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Title: Calibration of megavoltage cone-beam CT for radiotherapy dose calculations: Correction of cupping artifacts and conversion of CT numbers to electron density

Abstract

Megavoltage cone-beam CT (MV CBCT) is used for three-dimensional imaging of the patient anatomy on the treatment table prior to or just after radiotherapy treatment. To use MV CBCT images for radiotherapy dose calculation purposes, reliable electron density (ED) distributions are needed. Patient scatter, beam hardening and softening effects result in cupping artifacts in MV CBCT images and distort the CT number to ED conversion. A method based on transmission images is presented to correct for these effects without using prior knowledge of the object's geometry. The scatter distribution originating from the patient is calculated with pencil beam scatter kernels that are fitted based on transmission measurements. The radiological thickness is extracted from the scatter subtracted transmission images and is then converted to the primary transmission used in the cone-beam reconstruction. These corrections are performed in an iterative manner, without using prior knowledge regarding the geometry and composition of the object. The method was tested using various homogeneous and inhomogeneous phantoms with varying shapes and compositions, including a phantom with different electron density inserts, phantoms with large density variations, and an anthropomorphic head phantom. For all phantoms, the cupping artifact was substantially removed from the images and a linear relationmore » between the CT number and electron density was found. After correction the deviations in reconstructed ED from the true values were reduced from up to 0.30 ED units to 0.03 for the majority of the phantoms; the residual difference is equal to the amount of noise in the images. The ED distributions were evaluated in terms of absolute dose calculation accuracy for homogeneous cylinders of different size; errors decreased from 7% to below 1% in the center of the objects for the uncorrected and corrected images, respectively, and maximum differences were reduced from 17% to 2%, respectively. The presented method corrects the MV CBCT images for cupping artifacts and extracts reliable ED information of objects with varying geometries and composition, making these corrected MV CBCT images suitable for accurate dose calculation purposes.« less

Authors:
; ; ; ;  [1]
  1. Department of Radiation Oncology (MAASTRO), GROW, University Hospital Maastricht, Maastricht (Netherlands)
Publication Date:
OSTI Identifier:
21036183
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Physics; Journal Volume: 35; Journal Issue: 3; Other Information: DOI: 10.1118/1.2836945; (c) 2008 American Association of Physicists in Medicine; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ACCURACY; ANATOMY; CALIBRATION; COMPUTERIZED TOMOGRAPHY; CORRECTIONS; DOSIMETRY; ELECTRON DENSITY; ERRORS; IMAGE PROCESSING; IMAGES; ITERATIVE METHODS; PATIENTS; PHANTOMS; RADIATION DOSES; RADIOTHERAPY

