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Purpose: Ultra-fast scintillation imaging has been shown to provide a uniquetool for spatio-temporal dosimetry of conventional cyclotron andsynchrocyclotron pencil beam scanning (PBS) deliveries, indicating thepotential use for characterization of ultra-UHDR PBS proton beams. The goal ofthis work is to introduce this novel concept and demonstrate its capabilitiesin recording complex dose rate maps at FLASH-capable proton beam currents, ascompared to log-based dose rate calculation, internally developed UHDR beamsimulation, and a fast point detector (EDGE diode). Methods: The light responseof a scintillator sheet located at isocenter and irradiated by pencil beamscanning proton fields (40-210 nA, 250 MeV) was imaged by an ultra-fast iCMOScamera at 4.5-12 kHz sampling frequency. Image intensity was calibrated to dosewith film and the recorded spatio-temporal data was compared to a PPC05 ionchamber, log-based reconstruction, and EDGE diode. Calculation of full-fieldmean and PBS dose rate maps were used to highlight the importance of highresolution, full-field information in UHDR studies. Results: Camera responsewas linear with dose (R2 = 0.997) and current (R2 = 0.98) in the range from2-22 Gy and 40-210 nA, respectively, when compared to ion chamber readings.Planned and delivered spot positions agreed within 0.2+/-0.1 mm and totalirradiation time agreed within 0.2+/-0.2 ms when compared with the log files,indicating the high concurrent spatial and temporal resolution. For alldeliveries, the PBS dose rate measured at the diode location agreed between theimaging and the diode within 3+/-2% and with the simulation within 5+/-3%.Conclusion: The high linearity and various spatiotemporal metric reportingcapabilities confirm the continued use of this camera system for UHDR beamcharacterization, especially for spatially resolved dose rate information.

Quantitative real-time measurements of dose and dose rate in UHDR proton pencil beams via scintillation imaging system