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Med. Biol."],"published-print":{"date-parts":[[2026,7,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:italic>Objective.<\/jats:italic>\n                    A low-energy x-rays camera\u2013based system has been introduced to image secondary electron bremsstrahlung x-rays, enabling external visualization of proton beam profiles during irradiation. To date, this approach has been demonstrated only in phantom studies and simulations, and has not yet been successfully applied in patients. To overcome this limitation, it is essential to establish the feasibility of SEB x-ray imaging in a clinical condition.\n                    <jats:italic>Approach.<\/jats:italic>\n                    We first optimized the energy window and threshold settings for range estimation by acquiring SEB x-ray images of a water phantom comparable in size to the human lower abdomen, using a cerium doped yttrium aluminum perovskite (YAP(Ce)) x-ray camera with a pinhole collimator. We then performed the first\n                    <jats:italic>in vivo<\/jats:italic>\n                    SEB x-ray measurement by imaging proton beams during treatment of a patient of prostate cancer with two opposed fields, each delivering an RBE-weighted dose of 1.5 Gy.\n                    <jats:italic>Main results.<\/jats:italic>\n                    In the patient study, SEB x-ray distributions were observed in the measured images using the same energy window as that established in the water phantom study. From these images, the beam ranges were estimated to be within approximately 1 cm of the values calculated by the treatment planning system using the optimized profile threshold. Dynamic imaging at 1 s time intervals was achieved, enabling temporal evaluation of count rate curves.\n                    <jats:italic>Significance.<\/jats:italic>\n                    We present, for the first time, measurements of SEB x-ray images acquired in a patient during proton beam irradiation. These preliminary results indicate that\n                    <jats:italic>in vivo<\/jats:italic>\n                    SEB x-ray imaging could be a promising approach for clinical real-time beam monitoring in proton therapy.\n                    <jats:italic>Ethics approval.<\/jats:italic>\n                    Ethics approval was obtained from the institutional review board of Kobe Proton\nCenter: approval number: 06-10.\n                  <\/jats:p>","DOI":"10.1088\/1361-6560\/ae88b0","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T06:34:28Z","timestamp":1785134068000},"page":"145016","update-policy":"https:\/\/doi.org\/10.1088\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["First imaging of secondary electron bremsstrahlung x-rays emitted from a patient during proton beam irradiation"],"prefix":"10.1088","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1280-0043","authenticated-orcid":true,"given":"Seiichi","family":"Yamamoto","sequence":"first","affiliation":[{"name":"Waseda University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomohiro","family":"Yamashita","sequence":"additional","affiliation":[{"name":"Kobe Proton Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3190-5921","authenticated-orcid":true,"given":"Takuya","family":"Yabe","sequence":"additional","affiliation":[{"name":"Ludwig-Maximilians-Universit\u00e4t M\u00fcnchen"},{"name":"National Institutes for Quantum Science and Technology (QST)"},{"name":"Japan Society for the Promotion of Science"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3412-4066","authenticated-orcid":true,"given":"Mitsutaka","family":"Yamaguchi","sequence":"additional","affiliation":[{"name":"National Institutes for Quantum Science and Technology (QST)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoki","family":"Kawachi","sequence":"additional","affiliation":[{"name":"National Institutes for Quantum Science and Technology (QST)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kei","family":"Kamada","sequence":"additional","affiliation":[{"name":"Tohoku University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Yoshikawa","sequence":"additional","affiliation":[{"name":"Tohoku University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Kataoka","sequence":"additional","affiliation":[{"name":"Waseda University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7779-6690","authenticated-orcid":true,"given":"Katia","family":"Parodi","sequence":"additional","affiliation":[{"name":"Ludwig-Maximilians-Universit\u00e4t M\u00fcnchen"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"266","published-online":{"date-parts":[[2026,7,27]]},"reference":[{"key":"pmbae88b0bib1","doi-asserted-by":"publisher","first-page":"5006","DOI":"10.1088\/1361-6560\/aa7166","type":"journal-article","article-title":"Development of a low-energy x-ray camera for imaging of secondary electron bremsstrahlung x-rays emitted during proton irradiation for range estimation","volume":"62","author":"Ando","year":"2017","journal-title":"Phys. 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All rights, including for text and data mining, AI training, and similar technologies, are reserved.","name":"copyright_information","label":"Copyright Information"},{"value":"2026-03-15","name":"date_received","label":"Date Received","group":{"name":"publication_dates","label":"Publication dates"}},{"value":"2026-07-09","name":"date_accepted","label":"Date Accepted","group":{"name":"publication_dates","label":"Publication dates"}},{"value":"2026-07-27","name":"date_epub","label":"Online publication date","group":{"name":"publication_dates","label":"Publication dates"}}]}}