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Imaging Cherenkov photons emitted during radiation therapy can provide real-time information of the external beam field. It is well established that Cherenkov emission is correlative to dose deposited; however, differential photon energies and tissue attenuation properties, along with complicated camera geometries, entangle this relationship and introduce variability in the Cherenkov emission-to-dose ratio from patient-to-patient. This study aims to better understand the effects of optical properties, skin color, and patient-specific geometries (i.e. angle of camera incidence and curvature) on the Cherenkov emission-to-dose relationship. To do so, a series of phantom experiments were conducted with tissuesimulating optical phantoms and an andromorphic breast phantom in which optical properties, curvature, and camera angle of incidence were all examined as a function of normalized Cherenkov emission-to-dose. To acquire clinical Cherenkov data along with patient skin color, Cherenkov images and OSLD measurements for the ground-truth surface dose were collected weekly on 13 whole-breast radiotherapy patients, alongside high-resolution 3D color and texture scans. Phantom results suggest there to be a moderately strong correlation between dose percent error and patient curvature (R2 = 0.57), as well as angle of camera incidence (R2 = 0.56). Initial patient results suggest there to be a correlation between the redness of a patient’s skin, and the Cherenkov emission-to-dose ratio, with higher amounts of redness correlating to lower Cherenkov signal. By better characterizing these trends, we are potentially able to find generalizable optics-based corrections that improve the accuracy in mapping Cherenkov emission to real-time skin dose.
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