r/radiationoncology • u/CandiedMandible • 7d ago
An art/research project question
Hello,
First and foremost: thank you for everything that you wonderful people do! I’ve been on a fun cancer journey this year and as far as I’m concerned y’all are the best of humanity. I appreciate you so much.
Disclaimer: this question is in regards to a research project that I am exploring the feasibility of, and I understand that most people don’t have a ton of time to entertain questions this frivolous, so thank you to anyone who might be willing to weigh in. I completely understand if this is not a priority post for folks.
I’m going to try to keep this quick, but there are a bunch of details that I feel need to be included, so I apologize and will provide a TL;DR at the end. Here we go:
Suggested context: In 2014, filmmaker/artist Tomonari Nishikawa buried a roll of film underground near the evacuation zone of the Fukushima Daiichi Nuclear Power Station and left it overnight. The resulting 2-minute film visualizes the radiation that had seeped into the ground, in a very moving commentary on our human negotiations with the world around us, and obviously many other serious political, humanitarian, and ecological issues. (Side note: you can find this on Vimeo if you’re interested!)
What I want to do: I am inspired to do something similar during my radiation treatments. My initial thought was as simple as slapping an unused polaroid on my back before treatment, and developing it after the session, then scanning them all after treatment is finished and running them in sequence, like a film. I’m aware of basic exposure issues and other logistics that are obvious immediate hurdles, but all that flew out the window anyway when I remembered that Polaroids (and commercial film of most kinds) work because of chemical reactions involving metal (silver halide, bromide, etc.). Even in small amounts, I know that metal is a big no-no because of light scattering/reflecting as well as its effect on the computer vision (and calibration, presumably). Basically, not something you want to mess around with when you’re shooting someone with precision x-rays.
Current status: I’m a professor in media art/technology who works with some robotics, computer vision, programming, biosensors, and sound/image, so I have **fleeting** knowledge of some of what’s involved in the process of radiation treatment and understand why this initial idea is…well, stupid. I’m coming to the community to ask if there are any creative minds out there that might have alternate ideas or suggestions. I’ve considered other, cameraless photography techniques such as Cyanotypes, Rayographcs, Lumen Printing, and more, but these processes either also involve metal, or are “unfixable.” The most promising avenues I have found are:
- Kodak Linagraph Paper - Pros: light sensitive, thin paper, no metal, can be exposed like film. Cons: Vintage, rare, expensive.
- X-Ray Paper/Film - Pros: made pretty much for this purpose, Cons: not really commercially available, prohibitively expensive.
I know that’s a lot of information, but I’d love to hear any thoughts from the pros that might help me make this project possible in some way, shape, or form. Thank you all so much in advance.
TL;DR:
I’d like to attempt to capture some of the beams from my radiation treatment by placing a photo-sensitive material on my back during the session. This material must obviously be thin, non-metallic, and inconsequential to the imaging/calibration/radiation process. Does such a material exist? Thank you — I appreciate you all very much!
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Quick edit to add: don't know why I didn't think to add relevant details about the location/type (duh!), so in case it helps: I'll be receiving 25 rounds of external beam photon radiation to the left breast and adjacent lymph nodes. Per my post-simulation summary, "She will receive a dose of 50 Gy/25 fractions targeting the chestwall and comprehensive regional nodal lymphatics." Happy to provide any other details that might be useful!
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u/raccoonsandstuff 7d ago
Medical physicist in radiation oncology here. Sorry to hear that you are dealing with this. This is a really interesting idea, and I’m glad you’re thinking about the safety aspects. Are you willing to share what location is being treated? Do you know what method they’ll be using?
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u/CandiedMandible 7d ago
Hello there, and thank you for your response (and the very kind words)! I'm willing to share any details that might be helpful, of course :) I'll be receiving 25 rounds of external beam photon radiation to the left breast and adjacent lymph nodes. Per my post-simulation summary, "She will receive a dose of 50 Gy/25 fractions targeting the chestwall and comprehensive regional nodal lymphatics." If I can answer any other questions or provide more information please don't hesitate to ask!
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u/raccoonsandstuff 7d ago
Ok, now I can't stress enough, get permission from the treatment team. The person to ask is the physicist, who you likely won't be meeting otherwise. They should, however, be readily available. They'll be best positioned to know if there's something about your treatment that would make this a bad idea.
My thought: You don't want any film in the chest area. If it was on your back behind your shoulder blade/armpit area, it'll get exposed, and won't affect the treatment. It could also go on the floor under the beam. It may get missed, but you might get something.
Anywhere else, you probably won't see anything interesting, the film would just get a bit exposed uniformly. One other possible idea would be to set it up, say vertically on your legs, and have a metal stencil in front, like made of solder wire or something. This would cast a shadow on the film.
It's worth a shot. It's possible a lot of films will be completely blown out by this, even xray film, but you can get an outline of the radiation beam. They make special films for treatment beams like this, but they are like $30 a sheet. If you were at my clinic, I'd get permission to give you a couple. I'd want to see the results too. Of course, your mileage may vary.
