Review of real time 2D dosimetry in external radiotherapy: Advancements and techniques

The objective of this paper is to provide a comprehensive review of the advancements and techniques in real time two-dimensional (2D) dosimetry for external radiation therapy with emphasis in vivo dosimetry and patient specific quality assurance. External radiation therapy plays a crucial role in cancer treatment, delivering high-energy radiation beams to target tumours while minimizing damage to surrounding healthy tissues. Accurate dosimetry, as both the measurement of the dose and its delivered location, is paramount to ensure effective treatment outcomes and minimize potential side effects.

The planned content of this paper encompasses a thorough examination of the advancements made in 2D dosimetry techniques, including solid state and electronic systems. The evolution from traditional passive dosimetry to modern real time detectors, such as portal imaging, has revolutionized the field, offering enhanced precision, efficiency, and convenience. This review will discuss the principles, advantages, and limitations of these systems, along with their practical implementation and calibration procedures.

Furthermore, the paper will highlight novel technologies, such as luminescence coatings, for quality assurance (QA) and real-time dose verification during treatment. The use of innovative materials and designs in dosemeters, including high spatial resolution detectors and tissue-equivalent phantoms, will also be explored. Additionally, the incorporation of advanced data analysis techniques, such as machine/deep learning algorithms, for dose reconstruction and QA will be addressed.

The review will also explore the application of real time 2D dosimetry in modern clinical and pre-clinical modalities, including intensity-modulated radiation therapy and volumetric modulated arc therapy, stereotactic radiosurgery, image-guided radiation therapy, particle therapy, adaptive radiotherapy, electron and proton ultra-high dose rate therapy and very high energy electrons.

By providing an up-to-date overview of the state-of-the-art in real time 2D dosimetry in vivo dosimetry and patient specific quality assurance, this paper aims to inform and guide professionals in the field, facilitating the adoption of cutting-edge techniques and improving the accuracy and safety of external radiotherapy treatments.