Citation Formats

Petit, Steven F., Elmpt, Wouter J. C. van, Nijsten, Sebastiaan M. J. J. G., Lambin, Philippe, and Dekker, Andre L. A. J. Calibration of megavoltage cone-beam CT for radiotherapy dose calculations: Correction of cupping artifacts and conversion of CT numbers to electron density. United States: N. p., 2008. Web. doi:10.1118/1.2836945.
Petit, Steven F., Elmpt, Wouter J. C. van, Nijsten, Sebastiaan M. J. J. G., Lambin, Philippe, & Dekker, Andre L. A. J. Calibration of megavoltage cone-beam CT for radiotherapy dose calculations: Correction of cupping artifacts and conversion of CT numbers to electron density. United States. doi:10.1118/1.2836945.
Petit, Steven F., Elmpt, Wouter J. C. van, Nijsten, Sebastiaan M. J. J. G., Lambin, Philippe, and Dekker, Andre L. A. J. 2008. "Calibration of megavoltage cone-beam CT for radiotherapy dose calculations: Correction of cupping artifacts and conversion of CT numbers to electron density". United States. doi:10.1118/1.2836945.
@article{osti_21036183,
title = {Calibration of megavoltage cone-beam CT for radiotherapy dose calculations: Correction of cupping artifacts and conversion of CT numbers to electron density},
author = {Petit, Steven F. and Elmpt, Wouter J. C. van and Nijsten, Sebastiaan M. J. J. G. and Lambin, Philippe and Dekker, Andre L. A. J.},
abstractNote = {Megavoltage cone-beam CT (MV CBCT) is used for three-dimensional imaging of the patient anatomy on the treatment table prior to or just after radiotherapy treatment. To use MV CBCT images for radiotherapy dose calculation purposes, reliable electron density (ED) distributions are needed. Patient scatter, beam hardening and softening effects result in cupping artifacts in MV CBCT images and distort the CT number to ED conversion. A method based on transmission images is presented to correct for these effects without using prior knowledge of the object's geometry. The scatter distribution originating from the patient is calculated with pencil beam scatter kernels that are fitted based on transmission measurements. The radiological thickness is extracted from the scatter subtracted transmission images and is then converted to the primary transmission used in the cone-beam reconstruction. These corrections are performed in an iterative manner, without using prior knowledge regarding the geometry and composition of the object. The method was tested using various homogeneous and inhomogeneous phantoms with varying shapes and compositions, including a phantom with different electron density inserts, phantoms with large density variations, and an anthropomorphic head phantom. For all phantoms, the cupping artifact was substantially removed from the images and a linear relation between the CT number and electron density was found. After correction the deviations in reconstructed ED from the true values were reduced from up to 0.30 ED units to 0.03 for the majority of the phantoms; the residual difference is equal to the amount of noise in the images. The ED distributions were evaluated in terms of absolute dose calculation accuracy for homogeneous cylinders of different size; errors decreased from 7% to below 1% in the center of the objects for the uncorrected and corrected images, respectively, and maximum differences were reduced from 17% to 2%, respectively. The presented method corrects the MV CBCT images for cupping artifacts and extracts reliable ED information of objects with varying geometries and composition, making these corrected MV CBCT images suitable for accurate dose calculation purposes.},
doi = {10.1118/1.2836945},
journal = {Medical Physics},
number = 3,
volume = 35,
place = {United States},
year = 2008,
month = 3
}
  • In cone beam breast computed tomography (CT), scattered radiation leads to nonuniform biasing of CT numbers known as a cupping artifact. Besides being visual distractions, cupping artifacts appear as background nonuniformities, which impair efficient gray scale windowing and pose a problem in threshold based volume visualization/segmentation. To overcome this problem, we have developed a background nonuniformity correction method specifically designed for cone beam breast CT. With this technique, the cupping artifact is modeled as an additive background signal profile in the reconstructed breast images. Due to the largely circularly symmetric shape of a typical breast, the additive background signal profilemore » was also assumed to be circularly symmetric. The radial variation of the background signals was estimated by measuring the spatial variation of adipose tissue signals in front view breast images. To extract adipose tissue signals in an automated manner, a signal sampling scheme in polar coordinates and a background trend fitting algorithm were implemented. The background fits compared with targeted adipose tissue signal value (constant throughout the breast volume) to get an additive correction value for each tissue voxel. To test the accuracy, we applied the technique to cone beam CT images of mastectomy specimens. After correction, the images demonstrated significantly improved signal uniformity in both front and side view slices. The reduction of both intraslice and interslice variations in adipose tissue CT numbers supported our observations.« less
