Improving the Inclusivity of Cherenkov Imaging in Radiotherapy for Diverse Patient Groups

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Recently, Cherenkov imaging has emerged as a novel clinical tool, revolutionizing how the radiotherapy (RT) team can view treatments. RT had always been considered a “blind” procedure since clinical radiation beams are invisible to the human eye. However, as patients are irradiated with x-rays or electrons, a low light signal is generated within their tissue, called the “Cherenkov effect”, and the amount of light is proportional to the amount of radiation dose delivered. At Dartmouth, the Optics in Medicine Laboratory has developed a way to image this light signal on the surface of a patient during RT, transforming RT to no longer be a “blind” procedure. This novel imaging tool lends itself to many practical applications, including the opportunity to develop a non-contact, passive, whole surface dosimetry tool following the relationship between Cherenkov emission and dose deposition. However, many factors influence this relationship and must be accounted for before this can be achieved. One of the most important factors is melanin concentration. We know that higher melanin concentrations found in dark-skinned patients can reduce the amount of light signal by nearly an order of magnitude compared to light-skinned patients. However, due to the limited patient demographics at Dartmouth-Hitchcock Health (DHH), the team has not imaged dark skin patients and any development thus far has been made with the predominant light-skinned population in the catchment area. The primary objectives of this proposed research project are to collect and analyze a diverse patient data set representative of the country and develop a skin color calibration algorithm for clinical Cherenkov imaging, with the ultimate goal of transforming Cherenkov imaging into an inclusive dosimetry tool that works for all patients. This will be achieved through a collaboration that the research applicant has formed between DHH (Lebanon, NH), Moffitt Cancer Center (Tampa, FL) and DoseOptics LLC (Lebanon, NH), who will provide the Cherenkov imaging hardware and software support. Moffitt Cancer Center’s catchment area is comprised of ~33% minorities, compared to DHH’s ~4%. This work will be first to address clinical Cherenkov imaging for dark-skinned patients and develop a calibration for skin tone, an essential component for an optical dosimetry tool. The applicant’s training objectives include facilitating a multi-institutional collaboration, broadening knowledge of medical physics, and developing clinical and technical skills for a career in medical physics. Giving formal presentations, participating in workshops and journal clubs, mentoring and teaching other students, and authoring peer-reviewed papers will contribute to the applicant’s professional development. With support from sponsors and collaborators, this proposed fellowship will advance the applicant towards a successful and productive career in medical physics, contributing meaningful research for the entirety of her career.