture for Medicine-Oriented Simulations) Monte Carlo particle simulation software was used to obtain the CSF and DSF. The dose distribution was calculated from the Cerenkov photon intensity data using an iterative deconvolution method with the CDSF. The theoretical formulation was experimentally evaluated by using an optical phantom irradiated by high-energy photon beams.

RESULTS

The intensity of the deconvolved Cerenkov photon image showed linear dependence on the dose rate and the photon beam energy. The relative intensity showed a field size dependence similar to the beam output factor. Deconvolved Cerenkov images showed improvement in dose profiles compared with the raw image data. In particular, the deconvolution significantly improved the agreement in the high dose gradient region, such as in the penumbra. Deconvolution with a single iteration was found to provide the most accurate solution of the dose. Two-dimensional dose distributions of the deconvolved Cerenkov images agreed well with the reference distributions for both square fields and a multileaf collimator (MLC) defined, irregularly shaped field.

CONCLUSIONS

The proposed technique improved the accuracy of the Cerenkov photon dosimetry in the penumbra region. The results of this study showed initial validation of the deconvolution method for beam profile measurements in a homogeneous media. The new formulation accounted for the physical processes of Cerenkov photon transport in the medium more accurately than previously published methods.

Signal intensity analysis and optimization for in vivo imaging of Cherenkov and excited luminescence

During external beam radiotherapy (EBRT), in vivo Cherenkov optical emissions can be used as a dosimetry tool or to excite luminescence, termed Cherenkov-excited luminescence (CEL) with microsecond-level time-gated cameras. The goal of this work was to develop a complete theoretical foundation for the detectable signal strength, in order to provide guidance on optimization of the limits of detection and how to optimize near real time imaging. The key parameters affecting photon production, propagation and detection were considered and experimental validation with both tissue phantoms and a murine model are shown. Both the theoretical analysis and experimental data indicate that the detection level is near a single photon-per-pixel for the detection geometry and frame rates commonly used, with the strongest factor being the signal decrease with the square of distance from tissue to camera. Experimental data demonstrates how the SNR improves with increasing integration time, but only up to the point where the dominance of camera read noise is overcome by stray photon noise that cannot be suppressed. For the current camera in a fixed geometry, the signal to background ratio limits the detection of light signals, and the observed in vivo Cherenkov emission is on the order of 100×  stronger than CEL signals. As a result, imaging signals from depths  <15 mm is reasonable for Cherenkov light, and depths  <3 mm is reasonable for CEL imaging. The current investigation modeled Cherenkov and CEL imaging of two oxygen sensing phosphorescent compounds, but the modularity of the code allows for easy comparison of different agents or alternative cameras, geometries or tissues.

Monte Carlo simulations support non-Cerenkov radioluminescence production in tissue

There is experimental evidence for the production of non-Cerenkov radioluminescence in a variety of materials, including tissue. We constructed a Geant4 Monte Carlo simulation of the radiation from P32 and Tc99m interacting in chicken breast and used experimental imaging data to model a scintillation-like emission. The same radioluminescence spectrum is visible from both isotopes and cannot otherwise be explained through fluorescence or filter miscalibration. We conclude that chicken breast has a near-infrared scintillation-like response with a light yield three orders of magnitude smaller than BGO.

Beam and tissue factors affecting Cherenkov image intensity for quantitative entrance and exit dosimetry on human tissue

This study's goal was to determine how Cherenkov radiation emission observed in radiotherapy is affected by predictable factors expected in patient imaging. Factors such as tissue optical properties, radiation beam properties, thickness of tissues, entrance/exit geometry, curved surface effects, curvature and imaging angles were investigated through Monte Carlo simulations. The largest physical cause of variation of the correlation ratio between of Cherenkov emission and dose was the entrance/exit geometry (˜50%). The largest human tissue effect was from different optical properties (˜45%). Beyond these, clinical beam energy varies the correlation ratio significantly (˜20% for X-ray beams), followed by curved surfaces (˜15% for X-ray beams and ˜8% for electron beams), and finally, the effect of field size (˜5% for X-ray beams). Other investigated factors which caused variations less than 5% were tissue thicknesses and source to surface distance. The effect of non-Lambertian emission was negligible for imaging angles smaller than 60 degrees. The spectrum of Cherenkov emission tends to blue-shift along the curved surface. A simple normalization approach based on the reflectance image was experimentally validated by imaging a range of tissue phantoms, as a first order correction for different tissue optical properties.