  • Precise calibration of Hounsfield units (HU) to electron density (HU-density) is essential to dose calculation. On-board kV cone beam computed tomography (CBCT) imaging is used predominantly for patients' positioning, but will potentially be used for dose calculation. The impacts of varying 3 imaging parameters (mAs, source-imager distance [SID], and cone angle) and phantom size on the HU number accuracy and HU-density calibrations for CBCT imaging were studied. We proposed a site-specific calibration method to achieve higher accuracy in CBCT image-based dose calculation. Three configurations of the Computerized Imaging Reference Systems (CIRS) water equivalent electron density phantom were used to simulatemore » sites including head, lungs, and lower body (abdomen/pelvis). The planning computed tomography (CT) scan was used as the baseline for comparisons. CBCT scans of these phantom configurations were performed using Varian Trilogy{sup TM} system in a precalibrated mode with fixed tube voltage (125 kVp), but varied mAs, SID, and cone angle. An HU-density curve was generated and evaluated for each set of scan parameters. Three HU-density tables generated using different phantom configurations with the same imaging parameter settings were selected for dose calculation on CBCT images for an accuracy comparison. Changing mAs or SID had small impact on HU numbers. For adipose tissue, the HU discrepancy from the baseline was 20 HU in a small phantom, but 5 times lager in a large phantom. Yet, reducing the cone angle significantly decreases the HU discrepancy. The HU-density table was also affected accordingly. By performing dose comparison between CT and CBCT image-based plans, results showed that using the site-specific HU-density tables to calibrate CBCT images of different sites improves the dose accuracy to {approx}2%. Our phantom study showed that CBCT imaging can be a feasible option for dose computation in adaptive radiotherapy approach if the site-specific calibration is applied.« less
  • Purpose: Megavoltage cone beam computed tomography (MV-CBCT) dose can be integrated with the patient's prescription. Here, we investigated the effects of imaging dose and the necessity for additional optimization when using intensity-modulated radiotherapy (IMRT) to treat prostate cancer. Methods and Materials: An arc beam mimicking MV-CBCT was generated using XiO (version 4.50; Elekta, Stockholm, Sweden). The monitor units (MU) for dose calculation were determined by conforming the calculated dose to the dose measured using an ionization chamber. IMRT treatment plans of 22 patients with prostate cancer were retrospectively analyzed. Arc beams of 3, 5, 8, and 15 MU were addedmore » to the IMRT plans, and the dose covering 95% of the planning target volume (PTV) was normalized to the prescribed dose with (reoptimization) or without optimization (compensation). Results: PTV homogeneity and conformality changed negligibly with MV-CBCT integration. For critical organs, an imaging dose-dependent increase was observed for the mean rectal/bladder dose (D{sub mean}), and reoptimization effectively suppressed the D{sub mean} elevations. The bladder generalized equivalent uniform dose (gEUD) increased with imaging dose, and reoptimization suppressed the gEUD elevation when 5- to 15-MU CBCT were added, although rectal gEUD changed negligibly with any imaging dose. Whereas the dose elevation from the simple addition of the imaging dose uniformly increased rectal and bladder dose, the rectal D{sub mean} increase of compensation plans was due mainly to low-dose volumes. In contrast, bladder high-dose volumes were increased by integrating the CBCT dose, and reoptimization reduced them when 5- to 15-MU CBCT were added. Conclusion: Reoptimization is clearly beneficial for reducing dose to critical organs, elevated by addition of high-MU CBCT, especially for the bladder. For low-MU CBCT aimed at bony structure visualization, compensation is sufficient.« less
  • We propose an empirical cupping correction (ECC) algorithm to correct for CT cupping artifacts that are induced by nonlinearities in the projection data. The method is raw data based, empirical, and requires neither knowledge of the x-ray spectrum nor of the attenuation coefficients. It aims at linearizing the attenuation data using a precorrection function of polynomial form. The coefficients of the polynomial are determined once using a calibration scan of a homogeneous phantom. Computing the coefficients is done in image domain by fitting a series of basis images to a template image. The template image is obtained directly from themore » uncorrected phantom image and no assumptions on the phantom size or of its positioning are made. Raw data are precorrected by passing them through the once-determined polynomial. As an example we demonstrate how ECC can be used to perform water precorrection for an in vivo micro-CT scanner (TomoScope 30 s, VAMP GmbH, Erlangen, Germany). For this particular case, practical considerations regarding the definition of the template image are given. ECC strives to remove the cupping artifacts and to obtain well-calibrated CT values. Although ECC is a first-order correction and cannot compete with iterative higher-order beam hardening or scatter correction algorithms, our in vivo mouse images show a significant reduction of bone-induced artifacts as well. A combination of ECC with analytical techniques yielding a hybrid cupping correction method is possible and allows for channel-dependent correction functions.« less
  • Purpose: To reduce cupping artifacts and improve the contrast-to-noise ratio in cone-beam computed tomography (CBCT). Methods: A level set method is proposed to reduce cupping artifacts in the reconstructed image of CBCT. The authors derive a local intensity clustering property of the CBCT image and define a local clustering criterion function of the image intensities in a neighborhood of each point. This criterion function defines an energy in terms of the level set functions, which represent a segmentation result and the cupping artifacts. The cupping artifacts are estimated as a result of minimizing this energy. Results: The cupping artifacts inmore » CBCT are reduced by an average of 90%. The results indicate that the level set-based algorithm is practical and effective for reducing the cupping artifacts and preserving the quality of the reconstructed image. Conclusions: The proposed method focuses on the reconstructed image without requiring any additional physical equipment, is easily implemented, and provides cupping correction through a single-scan acquisition. The experimental results demonstrate that the proposed method successfully reduces the cupping artifacts.« less