With advances in high-dose-rate (HDR) brachytherapy, the importance of quality assurance (QA) is increasing to ensure safe delivery of the treatment by measuring dose distribution and positioning the source with much closer intervals for highly active sources. However, conventional QA is timeconsuming, involving the use of several different measurement tools. Here, we developed simple QA method for HDR brachytherapy based on the imaging of Cherenkov emission and evaluated its performance. Light emission from pure water irradiated by an 192 ir γ-ray source was captured using a charge-coupled device camera. Monte carlo calculations showed that the observed light was primarily cherenkov emissions produced by compton-scattered electrons from the γ-rays. the uncorrected Cherenkov light distribution, which was 5% on average except near the source (within 7 mm from the centre), agreed with the dose distribution calculated using the treatment planning system. The accuracy was attributed to isotropic radiation and short-range compton electrons. the source positional interval, as measured from the light images, was comparable to the expected intervals, yielding spatial resolution similar to that permitted by conventional film measurements. The method should be highly suitable for quick and easy QA investigations of HDR brachytherapy as it allows simultaneous measurements of dose distribution, source strength, and source position using a single image.

Quality assurance (QA) of clinical electron beams is essential for performing accurate and safe radiation therapy. However, with advances in radiation therapy, QA has become increasingly labor-intensive and time-consuming. In this paper, we propose a tissue-equivalent plastic scintillator for quick and easy QA of clinical electron beams. The proposed tool comprises a plastic scintillator plate and a charge-coupled device camera that enable the scintillation light by electron beams to be recorded with high sensitivity and high spatial resolution. Further, the Cerenkov image is directly subtracted from the scintillation image to discriminate Cerenkov emissions and accurately measure the dose profiles of electron beams with high spatial resolution. Compared with conventional methods, discrepancies in the depth profile improved from 7% to 2% in the buildup region via subtractive corrections. Further, the output brightness showed good linearity with dose, good reproducibility (deviations below 1%), and dose rate independence (within 0.5%). The depth of 50% dose measured with the tool, an index of electron beam quality, was within  ±0.5 mm of that obtained with an ionization chamber. Lateral brightness profiles agreed with the lateral dose profiles to within 4% and no significant improvement was obtained using Cerenkov corrections. Field size agreed to within 0.5 mm with those obtained with ionization chamber. For clinical QA of electron boost treatment, a disk scintillator that mimics the shape of a patient's breast is applied. The brightness distribution and dose, calculated using a treatment planning system, was generally acceptable for clinical use, except in limited zones. Overall, the proposed plastic scintillator plate tool efficiently performs QA for electron beam therapy and enables simultaneous verification of output constancy, beam quality, depth, and lateral dose profiles during monthly QAs at lower doses of irradiation (small monitor units, MUs).

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Quality assurance (QA) of the source movement is essential for ensuring the safe delivery of high-dose-rate (HDR) brachytherapy. Here, we proposed a simple and effective method for real-time tracking of the source movement in high-dose-rate brachytherapy based on Cherenkov emission imaging. The Cherenkov light emitted from water irradiated by 192Ir-source γ-rays was captured using a high-sensitivity video camera. The source positions and dwell intervals were determined from the light images and compared with the preset values. The source dwell times and transit speeds were measured from the time course of the source positions. The brightness profiles were compared with the dose distributions provided by the treatment planning system. The source movements were visualized in real time as a movie of Cherenkov light emissions. The source positional intervals measured from the Cherenkov emission images agreed well to the preset values within 0.3 mm. The source dwell times were comparable to the preset values within 0.2 s, and the transit speeds were similar to those of previous reports. The brightness distributions agreed with the dose distributions within approximately 40%, except near the source center. The proposed Cherenkov method has good potential for tracking the source movement in real time in brachytherapy, as it could enable simultaneous measurements of the source positions, dwell times, and dose distributions.