Quantitative assessment of Cerenkov luminescence for radioguided brain tumor resection surgery

Cerenkov luminescence imaging (CLI) is a developing imaging modality that detects radiolabeled molecules via visible light emitted during the radioactive decay process. We used a Monte Carlo based computer simulation to quantitatively investigate CLI compared to direct detection of the ionizing radiation itself as an intraoperative imaging tool for assessment of brain tumor margins. Our brain tumor model consisted of a 1 mm spherical tumor remnant embedded up to 5 mm in depth below the surface of normal brain tissue. Tumor to background contrast ranging from 2:1 to 10:1 were considered. We quantified all decay signals (e^±, gamma photon, Cerenkov photons) reaching the brain volume surface. CLI proved to be the most sensitive method for detecting the tumor volume in both imaging and non-imaging strategies as assessed by contrast-to-noise ratio and by receiver operating characteristic output of a channelized Hotelling observer.

Near infrared spectroscopy for body fat sensing in neonates: quantitative analysis by GAMOS simulations

BACKGROUND

Under-nutrition in neonates is closely linked to low body fat percentage. Undernourished neonates are exposed to immediate mortality as well as unwanted health impacts in their later life including obesity and hypertension. One potential low cost approach for obtaining direct measurements of body fat is near-infrared (NIR) interactance. The aims of this study were to model the effect of varying volume fractions of melanin and water in skin over NIR spectra, and to define sensitivity of NIR reflection on changes of thickness of subcutaneous fat. GAMOS simulations were used to develop two single fat layer models and four complete skin models over a range of skin colour (only for four skin models) and hydration within a spectrum of 800-1100 nm. The thickness of the subcutaneous fat was set from 1 to 15 mm in 1 mm intervals in each model.

RESULTS

Varying volume fractions of water in skin resulted minimal changes of NIR intensity at ranges of wavelengths from 890 to 940 nm and from 1010 to 1100 nm. Variation of the melanin volume in skin meanwhile was found to strongly influence the NIR intensity and sensitivity. The NIR sensitivities and NIR intensity over thickness of fat decreased from the Caucasian skin to African skin throughout the range of wavelengths. For the relationship between the NIR reflection and the thickness of subcutaneous fat, logarithmic relationship was obtained.

CONCLUSIONS

The minimal changes of NIR intensity values at wavelengths within the ranges from 890 to 940 nm and from 1010 to 1100 nm to variation of volume fractions of water suggests that wavelengths within those two ranges are considered for use in measurement of body fat to solve the variation of hydration in neonates. The stronger influence of skin colour on NIR shows that the melanin effect needs to be corrected by an independent measurement or by a modeling approach. The logarithmic response obtained with higher sensitivity at the lower range of thickness of fat suggests that implementation of NIRS may be suited for detecting under-nutrition and monitoring nutritional interventions for malnutrition in neonates in resource-constrained communities.

