Accurate dose definition is vital for ensuring optimal radiation therapy (RT) outcomes. The combination of ionizing radiation acoustic imaging (iRAI) and volumetric ultrasound imaging (US) holds the potential for real-time and precise determination of the radiation dose on anatomical structures. We developed an iRAI-US dual-modality system, utilizing a custom 2D matrix array transducer for iRAI and a commercial 2D MAT for US. The studies on phantoms quantified the system performance, and then the experiments using a rabbit liver model in vivo achieved online monitoring of dose on anatomy during RT in real time. These findings demonstrated the potential of iRAI-US combined imaging for personalized RT with improved efficacy and safety.
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