Low-energy x-ray imaging of the secondary electron bremsstrahlung (SEB) x-ray emitted during carbon-ion irradiation is a promising method for range estimation. However, it remains unclear whether the method can be used for imaging with the clinical dose levels of carbon-ion and whether the bremsstrahlung x-ray can be detected from the deeper part of the body. To clarify these points, we developed a new high resolution low-energy x-ray camera and conducted imaging of the SEB x-ray during the irradiation of carbon-ions of different energies and intensities. Imaging was also tried with an x-ray camera using a human-head-sized, 17 cm diameter cylindrical phantom. To develop a high resolution imaging detector for a low-energy x-ray, we used a 20 20 0.5 mm thick cerium-doped yttrium aluminum perovskite, YA1O3 (YAP(Ce)) scintillator plate, which was optically coupled to a 25 mm square high quantum efficiency (HQE) type position sensitive photomultiplier tube (PSPMT). The imaging detector was encased in a 2 cm thick tungsten container and a pinhole collimator was attached to its camera head. After evaluating the camera's performance, SEB x-ray imaging was tried during irradiation of the carbon-ion and compared the results with a Monte Carlo simulation. We imaged the beam tracks by the SEB x-ray in real-time during irradiation of the carbon-ion and imaging and range estimation were possible even with near clinical dose level of 7.5 ? 108 particles of carbon-ion. Clear images of a SEB x-ray were also obtained for a 17 cm diameter cylindrical phantom. The measured images were good agreement with the Monte Carlo simulation. We confirmed that our developed YAP(Ce) camera is promising for imaging SEB x-rays during irradiation of carbon-ions even near clinical conditions.
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