Assessing the imaging performance of light sheet microscopies in highly scattering tissues

Light sheet microscopy (LSM) has emerged as an optical-imaging method for high spatiotemporal volumetric imaging of relatively transparent samples. While this capability has allowed the technique to be highly impactful in fields such as developmental biology, applications involving highly scattering thick tissues have been largely unexplored. Herein, we employ Monte Carlo simulations to explore the use of LSM for imaging turbid media. In particular, due to its similarity to dual-axis confocal (DAC) microscopy, we compare LSM performance to point-scanned (PS-DAC) and line-scanned (LS-DAC) dual-axis confocal microscopy techniques that have been previously shown to produce high-quality images at round-trip optical lengths of ~9 - 10 and ~3 - 4 respectively. The results of this study indicate that LSM using widefield collection (WF-LSM) provides comparable performance to LS-DAC in thick tissues, due to the fact that they both utilize an illumination beam focused in one dimension (i.e. a line or sheet). On the other hand, LSM using confocal line detection (CL-LSM) is more analogous to PS-DAC microscopy, in which the illumination beam is focused in two dimensions to a point. The imaging depth of LSM is only slightly inferior to DAC (~2 - 3 and ~6 - 7 optical lengths for WF-LSM and CL-LSM respectively) due to the use of a lower numerical aperture (NA) illumination beam for extended imaging along the illumination axis. Therefore, we conclude that the ability to image deeply is dictated most by the confocality of the microscope technique. In addition, we find that imaging resolution is mostly dependent on the collection NA, and is relatively invariant to imaging depth in a homogeneous scattering medium. Our results indicate that superficial imaging of highly scattering tissues using light sheet microscopy is possible.

Cherenkov radiation fluence estimates in tissue for molecular imaging and therapy applications

Cherenkov radiation has recently emerged as an interesting phenomenon for a number of applications in the biomedical sciences. Its unique properties, including broadband emission spectrum, spectral weight in the ultraviolet and blue wavebands, and local generation of light within a given tissue, have made it an attractive new source of light within tissue for molecular imaging and phototherapy applications. While several studies have investigated the total Cherenkov light yield from radionuclides in units of [photons/decay], further consideration of the light propagation in tissue is necessary to fully consider the utility of this signal in vivo. Therefore, to help further guide the development of this novel field, quantitative estimates of the light fluence rate of Cherenkov radiation from both radionuclides and radiotherapy beams in a biological tissue are presented for the first time. Using Monte Carlo simulations, these values were found to be on the order of 0.01-1 nW cm(-2) per MBq g(-1) for radionuclides, and 1-100 μW cm(-2) per Gy s(-1) for external radiotherapy beams, dependent on the given waveband, optical properties, and radiation source. For phototherapy applications, the total light fluence was found to be on the order of nJ cm(-2) for radionuclides, and mJ cm(-2) for radiotherapy beams. The results indicate that diagnostic potential is reasonable for Cherenkov excitation of molecular probes, but phototherapy may remain elusive at such exceedingly low fluence values. The results of this study are publicly available for distribution online at www.dartmouth.edu/optmed/.

Macroscopic optical imaging technique for wide-field estimation of fluorescence depth in optically turbid media for application in brain tumor surgical guidance

A diffuse imaging method is presented that enables wide-field estimation of the depth of fluorescent molecular markers in turbid media by quantifying the deformation of the detected fluorescence spectra due to the wavelength-dependent light attenuation by overlying tissue. This is achieved by measuring the ratio of the fluorescence at two wavelengths in combination with normalization techniques based on diffuse reflectance measurements to evaluate tissue attenuation variations for different depths. It is demonstrated that fluorescence topography can be achieved up to a 5 mm depth using a near-infrared dye with millimeter depth accuracy in turbid media having optical properties representative of normal brain tissue. Wide-field depth estimates are made using optical technology integrated onto a commercial surgical microscope, making this approach feasible for real-world applications.

