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Title: SU-E-J-136: Investigation Into Robustness of Stopping Power Calculated by DECT and SECT for Proton Therapy Treatment Planning

Abstract

Purpose: To investigate the robustness of dual energy CT (DECT) and single energy CT (SECT) proton stopping power calibration techniques and quantify the associated errors when imaging a phantom differing in chemical composition to that used during stopping power calibration. Methods: The CIRS tissue substitute phantom was scanned in a CT-simulator at 90kV and 140kV. This image set was used to generate a DECT proton SPR calibration based on a relationship between effective atomic number and mean excitation energy. A SECT proton SPR calibration based only on Hounsfield units (HUs) was also generated. DECT and SECT scans of a second phantom of known density and chemical composition were performed. The SPR of the second phantom was calculated with the DECT approach (SPR-DECT),the SECT approach (SPR-SECT) and finally the known density and chemical composition of the phantom (SPR-ref). The DECT and SECT image sets were imported into the Pinnacle{sup 3} research release of proton therapy treatment planning. The difference in dose when exposed to a common pencil beam distribution was investigated. Results: SPR-DECT was found to be in better agreement with SPR-ref than SPR- SECT. The mean difference in SPR for all materials was 0.51% for DECT and 6.89% for SECT.more » With the exception of Teflon, SPR-DECT was found to agree with SPR-ref to within 1%. Significant differences in calculated dose were found when using the DECT image set or the SECT image set. Conclusion: The DECT calibration technique was found to be more robust to situations in which the physical properties of the test materials differed from the materials used during SPR calibration. Furthermore, it was demonstrated that the DECT and SECT SPR calibration techniques can Result in significantly different calculated dose distributions.« less

Authors:
 [1];  [1];  [2]
  1. University of Adelaide, Adelaide, SA (Australia)
  2. (Australia)
Publication Date:
OSTI Identifier:
22494148
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Physics; Journal Volume: 42; Journal Issue: 6; Other Information: (c) 2015 American Association of Physicists in Medicine; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
60 APPLIED LIFE SCIENCES; ANIMAL TISSUES; BIOMEDICAL RADIOGRAPHY; CALIBRATION; CHEMICAL COMPOSITION; COMPUTERIZED TOMOGRAPHY; IMAGES; PHANTOMS; PLANNING; PROTON BEAMS; RADIATION DOSE DISTRIBUTIONS; RADIATION DOSES; RADIOTHERAPY; SIMULATORS; STOPPING POWER; TEFLON

