Design and Characterization of a Novel Scintillator Array for In Vivo Monitoring During UHDR PBS Proton Therapy

Background: Ultra-high dose rate proton therapy shows promise in tissue sparing by enhancing therapeutic ratio through the FLASH effect. In radiotherapy, accurate in vivo dosimetry is crucial for quality assurance, but remains challenging for UHDR as existing systems lack spatial and temporal resolution to verify dose and dose rate in complex anatomical regions, especially for PBS proton therapy. Purpose: To develop and evaluate a novel 3D surface dosimetry method for UHDR PBS proton therapy using high-speed imaging of a scintillator array for real-time, high-resolution surface dose monitoring. The spatial, temporal, and dosimetric components are validated via imaging of a QA phantom and comparison against TPS predictions. Methods: A deformable multi-element scintillator array was designed with 7.5mm element pitch and 0.5mm inter-element gap. Scintillation linearity with dose was evaluated with variation in response to increasing imaging and irradiation angles. WED testing evaluated beam attenuation at two energy levels. Scintillation emission was imaged at 1kHz and mesh position was monitored via 2-camera stereovision. System setup was validated using a 3D QA phantom to assess spatial accuracy and guide setup correction. Stereovision properties of array elements guided angular correction and geometric transformation. Kernel-based residual spot fitting derived cumulative dose maps compared to TPS dose profile of 5x5cm UHDR PBS delivery using 3%/2mm gamma analysis. PBS and maximum dose rate maps were calculated. Results: Setup achieved average localization error of 0.62 mm, surpassing typical 1+ mm clinical threshold. Intensity correction based on angular information yielded cumulative spot dose uncertainty of ~1% (5.428mGy). Processed dose map compared to TPS via gamma analysis showed 99.9% passing rate at 3%/2mm. WED of the array measured 1.1mm, minimizing impact on dose distribution.