# Everyday Use of Optical Cherenkov Imaging Identifies Adverse Events and Opportunities for Improved Radiation Treatment

> **NIH NIH R44** · DOSEOPTICS, LLC · 2021 · $999,998

## Abstract

ABSTRACT
Radiation therapy is a supplementary curative treatment used adjuvant with most surgery and chemotherapy,
being delivered to nearly 1 out of every 4 people in their lifetime. External beam treatment is commonly
fractionated (i.e. delivered every day for 25-40 days). While it is generally considered safe and effective, many
in the field believe it could be safer. Major potential side effects can occur if not administered with high daily
accuracy, including millimeter level patient alignment and care to keep normal tissue doses sufficiently low.
However, there is a proven 1-5% incidence of secondary cancer from this treatment. This is particularly relevant
in breast radiotherapy, where even a 1% dose to the contralateral breast has been proven to lead to a high
probability for a secondary cancer. In reality, no clinic actually knows their true incident rate, because no system
exists to visualize every treatment as part of routine clinical practice. The invention of the BeamSiteTM system,
for time-gated single photon imaging of Cherenkov light emissions, provides the first direct video imaging of the
radiation dose delivery as it happens. The system captures a direct visualization of delivery incidents in real time,
so that intuitive observations can be made by the therapists and daily corrections can be made as needed. In
this application, we will carry out a multicenter clinical study to investigate the capability of Cherenkov imaging
to detect events which, heretofore, would go undetected. We will also advance the workflow of the system with
automated incident detection tools to make BeamSiteTM easily used by the therapy team. Finally, the system will
also be expanded with dose estimation algorithms to estimate long term secondary cancer risk. The project is
based upon previous NIH supported hardware that is FDA 510(k) cleared for marketing and will be deployed
with augmentation from the tools proposed here. The current proposal provides resources for the goals of: (i)
quantifying error rates in the overall treatment of patients in multiple radiotherapy clinical settings, and (ii) quantify
the unplanned dose delivered to non-target tissues, including contralateral breast in whole breast radiotherapy.
The work includes software support and optical scintillator dosimetry development, to be leveraged towards
these goals. The prospective human study of the incident rates will be carried out as a multisite effort within the
Dartmouth-Hitchcock Health medical centers. The data produced with this system will demonstrate that
visualization of treatment can change the way that daily radiotherapy is tracked and provide a tool for continuous
improvement for each participating center, thereby reducing the secondary morbidity of off-target radiation.
Financial reimbursement exists and as the field shifts to quality-based reimbursement versus quantity-based,
Cherenkov imaging will become a staple of all leading radiotherapy units.

## Key facts

- **NIH application ID:** 10325725
- **Project number:** 1R44CA265654-01
- **Recipient organization:** DOSEOPTICS, LLC
- **Principal Investigator:** William Ware
- **Activity code:** R44 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $999,998
- **Award type:** 1
- **Project period:** 2021-08-24 → 2023-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10325725

## Citation

> US National Institutes of Health, RePORTER application 10325725, Everyday Use of Optical Cherenkov Imaging Identifies Adverse Events and Opportunities for Improved Radiation Treatment (1R44CA265654-01). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10325725. Licensed CC0.

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