Simulation-based optimization of a near-infrared spectroscopic subcutaneous fat thickness measuring device

Using Monte Carlo simulations we optimized the wavelength and source-detector distance (SDD) of a reflectance-based spectroscopic device used for measuring subcutaneous fat thickness. As the optical properties of muscle, fat and dermis are wavelength dependent, it is necessary to choose a wavelength that is highly sensitive to fat but insensitive to water and melanin. The SDD is important since it determines average photon penetration depth. With a tissue optics plug-in for the GEANT4/GAMOS system and published ex vivo tissue optical properties we were able to predict the behavior of different device configurations when used with varying thicknesses of fat, melanin concentrations or hydration levels. Our results indicate that the ideal wavelengths for fat measurement are 630-650 nm with an SDD of 2.6-29 cm. We also examined the potential of using near infrared (NIR) spectroscopy to determine tissue hydration levels, but concluded that this wavelength range was not ideal.

Pixel-based absorption correction for dual-tracer fluorescence imaging of receptor binding potential

Ratiometric approaches to quantifying molecular concentrations have been used for decades in microscopy, but have rarely been exploited in vivo until recently. One dual-tracer approach can utilize an untargeted reference tracer to account for non-specific uptake of a receptor-targeted tracer, and ultimately estimate receptor binding potential quantitatively. However, interpretation of the relative dynamic distribution kinetics is confounded by differences in local tissue absorption at the wavelengths used for each tracer. This study simulated the influence of absorption on fluorescence emission intensity and depth sensitivity at typical near-infrared fluorophore wavelength bands near 700 and 800 nm in mouse skin in order to correct for these tissue optical differences in signal detection. Changes in blood volume [1-3%] and hemoglobin oxygen saturation [0-100%] were demonstrated to introduce substantial distortions to receptor binding estimates (error > 30%), whereas sampled depth was relatively insensitive to wavelength (error < 6%). In response, a pixel-by-pixel normalization of tracer inputs immediately post-injection was found to account for spatial heterogeneities in local absorption properties. Application of the pixel-based normalization method to an in vivo imaging study demonstrated significant improvement, as compared with a reference tissue normalization approach.

Cherenkov excited phosphorescence-based pO2 estimation during multi-beam radiation therapy: phantom and simulation studies

Megavoltage radiation beams used in External Beam Radiotherapy (EBRT) generate Cherenkov light emission in tissues and equivalent phantoms. This optical emission was utilized to excite an oxygen-sensitive phosphorescent probe, PtG4, which has been developed specifically for NIR lifetime-based sensing of the partial pressure of oxygen (pO2). Phosphorescence emission, at different time points with respect to the excitation pulse, was acquired by an intensifier-gated CCD camera synchronized with radiation pulses delivered by a medical linear accelerator. The pO2 distribution was tomographically recovered in a tissue-equivalent phantom during EBRT with multiple beams targeted from different angles at a tumor-like anomaly. The reconstructions were tested in two different phantoms that have fully oxygenated background, to compare a fully oxygenated and a fully deoxygenated inclusion. To simulate a realistic situation of EBRT, where the size and location of the tumor is well known, spatial information of a prescribed region was utilized in the recovery estimation. The phantom results show that region-averaged pO2 values were recovered successfully, differentiating aerated and deoxygenated inclusions. Finally, a simulation study was performed showing that pO2 in human brain tumors can be measured to within 15 mmHg for edge depths less than 10-20 mm using the Cherenkov Excited Phosphorescence Oxygen imaging (CEPhOx) method and PtG4 as a probe. This technique could allow non-invasive monitoring of pO2 in tumors during the normal process of EBRT, where beams are generally delivered from multiple angles or arcs during each treatment fraction.

Optical dosimetry of radiotherapy beams using Cherenkov radiation: the relationship between light emission and dose

