We describe a high-sensitivity, fiber-optic dosimetry system based on optically stimulated luminescence (OSL) and radioluminescence from Al2O3: C single-crystal fibers (detectors). The detectors are coupled to a fiber optic delivery system and OSL from the detector is stimulated via the optical fiber cable using light from a Nd:YAG laser. The OSL is guided back along the same fiber and is detected by a photomultiplier tube. The Al2O3: C detectors are small and demonstrate high sensitivity with a large signal-to-noise ratio. We describe two modes of operation of the system and discuss algorithms that provide accurate estimation of dose rate and integrated dose in near real time. The system is free from magnetic and electrical interference, and is designed for use in several forms of radiotherapy, including in vitro brachytherapy source calibration, and in vivo dosimetry during patient treatment. (C) 2004 Elsevier Ltd. All rights reserved.