ArticleJournal of applied clinical medical physics2026
Real-time monitoring of seroma changes during breast cancer radiotherapy using Cherenkov imaging: A technical note.
Article in Journal of applied clinical medical physics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundSeroma formation after breast-conserving surgery is a common postoperative occurrence that can significantly affect the accuracy of radiation therapy. Variations in seroma size and shape during treatment introduce uncertainties in dose delivery, potentially compromising target coverage and increasing exposure to healthy tissue. Conventional monitoring relies on periodic imaging such as CT or MRI, which may not capture dynamic changes during the treatment course. PURPOSE: This technical note investigates the feasibility of using Cherenkov imaging for real-time monitoring of seroma evolution during breast cancer radiotherapy. The goal is to determine whether this approach can provide actionable information to improve treatment accuracy and support adaptive planning.
methodsBreast cancer patients undergoing whole-breast irradiation were treated using a TrueBeam linear accelerator (Varian, Palo Alto, CA) with surface guided radiation therapy (SGRT) for positioning and breath-hold gating. Seromas were initially contoured during treatment planning and reassessed mid-treatment using cone-beam CT. Cherenkov imaging (DoseRT, VisionRT) was integrated into daily treatment sessions to visualize seroma changes in real time. Seroma size and shape were recorded for each fraction and compared with initial planning volumes and mid-treatment imaging.
resultsCherenkov imaging successfully identified and tracked seroma changes throughout the treatment course. Significant variability was observed among patients: some exhibited progressive enlargement, while others demonstrated resolution. For example, one patient's seroma increased from 24 cm
conclusionsCherenkov imaging offers a practical, noninvasive solution for real-time monitoring of seroma changes during breast cancer radiotherapy. By providing immediate feedback on anatomical variations, this technology can enhance treatment accuracy, reduce unnecessary radiation exposure to healthy tissues, and inform adaptive planning strategies. Further research is warranted to evaluate clinical outcomes, workflow integration, and cost-effectiveness.
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