Purpose: An in vivo transmission scintillation fiber detector was developed to monitor patient treatment in real time for the enhancement of patient safety and treatment accuracy. The detector system is capable of monitoring each pulse from a medical LINAC during treatment to determine the dose delivered as treatment progresses. Methods: The detector system consists of 60 parallel scintillating fibers coupled to fast data processing optoelectronics that can monitor the beam fluence in real time. Each 2.5mm2 square fiber is aligned with an MLC leaf pair and is long enough to capture a 40cm field. The fibers are embedded within a water equivalent polymer substrate that is secured in the LINAC accessory tray. The fibers are coupled to high speed photosensors and front end amplifiers that filter noise and pass each pulse to a high speed analog‐to‐digital converter. The system components are capable of detecting pulse repetition times shorter than what is delivered by a medical LINAC to ensure true real time data acquisition. Results: The system was able to capture and record the signal from each linac pulse and display the information in real time with no pulse pile up. It was found that the fiber array attenuates 2.65% of the beam which can easily be compensated for in treatment planning. The fibers responded linearly with dose, are independent of clinical beam energies, and are independent of dose rate. Calibration of the system was performed as a function of beam energy, beam size, dose rate, and monitor units to optimize beam fluence error detection. Conclusion: The detector system presented provides true real time in vivo beam monitoring to enhance patient safety and treatment delivery accuracy. Furthermore, the detector can be used for current patient specific QA.

Purpose: We have built a high resolution real time scintillating fiber detector prototype to determine in real time the accuracy of stereotactic radiosurgery (SRS) and stereotactic body radiotherapy (SBRT) treatments when only a fraction of the planned dose was delivered. The motivation of this work is to enhance dose delivery accuracy and to achieve error free radiosurgery. Methods: A high density array of scintillating fibers and a high speed photo detectors array were integrated to implement a high resolution real time dosimeter that can sample with high resolution pulsed SRS and SBRT beams cross sections. The high efficiency of the developed system allows to read each linac pulse in real time and to compute the accumulated dose and dose errors when only a fraction of the beam was delivered. The fibers are highly packed in a substrate that is directly coupled to two 128 pixel arrays with a pitch matching the fiber spacing to achieve accurate spatial localization. The small cross section of the fiber array allows stacking multiple fiber arrays to measure independent angular profiles that are digitally processed in parallel for real time dosimetry. Results: We implemented a high density array detector prototype with a pitch of 0.5 mm, readout speed of 1.2 msec, and a response time of 0.5 usec. The fast reading speed has the capability to determining the dose in flattening free filter beams. The detector can be installed in transmission mode at the output port of a micro‐MLC. Treatment deviations smaller than 3% are detected when less than 1/100 of the planned dose was delivered. Conclusions: We built a prototype of a high resolution fiber scintillator array detector for SRS and SBRT in vivo dosimetry. Results show that the developed detector has the potential to assure error free SRS and SBRT treatments.

Purpose: A high‐resolution scintillating fiber detector was built for in‐vivo real‐time patient specific quality assurance (QA). The detector is designed for stereotactic body radiotherapy (SBRT) and stereotactic radiosurgery (SRS) to monitor treatment delivery and detect real‐time deviations from planned dose to increase patient safety and treatment accuracy. Methods: The detector consists of two high‐density scintillating fiber arrays layered to form an X‐Y grid which can be attached to the accessory tray of a medical linac for SBRT and cone SRS treatment QA. Fiber arrays consist of 128 scintillating fibers embedded within a precision‐machined, high‐transmission polymer substrate with 0.8mm pitch. The fibers are coupled on both ends to high‐sensitivity photodetectors and the output is recorded through a high‐speed analog‐to‐digital converter to capture the linac pulse sequence as treatment delivery progresses. The detector has a software controlled 360 degree rotational system to capture angular beam projections for high‐resolution beam profile reconstruction. Results: The detector was validated using SRS cone sizes from 6mm to 34mm and MLC defined field sizes from 5×5mm2 to 100×100mm2. The detector output response is linear with dose and is dose rate independent. Each field can be reconstructed accurately with a spatial resolution of 0.8mm and the current beam output is displayed every 50msec. Dosimetric errors of 1% with respect to the treatment plan can be identified and clinically significant deviations from the expected treatment can be displayed in real‐time to alert the therapists. Conclusion: The high resolution detector is capable of reconstructing beam profiles in real‐time with submillimeter resolution and 1% dose resolution. This system has the ability to project in‐vivo both spatial and dosimetric errors during SBRT and SRS treatments when only a non‐clinically significant fraction of the intended dose was delivered. The device has the potential to establish new standards for in‐vivo patient specific QA.