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Volumetric FLASH dosimetry in vivo using real-time radiacoustic imaging

  • Kristina Bjegovic
  • , Lucy Whitmore
  • , Prabodh Kumar Pandey
  • , Leshan Sun
  • , Luke Connell
  • , Yifei Xu
  • , Edgardo A. Aguilar
  • , Brett D. Velasquez
  • , Emil Schüler
  • , Shawn Liangzhong Xiang

Research output: Contribution to journalArticlepeer-review

Abstract

Objective. The main goal of this research is to verify the spatial fidelity of radiacoustic imaging (RAI) as a quantitative dosimetric monitoring tool for FLASH radiotherapy (FLASH-RT) in vivo. FLASH-RT delivers therapeutic radiation at ultra-high instantaneous dose rates (>106 Gy s−1), offering substantial reductions in normal tissue toxicity while maintaining tumor control. However, clinical translation remains limited by the absence of real-time, in vivo dosimetry systems capable of resolving dose delivery at microsecond timescales. Approach. Here, we present an RAI platform that enables volumetric, single-pulse mapping of radiation dose deposition during FLASH-RT in vivo. The system utilizes a 16 × 16 ultrasound transducer matrix array with a model-based reconstruction algorithm to generate quantitative, three-dimensional dose maps with single pulse-level temporal resolution. Main results. In both water phantoms and in vivo murine models, RAI demonstrates high concordance with film dosimetry and TOPAS Monte Carlo simulations (3%/3 mm gamma index pass rates greater than 90% for small fields). Significance. This work establishes RAI as a viable technology for real-time, quantitative electron FLASH dosimetry in vivo for the first time, with the potential to support adaptive delivery, improve treatment safety, and facilitate the clinical translation of FLASH-RT.

Original languageEnglish (US)
Article number135020
JournalPhysics in medicine and biology
Volume71
Issue number13
DOIs
StatePublished - Jul 14 2026

Keywords

  • FLASH radiotherapy
  • in vivodosimetry
  • radiacoustic imaging
  • radiotherapy

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging

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