Photon-limited Cherenkov imaging of radiation therapy dose.

Cherenkov imaging is a unique verification tool that could provide both dosimetric and tissue functional information during radiation therapy. However, the number of interrogated Cherenkov photons in tissue is always limited and tangled with stray radiation photons, severely frustrating the measurement the signal-to-noise ratio (SNR). As such, here, a noise-robust photon-limited imaging technique is proposed by comprehensively exploiting the physical rationale of low-flux Cherenkov measurements together with the spatial correlations of the objects. Validation experiments confirmed that the Cherenkov signal could be promisingly recovered with high SNR by irradiating at as few as one x ray pulse from a linear accelerator (10 mGy dose), and the Cherenkov excited luminescence imaging depth can be extended by >100% on average, for most concentrations of phosphorescent probe. This approach demonstrates that improved applications in radiation oncology could be seen when signal amplitude, noise robustness, and temporal resolution are comprehensively considered in the image recovery process.