Recent studies have proposed that light emitted by the Cherenkov effect may be used for a number of radiation therapy dosimetry applications. There is a correlation between the captured light and expected dose under certain conditions, yet discrepancies have also been observed and a complete examination of the theoretical differences has not been done. In this study, a fundamental comparison between the Cherenkov emission and absorbed dose was explored for x-ray photons, electrons, and protons using both a theoretical and Monte Carlo-based analysis. Based on the findings of where dose correlates with Cherenkov emission, it was concluded that for x-ray photons the light emission would be optimally suited for narrow beam stereotactic radiation therapy and surgery validation studies, for verification of dynamic intensity-modulated and volumetric modulated arc therapy treatment plans in water tanks, near monoenergetic sources (e.g., Co-60 and brachy therapy sources) and also for entrance and exit surface imaging dosimetry of both narrow and broad beams. For electron use, Cherenkov emission was found to be only suitable for surface dosimetry applications. Finally, for proton dosimetry, there exists a fundamental lack of Cherenkov emission at the Bragg peak, making the technique of little use, although post-irradiation detection of light emission from radioisotopes could prove to be useful.

Monte Carlo simulation of laser beams interaction with the human eye using Geant4

Background

Due to the unique characteristics of the eye, ophthalmologic diagnostic techniques often rely on the photons interaction with the retina to infer its internal structure. Although these techniques are widely used, the interpretation of the generated images is not always fully understood, as in scanning laser ophthalmoscopy dark field imaging. This limits the exploitation of its full potential as a diagnostic tool for deep abnormalities in the retina, as in the situation of drusen.

Methods

With the aim of better understanding the retinal diagnostic images, we have carried out computer simulations of incident laser beams interacting with different structures of the human eye, including a retina with and without drusen. We have used the Geant4 simulation toolkit, applying the optical package of the electromagnetic (EM) physics working group, to simulate the physical processes of reflection, refraction, absorption, and scattering of low energy photons (2 eV) in biological tissues. For each simulation it was used a single beam of orange light, with a Gaussian profile, that travels through all optical elements of the eye. The reflected beam characteristics were analyzed by virtual detectors in different locations, which collected information about the number and position of photons. The geometry and optical properties of all components of the eye were considered according to the published data.

Results

Simulation results put in evidence that the presence of drusen influences the profile of the reflected beams. It changes the mean free path of the photons, modifying its reflection pattern, which depends on the area illuminated by the incident beam. This result is also visible when the reflected beam is analyzed outside of the eye, when the profile has no longer a symmetrical Gaussian distribution. These results will support the retinal diagnostic images that will be obtained in a near future with a new developed ophthalmic apparatus.

Conclusions

The shape analysis of the reflected beams in retinal laser scanning techniques could increase its potential as a diagnostic examination tool for the deeper structures of the retina.

Superficial dosimetry imaging based on Čerenkov emission for external beam radiotherapy with megavoltage x-ray beam

PURPOSE

Čerenkov radiation emission occurs in all tissue, when charged particles (either primary or secondary) travel at velocity above the threshold for the Čerenkov effect (about 220 KeV in tissue for electrons). This study presents the first examination of optical Čerenkov emission as a surrogate for the absorbed superficial dose for MV x-ray beams.

METHODS

In this study, Monte Carlo simulations of flat and curved surfaces were studied to analyze the energy spectra of charged particles produced in different regions near the surfaces when irradiated by MV x-ray beams. Čerenkov emission intensity and radiation dose were directly simulated in voxelized flat and cylindrical phantoms. The sampling region of superficial dosimetry based on Čerenkov radiation was simulated in layered skin models. Angular distributions of optical emission from the surfaces were investigated. Tissue mimicking phantoms with flat and curved surfaces were imaged with a time domain gating system. The beam field sizes (50 × 50-200 × 200 mm(2)), incident angles (0°-70°) and imaging regions were all varied.

RESULTS

The entrance or exit region of the tissue has nearly homogeneous energy spectra across the beam, such that their Čerenkov emission is proportional to dose. Directly simulated local intensity of Čerenkov and radiation dose in voxelized flat and cylindrical phantoms further validate that this signal is proportional to radiation dose with absolute average discrepancy within 2%, and the largest within 5% typically at the beam edges. The effective sampling depth could be tuned from near 0 up to 6 mm by spectral filtering. The angular profiles near the theoretical Lambertian emission distribution for a perfect diffusive medium, suggesting that angular correction of Čerenkov images may not be required even for curved surface. The acquisition speed and signal to noise ratio of the time domain gating system were investigated for different acquisition procedures, and the results show there is good potential for real-time superficial dose monitoring. Dose imaging under normal ambient room lighting was validated, using gated detection and a breast phantom.

