Optical Fiber Sensing Technologies in Radiation Therapy

Optical fiber technology is becoming essential in modern radiation therapy, enabling precise, real-time, and minimally invasive monitoring. As oncology moves toward patient-specific treatment, there is growing demand for adaptable and biologically compatible sensing tools. Fiber-optic systems meet this need by integrating into clinical workflows with highly localized dosimetric and spectroscopic feedback. Their small size and flexibility allow deployment within catheters, endoscopes, or treatment applicators, making them suitable for both external beam and internal therapies. This paper reviews the fundamental principles and diverse applications of optical fiber sensing technologies in radiation oncology, focusing on dosimetry, spectroscopy, imaging, and adaptive radiotherapy. Implementations such as scintillating and Bragg grating-based dosimeters demonstrate feasibility for in vivo dose monitoring. Spectroscopic techniques, such as Raman and fluorescence spectroscopy, offer real-time insights into tissue biochemistry, aiding in treatment response assessment and tumor characterization. However, despite such advantages of optical fiber sensors, challenges such as signal attenuation, calibration demands, and limited dynamic range remain. This paper further explores clinical application, technical limitations, and future directions, emphasizing multiplexing capabilities, integration and regulatory considerations, and trends in machine learning development. Collectively, these optical fiber sensing technologies show strong potential to improve the safety, accuracy, and adaptability of radiation therapy in personalized cancer care.