# Cherenkov imaging of Total Skin Electron Therapy (TSET)

> **NIH NIH R21** · UNIVERSITY OF PENNSYLVANIA · 2021 · $184,527

## Abstract

Cherenkov imaging of Total Skin Electron Therapy (TSET)
Abstract
Whole-body skin electron radiotherapy has been clinically demonstrated to be effective to treat
mycosis fungoides. However, due to setup positioning uncertainties and potential patient movements
during total skin electron therapy (TSET), dose delivered to the patient skin tissue can deviate from
dose prescription. Cherenkov emission from tissue has recently been demonstrated, providing a
mapping related to the radiation delivery to skin tissue. The signal is optimally captured by time-gated
intensified cameras, synchronized to the linear accelerator pulses, allowing rejection of the majority of
background room light, and providing real time video of each radiotherapy treatment with high dose
rates. The implementation of Cherenkov imaging offers an excellent technology to detect
abnormalities in the treatment, which would otherwise go unnoticed. This proposal seeks to advance
this technology as a verification tool through a clinical trial to monitor the daily treatment delivery of
TSET patients and develop proper corrections that can be applied to the acquired signal to ensure it
is quantitatively accurate in documenting delivered skin dose. Three of the most dominant factors,
which alter the linearity between dose and Cherenkov signal, are the corrections for perspective
direction, tissue curvature, and tissue optical properties. These important corrections are quantified in
this pilot study of TSET, in partnership with DoseOptics LLC, the company that developed the
Cherenkov imaging technology for radiation verification, to perfect technology for daily monitoring of
radiation delivery. We will compare the dosimetry accuracy of Cherenkov imaging by comparing
measurements in-vivo at 9 locations using diode, OSLD, and Scintillator detectors. In addition, we
will perform measurements in optical phantoms of known tissue optical properties at TSE treatment
conditions and Monte-Carlo simulation studies to quantity the three correction factors. We will also
develop techniques to overlay skin dose obtained from corrected Cherenkov image to patient-specific
surface anatomy based on surface 3D body contour data obtained before TSE treatment to assess
the actual skin dose distribution for daily TSE treatment. Taking together, this project will advance on
the most compelling systems for radiotherapy imaging in decades. The core of the project is
combined technology systems, testing the utility in the setting of TSET.

## Key facts

- **NIH application ID:** 10059190
- **Project number:** 5R21CA239127-02
- **Recipient organization:** UNIVERSITY OF PENNSYLVANIA
- **Principal Investigator:** Timothy C. Zhu
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $184,527
- **Award type:** 5
- **Project period:** 2019-12-01 → 2022-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10059190

## Citation

> US National Institutes of Health, RePORTER application 10059190, Cherenkov imaging of Total Skin Electron Therapy (TSET) (5R21CA239127-02). Retrieved via AI Analytics 2026-06-11 from https://api.ai-analytics.org/grant/nih/10059190. Licensed CC0.

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