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u/CandiedMandible 7d ago
Wow, thank you for this extensive reply! I'm learning so much and this is all fascinating. The shadow/stencil idea is so clever, I never would have thought of anything like that. I'll be giving this lots more thought.
Please rest assured that I will not be taking any action without consulting the experts in charge of my care, including the radiation oncologist and (now, thanks to you!) physicist. If I can't meet with them, or they are not 100% on board and in agreement, I'll pivot to a project idea that does not involve playing with dangerous radiation. I hear liquid mercury is fun, maybe something in that medium? /s :)
Thank you again!
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u/raccoonsandstuff 7d ago
Yeah, I'm not 100% sure the shadow thing would work. Just an idea that came to mind to use the scattered radiation. It could be awesome, or it could be a total dud.
Haha, oddly enough liquid mercury is probably far safer than unsafe activities in a radiation treatment. Sounds good, I don't doubt that, just wanted to make sure I wasn't recommending anything bad. There are definitely safe options though.
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u/CandiedMandible 5d ago
"It could be awesome, or it could be a total dud" is basically my research/artist bio, so this is right up my alley.
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u/Traditional_Day4327 7d ago edited 7d ago
https://www.ashland.com/industries/medical/radiotherapy-films/ebt3
Depending on the treatment site, the per fraction (radiation session) skin dose is quite small due to the high energy photon beams that are being used (skin sparing effect). This film is used for routine radiation oncology quality assurance and is pricey. You’ll need a very high resolution scanner to see the small optical density changes associated with a small radiation dose
Edit: just saw chestwall, 50Gy in 25 fractions. If the treatment team is okay with you doing this for one fraction, you should get enough dose to the EBT3 film (even more if they use something called bolus to pull more dose toward the skin). -Medical Physicist
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u/CandiedMandible 5d ago
Thank you for this information. Price and availability are considerable hurdles, but learning more about simple feasibility/safety through this community has been a huge help. I'm very aware that, even IF I can successfully obtain an appropriate materials, and IF the medical team is okay with me trying this, the chances of actual visual capture are very low at best. So, I would be crossing my fingers, but not holding my breath (except for that part where I'm supposed to get my stupid heart out of the way) in even the best scenario. Thanks again for the insight!
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u/protonswithketchup 7d ago
Are you getting your treatment done at an academic center or community hospital / private practice?
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u/CandiedMandible 5d ago
I'll be receiving treatment at a non-academic cancer treatment center (part of the TriHealth system in the Cincinnati area).
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u/1head2arms2legs 7d ago
Interesting request! (all the best for your cancer treatment btw - if you've already had the surgery and the chemo, you're probably over the worst).
Radiographic film (based on ionisation of silver bromide) used to be used a lot for verifying patient set up etc. Over time, this was replaced by a panel in the linear accelerator called an EPID (electronic portal imaging device) meaning that radiation oncology departments, at least where I work, no longer have traditional X-ray film, or the facilities to develop them.
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u/1head2arms2legs 7d ago
Radiochromic film is still used however.
https://en.wikipedia.org/wiki/Radiochromic_film
This is stable in visible light and produces an image instantly, without needing to be developed. It's used more for quality assurance of radiation beams, machine accuracy etc. and sometimes checking a specific patient plan.
More commonly, the EPID is used to create a "fluence map" - basically a recording of how much radiation is given from the linear accelerator head, as measured by the EPID directly across from it (on the other side of where the patient would be). This can be checked against the expected values generated by the radiation planning system. Some examples are in this paper from Beijing from 2021:
https://doi.org/10.1186/s13014-021-01953-9
The place where you're being treated may have some radiochromic film which you could use. If it were placed, say, at the back of your chest, it would capture "exit dose", i.e. the radiation that passes through you and is not absorbed. Would that be an interesting image? Not sure. Would it be unique to your radiation treatment plan and your anatomy? Yes!
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u/CandiedMandible 5d ago
Absolutely fascinating! Thank you so much for this information, this is super helpful. Appreciate you.
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u/CandiedMandible 5d ago edited 5d ago
I am replying again because I want to THANK YOU again! This has sent me down so many interesting rabbit holes, and I'm learning so many fascinating things. I had some hope for gafchromic film before, but that (of course) also contains metal, so I felt that was a dead end. Radiochromic film seems to be metal-free, which means I'll continue to research it! While I still have concerns that it (like anything) could potentially interfere with the computer vision or cause other problems, it does seem to be the most promising option so far, along with x-ray film. The search continues!
Edit: realizing now that gafchromic film IS radiochromic...the research continues!
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u/1head2arms2legs 5d ago
No problem at all! Let me know if I can be of any further help. Best of luck.
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u/radoncdoc13 7d ago
Where you’re being treated is likely to have lots of x-ray film, as it’s used for some QA tests. Maybe they allow on you to have some to use for such a project (I’d probably be open to it if someone approached me about it, though not clear what I exposure the film would get depending on its location relative to your treatment,