Evidence map›Paper›PMID 41026068›Full record

ArticleInternational journal of radiation oncology, biology, physics2025

Emulating Clinical Workflow of Scintillator Array Dosimetry for FLASH Pencil-Beam Scanning Proton Therapy.

Roman Vasyltsiv, Joseph Harms, Megan Clark, David J Gladstone, Brian W Pogue, Rongxiao Zhang, Petr Bruza

Abstract read
In one paragraph

Article in International journal of radiation oncology, biology, physics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Roman VasyltsivThayer School of Engineering, Dartmouth College, Hanover, New Hampshire.
Joseph HarmsDepartment of Radiation Oncology, University of Alabama at Birmingham, Birmingham, Alabama; Department of Radiation Oncology, Washington University School of Medicine, Saint Louis, Missouri.
Megan ClarkThayer School of Engineering, Dartmouth College, Hanover, New Hampshire.
David J GladstoneThayer School of Engineering, Dartmouth College, Hanover, New Hampshire.
Brian W PogueThayer School of Engineering, Dartmouth College, Hanover, New Hampshire; Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin.
Rongxiao ZhangThayer School of Engineering, Dartmouth College, Hanover, New Hampshire; Department of Radiation Oncology, University of Missouri, Columbia, Missouri.
Petr BruzaThayer School of Engineering, Dartmouth College, Hanover, New Hampshire. Electronic address: petr.bruza@dartmouth.edu.

Funding

Translational Engineering in Cancer (TEC)P30CA023108 · NCI · DARTMOUTH COLLEGE · PI Fred W Kolling IV · 1985 to 2026
$91.3M
Ultra-fast imaging for the safe delivery of electron FLASH radiation therapyR44CA268466 · NCI · DOSEOPTICS, LLC · PI BRUZA, PETR · 2022 to 2023
$2.0M
Training in Surgical InnovationT32EB021966 · NIBIB · DARTMOUTH COLLEGE · PI Eric R Fossum, Sohail K Mirza · 2017 to 2026
$1.7M
NCI NIH HHS P30 CA023108NCI NIH HHS R44 CA268466NIBIB NIH HHS T32 EB021966
6 · The paper itself

Abstract

purposeThe emergence of ultra-high dose rate (UHDR) pencil-beam scanning (PBS) proton therapy and associated clinical trials has outpaced the capabilities of in vivo treatment validation systems. Current dosimetry tools are limited in spatiotemporal resolution and are insufficient for clinical FLASH treatment monitoring. This study aimed to demonstrate the ability to monitor UHDR proton therapy in an emulated clinical in vivo setting using a novel scintillation imaging system. We demonstrate the system's ability and evaluate the accuracy of measuring two-dimensional dose and dose rate maps with verification against treatment plan projection. METHODS AND MATERIALS: A novel optical dosimetry imaging system composed of a 1 kHz intensified complementary metal-oxide semiconductor camera, stereo-vision system, and a deformable scintillator array was deployed at a clinical proton therapy center for end-to-end validation. A conventional lung PBS plan was modified to simulate FLASH treatment at 99 nA and 250 MeV. Validation was performed using an anthropomorphic chest phantom through cumulative dose comparison with gafchromic film, spot position analysis, and PBS dose rate area verification. Clinical workflow was evaluated for impact on treatment time and compatibility to prepare the system for large animal and clinical studies.

resultsScintillation imaging showed high gamma passing rates comparing the cumulative dose distribution to film (92.5% at 1%/1 mm, >99.9% at 2%/2 mm). Spot monitoring achieved submillimeter accuracy (0.32 ± 0.19 mm deviation). Planned and measured surface dose rates showed excellent agreement, with a 0.71% difference in coverage at 40 Gy/s. Time added to treatment workflow was limited to array placement, contributing ∼1 minute. Postbeam array activation showed negligible additional exposure (671 nSv/h).

conclusionsThis study presents the first practical implementation of scintillator array dosimetry for UHDR PBS proton therapy, enabling real-time dose and dose rate monitoring over complex geometries. The system offers a novel approach to in vivo treatment validation with clinical compatibility, providing unique metrics for UHDR proton beam dynamics.

Indexed as

Proton TherapyRadiometryScintillation CountingWorkflowHumansPhantoms, ImagingRadiotherapy DosageRadiotherapy Planning, Computer-Assisted

Identifiers

PMID41026068
PMCPMC12969705

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.