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Despite its wide use in clinical intervention, the delivered radiation dose can only be planned and verified via simulation. This makes precision radiotherapy challenging while in\u2010line verification of the delivered dose is still absent in the clinic. X\u2010ray\u2010induced acoustic computed tomography (XACT) has recently been proposed as an imaging tool for in vivo dosimetry.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Most of the XACT studies focus on localizing the radiation beam. However, it has not been studied for its potential for quantitative dosimetry. The aim of this study was to investigate the feasibility of using XACT for quantitative in vivo dose reconstruction during radiotherapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Varian Eclipse system was used to generate simulated uniform and wedged 3D radiation field with a size of 4 cm 4 cm. In order to use XACT for quantitative dosimetry measurements, we have deconvoluted the effects of both the x\u2010ray pulse shape and the finite frequency response of the ultrasound detector. We developed a model\u2010based image reconstruction algorithm to quantify radiation dose in vivo using XACT imaging, and universal back\u2010projection (UBP) reconstruction is used as comparison. The reconstructed dose was calibrated before comparing it to the percent depth dose (PDD) profile. Structural similarity index matrix (SSIM) and root mean squared error (RMSE) are used for numeric evaluation. Experimental signals were acquired from 4 cm 4 cm radiation field created by Linear Accelerator (LINAC) at depths of 6, 8, and 10 cm beneath the water surface. The acquired signals were processed before reconstruction to achieve accurate results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Applying model\u2010based reconstruction algorithm with non\u2010negative constraints successfully reconstructed accurate radiation dose in 3D simulation study. The reconstructed dose matches well with the PDD profile after calibration in experiments. The SSIMs between the model\u2010based reconstructions and initial doses are over 85%, and the RMSEs of model\u2010based reconstructions are eight times lower than the UBP reconstructions. We have also shown that XACT images can be displayed as pseudo\u2010color maps of acoustic intensity, which correspond to different radiation doses in the clinic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our results show that the XACT imaging by model\u2010based reconstruction algorithm is considerably more accurate than the dose reconstructed by UBP algorithm. With proper calibration, XACT is potentially applicable to the clinic for quantitative in vivo dosimetry across a wide range of radiation modalities. In addition, XACT's capability of real\u2010time, volumetric dose imaging seems well\u2010suited for the emerging field of ultrahigh dose rate \u201cFLASH\u201d radiotherapy.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mp.16476","type":"journal-article","created":{"date-parts":[[2023,5,19]],"date-time":"2023-05-19T06:46:25Z","timestamp":1684478785000},"page":"6894-6907","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Towards quantitative in vivo dosimetry using x\u2010ray acoustic computed tomography"],"prefix":"10.1002","volume":"50","author":[{"given":"Leshan","family":"Sun","sequence":"first","affiliation":[{"name":"Department of Biomedical Engineering University of California  Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilberto","family":"Gonzalez","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of Oklahoma Health Sciences Center  Oklahoma City Oklahoma USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prabodh Kumar","family":"Pandey","sequence":"additional","affiliation":[{"name":"Department of Radiological Sciences University of California at Irvine  Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siqi","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering University of California  Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaitlyn","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering University of California  Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Limoli","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of California Irvine, Medical Sciences I  Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of Oklahoma Health Sciences Center  Oklahoma City Oklahoma USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liangzhong","family":"Xiang","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering University of California  Irvine California USA"},{"name":"Department of Radiological Sciences University of California at Irvine  Irvine California USA"},{"name":"Beckman Laser Institute University of California at Irvine  Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,5,18]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"Khan's the Physics of Radiation Therapy","author":"Khan FM","year":"2014"},{"key":"e_1_2_8_3_1","volume-title":"Medical Imaging Signals and Systems","author":"Prince JL","year":"2006"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0360\u20103016(98)90033\u20105"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1754\u20109485.2010.02209.x"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13014\u2010017\u20100799\u20107"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms21186492"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.3026602"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/rpd\/ncn231"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1088\/0031\u20109155\/42\/1\/008"},{"key":"e_1_2_8_11_1","unstructured":"In vivo dosimetry in external beam radiotherapy \u2013 PubMed. 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