CONCLUSIONS

This study indicates that Čerenkov emission imaging might provide a valuable way to superficial dosimetry imaging in real time for external beam radiotherapy with megavoltage x-ray beams.

Monte Carlo simulation of light transport in turbid medium with embedded object--spherical, cylindrical, ellipsoidal, or cuboidal objects embedded within multilayered tissues

Monte Carlo modeling of light transport in multilayered tissue (MCML) is modified to incorporate objects of various shapes (sphere, ellipsoid, cylinder, or cuboid) with a refractive-index mismatched boundary. These geometries would be useful for modeling lymph nodes, tumors, blood vessels, capillaries, bones, the head, and other body parts. Mesh-based Monte Carlo (MMC) has also been used to compare the results from the MCML with embedded objects (MCML-EO). Our simulation assumes a realistic tissue model and can also handle the transmission/reflection at the object-tissue boundary due to the mismatch of the refractive index. Simulation of MCML-EO takes a few seconds, whereas MMC takes nearly an hour for the same geometry and optical properties. Contour plots of fluence distribution from MCML-EO and MMC correlate well. This study assists one to decide on the tool to use for modeling light propagation in biological tissue with objects of regular shapes embedded in it. For irregular inhomogeneity in the model (tissue), MMC has to be used. If the embedded objects (inhomogeneity) are of regular geometry (shapes), then MCML-EO is a better option, as simulations like Raman scattering, fluorescent imaging, and optical coherence tomography are currently possible only with MCML.

Extension of the GATE Monte-Carlo simulation package to model bioluminescence and fluorescence imaging

The Geant4 Application for Emission Tomography (GATE) is an advanced open-source software dedicated to Monte-Carlo (MC) simulations in medical imaging involving photon transportation (Positron emission tomography, single photon emission computed tomography, computed tomography) and in particle therapy. In this work, we extend the GATE to support simulations of optical imaging, such as bioluminescence or fluorescence imaging, and validate it against the MC for multilayered media standard simulation tool for biomedical optics in simple geometries. A full simulation set-up for molecular optical imaging (bioluminescence and fluorescence) is implemented in GATE, and images of the light distribution emitted from a phantom demonstrate the relevance of using GATE for optical imaging simulations.

Dual-channel red/blue fluorescence dosimetry with broadband reflectance spectroscopic correction measures protoporphyrin IX production during photodynamic therapy of actinic keratosis

Dosimetry for aminolevulinic acid (ALA)-induced protoporphyrin IX (PpIX) photodynamic therapy of actinic keratosis was examined with an optimized fluorescence dosimeter to measure PpIX during treatment. While insufficient PpIX generation may be an indicator of incomplete response, there exists no standardized method to quantitate PpIX production at depths in the skin during clinical treatments. In this study, a spectrometer-based point probe dosimeter system was used to sample PpIX fluorescence from superficial (blue wavelength excitation) and deeper (red wavelength excitation) tissue layers. Broadband white light spectroscopy (WLS) was used to monitor aspects of vascular physiology and inform a correction of fluorescence for the background optical properties. Measurements in tissue phantoms showed accurate recovery of blood volume fraction and reduced scattering coefficient from WLS, and a linear response of PpIX fluorescence versus concentration down to 1.95 and 250 nM for blue and red excitations, respectively. A pilot clinical study of 19 patients receiving 1-h ALA incubation before treatment showed high intrinsic variance in PpIX fluorescence with a standard deviation/mean ratio of > 0.9. PpIX fluorescence was significantly higher in patients reporting higher pain levels on a visual analog scale. These pilot data suggest that patient-specific PpIX quantitation may predict outcome response.

Photons across medicine: relating optical and nuclear imaging

The Optics in the Life Sciences conference sponsored by the Optical Society of America was held in Waikoloa Beach, HI on April 14 - 18, 2013. Papers were presented in the areas of Bio-Optics: Design & Application, Novel Techniques in Microscopy, Optical Molecular Probes, Imaging & Drug Delivery, and Optical Trapping Applications. A focal point of the meeting was a special symposium entitled "Photons Across Medicine", organized by Adam Wax, Duke University, highlighting activities of joint interest between the Optical Society of America (OSA) and the Society for Nuclear Medicine and Molecular Imaging (SNMMI). This paper is a synopsis of the presentations made at this joint symposium. Central to the special symposium presentations was the fact that the optical and nuclear imaging communities share common interests and challenges. These are highlighted in this article. Also discussed was the fact that the nuclear technologies in imaging have found their way into general clinical utility, a feat that has yet to be achieved by optical methods. Because of the common ground shared by the two technologies, coordination between the two societies should be planned.

Accelerated rescaling of single Monte Carlo simulation runs with the Graphics Processing Unit (GPU)

To interpret fiber-based and camera-based measurements of remitted light from biological tissues, researchers typically use analytical models, such as the diffusion approximation to light transport theory, or stochastic models, such as Monte Carlo modeling. To achieve rapid (ideally real-time) measurement of tissue optical properties, especially in clinical situations, there is a critical need to accelerate Monte Carlo simulation runs. In this manuscript, we report on our approach using the Graphics Processing Unit (GPU) to accelerate rescaling of single Monte Carlo runs to calculate rapidly diffuse reflectance values for different sets of tissue optical properties. We selected MATLAB to enable non-specialists in C and CUDA-based programming to use the generated open-source code. We developed a software package with four abstraction layers. To calculate a set of diffuse reflectance values from a simulated tissue with homogeneous optical properties, our rescaling GPU-based approach achieves a reduction in computation time of several orders of magnitude as compared to other GPU-based approaches. Specifically, our GPU-based approach generated a diffuse reflectance value in 0.08ms. The transfer time from CPU to GPU memory currently is a limiting factor with GPU-based calculations. However, for calculation of multiple diffuse reflectance values, our GPU-based approach still can lead to processing that is ~3400 times faster than other GPU-based approaches.

Superficial dosimetry imaging of Čerenkov emission in electron beam radiotherapy of phantoms

Čerenkov emission is generated from ionizing radiation in tissue above 264 keV energy. This study presents the first examination of this optical emission as a surrogate for the absorbed superficial dose. Čerenkov emission was imaged from the surface of flat tissue phantoms irradiated with electrons, using a range of field sizes from 6 cm × 6 cm to 20 cm × 20 cm, incident angles from 0° to 50°, and energies from 6 to 18 MeV. The Čerenkov images were compared with the estimated superficial dose in phantoms from direct diode measurements, as well as calculations by Monte Carlo and the treatment planning system. Intensity images showed outstanding linear agreement (R(2) = 0.97) with reference data of the known dose for energies from 6 to 18 MeV. When orthogonal delivery was carried out, the in-plane and cross-plane dose distribution comparisons indicated very little difference (± 2-4% differences) between the different methods of estimation as compared to Čerenkov light imaging. For an incident angle 50°, the Čerenkov images and Monte Carlo simulation show excellent agreement with the diode data, but the treatment planning system had a larger error (OPT = ± 1~2%, diode = ± 2~3%, TPS = ± 6-8% differences) as would be expected. The sampling depth of superficial dosimetry based on Čerenkov radiation has been simulated in a layered skin model, showing the potential of sampling depth tuning by spectral filtering. Taken together, these measurements and simulations indicate that Čerenkov emission imaging might provide a valuable method of superficial dosimetry imaging from incident radiotherapy beams of electrons.