Citation Formats

Zhu, J, Penfold, S, and Royal Adelaide Hospital, Adelaide, SA. SU-E-J-136: Investigation Into Robustness of Stopping Power Calculated by DECT and SECT for Proton Therapy Treatment Planning. United States: N. p., 2015. Web. doi:10.1118/1.4924222.
Zhu, J, Penfold, S, & Royal Adelaide Hospital, Adelaide, SA. SU-E-J-136: Investigation Into Robustness of Stopping Power Calculated by DECT and SECT for Proton Therapy Treatment Planning. United States. doi:10.1118/1.4924222.
Zhu, J, Penfold, S, and Royal Adelaide Hospital, Adelaide, SA. Mon . "SU-E-J-136: Investigation Into Robustness of Stopping Power Calculated by DECT and SECT for Proton Therapy Treatment Planning". United States. doi:10.1118/1.4924222.
@article{osti_22494148,
title = {SU-E-J-136: Investigation Into Robustness of Stopping Power Calculated by DECT and SECT for Proton Therapy Treatment Planning},
author = {Zhu, J and Penfold, S and Royal Adelaide Hospital, Adelaide, SA},
abstractNote = {Purpose: To investigate the robustness of dual energy CT (DECT) and single energy CT (SECT) proton stopping power calibration techniques and quantify the associated errors when imaging a phantom differing in chemical composition to that used during stopping power calibration. Methods: The CIRS tissue substitute phantom was scanned in a CT-simulator at 90kV and 140kV. This image set was used to generate a DECT proton SPR calibration based on a relationship between effective atomic number and mean excitation energy. A SECT proton SPR calibration based only on Hounsfield units (HUs) was also generated. DECT and SECT scans of a second phantom of known density and chemical composition were performed. The SPR of the second phantom was calculated with the DECT approach (SPR-DECT),the SECT approach (SPR-SECT) and finally the known density and chemical composition of the phantom (SPR-ref). The DECT and SECT image sets were imported into the Pinnacle{sup 3} research release of proton therapy treatment planning. The difference in dose when exposed to a common pencil beam distribution was investigated. Results: SPR-DECT was found to be in better agreement with SPR-ref than SPR- SECT. The mean difference in SPR for all materials was 0.51% for DECT and 6.89% for SECT. With the exception of Teflon, SPR-DECT was found to agree with SPR-ref to within 1%. Significant differences in calculated dose were found when using the DECT image set or the SECT image set. Conclusion: The DECT calibration technique was found to be more robust to situations in which the physical properties of the test materials differed from the materials used during SPR calibration. Furthermore, it was demonstrated that the DECT and SECT SPR calibration techniques can Result in significantly different calculated dose distributions.},
doi = {10.1118/1.4924222},
journal = {Medical Physics},
number = 6,
volume = 42,
place = {United States},
year = {Mon Jun 15 00:00:00 EDT 2015},
month = {Mon Jun 15 00:00:00 EDT 2015}
}
  • Purpose: To develop a calibration curve that includes and minimizes the variations of Hounsfield Unit (HU) from a CT scanner to Relative Stopping Power (RSP) of tissues along the proton beam path. The variations are due to scanner and proton energy, technique, phantom size and placement, and tissue arrangement. Methods: A CIRS 062 M phantom with 10 plugs of known relative electron density (RED) was scanned through a 16 slice GE Discovery CT Simulator scanner. Three setup combinations of plug distributions and techniques clinically implemented for five treatment regions were scanned with energies of 100, 120, and 140 kV. Volumetricmore » HU values were measured for each plug and scan. The RSP values derived through the Bethe-Bloch formula are currently being verified with parallel-plate ionization chamber measurements in water using 80, 150, and 225 MeV proton beam. Typical treatment plans for treatment regions of brain, head-&-neck, chest, abdomen, and pelvis are being planned and dose delivered will be compared with film and Optically Stimulated Luminescence (OSL) measurements. Results: Percentage variations were determined for each variable. For tissues close to water, variations were <1% from any given parameter. Tissues far from water equivalence (lung and bone) showed the greatest sensitivity to change (7.4% maximum) with scanner energy and up to 5.3% with positioning of the phantom. No major variations were observed for proton energies within the treatment range. Conclusion: When deriving a calibration curve, attention should be placed to low and high HU values. A thorough verification process of calculated vs. water-phantom measured RSP values at different proton energies, followed by dose validation of planned vs. measured doses in phantom with film and OSL detectors are currently being undertaken.« less
  • Purpose: We present an improved method to calculate patient-specific calibration curves to convert X-ray computed tomography (CT) Hounsfield Unit (HU) to relative stopping powers (RSP) for proton therapy treatment planning. Methods: By optimizing the HU-RSP calibration curve, the difference between a proton radiographic image and a digitally reconstructed X-ray radiography (DRR) is minimized. The feasibility of this approach has previously been demonstrated. This scenario assumes that all discrepancies between proton radiography and DRR originate from uncertainties in the HU-RSP curve. In reality, external factors cause imperfections in the proton radiography, such as misalignment compared to the DRR and unfaithful representationmore » of geometric structures (“blurring”). We analyze these effects based on synthetic datasets of anthropomorphic phantoms and suggest an extended optimization scheme which explicitly accounts for these effects. Performance of the method is been tested for various simulated irradiation parameters. The ultimate purpose of the optimization is to minimize uncertainties in the HU-RSP calibration curve. We therefore suggest and perform a thorough statistical treatment to quantify the accuracy of the optimized HU-RSP curve. Results: We demonstrate that without extending the optimization scheme, spatial blurring (equivalent to FWHM=3mm convolution) in the proton radiographies can cause up to 10% deviation between the optimized and the ground truth HU-RSP calibration curve. Instead, results obtained with our extended method reach 1% or better correspondence. We have further calculated gamma index maps for different acceptance levels. With DTA=0.5mm and RD=0.5%, a passing ratio of 100% is obtained with the extended method, while an optimization neglecting effects of spatial blurring only reach ∼90%. Conclusion: Our contribution underlines the potential of a single proton radiography to generate a patient-specific calibration curve and to improve dose delivery by optimizing the HU-RSP calibration curve as long as all sources of systematic incongruence are properly modeled.« less
  • Purpose: Range uncertainty from X-ray CT number conversion to stopping power ratio (SPR) is one of the key factors limiting the potential of proton therapy. The large margins required for deep seated tumors degrade the organ sparing achievable with the technology. Of interest is the application of dual energy CT (DECT) to SPR estimation. In this planning study proton range differences between SECT and DECT have been quantified for brain cases. Methods: A last generation dual source DECT scanner was used to acquire SECT (150 kVp with Sn filtration) and DECT (additionally 90 kVp) scans of phantoms and 5 headmore » trauma patients, acting as surrogate cancer patients. Phantom materials were characterized in terms of SPR in a particle beam to obtain reference values. IMPT treatment plans were generated on the basis of SECT and DECT SPR images for hypothetical brain tumors using a short and a long beam path. Range differences between SECT and DECT from plan recalculations were evaluated in beam-eye-view (BEV) by comparing the 80% isodose. Results: For the 18 phantom materials the SECT RMS SPR errors were 2.6% compared to 1.1% for DECT. Group median relative range differences between SECT and DECT plans were −1.0% for the short beam path over the 5 patients investigated in this study. For the long beam path the median difference was −1.4%. These relative range differences corresponded to −0.5 mm and −1.4 mm shifts respectively. Conclusion: This is the first study performing proton therapy treatment planning on DECT patient images. Important range differences of more than 1 mm were observed between SECT and DECT treatment plans, and DECT SPR accuracy was found superior on the basis of phantom measurements. While the patients investigated in this study did not have brain tumors, the findings we observed should apply to cancer patients. Deutsche Forschungsgemeinschaft (MAP); Bundesministerium fur Bildung und Forschung (01IB13001)« less
  • Purpose: In standard proton therapy clinical practice, proton stopping power uncertainties are in the order of 3.5%, which affects the ability of placing the proton Bragg peak at the edge of the tumor. The innovating idea of this project is to approach the uncertainty problem in RSP by using combined information from X-ray CT and proton radiography along a few beam angles. In addition, this project aims to quantify the systematic error introduced by the theoretical models (Janni, ICRU49, Bischel) for proton stopping power in media. Methods: A 3D phantom of 36 cm3 composed of 9 materials randomly placed ismore » created. Measured RSP values are obtained using a Gammex phantom with a proton beam. Theoretical RSP values are calculated with Beth-Block equation in combination with three databases (Janni, ICRU49 and Bischel). Clinical RSP errors are simulated by introducing a systematic (1.5%, 2.5%, 3.5%) and a random error (+/−0.5%) to the theoretical RSP. A ray-tracing algorithm uses each of these RSP tables to calculate energy loss for proton crossing the phantom through various directions. For each direction, gradient descent (GD) method is done on the clinical RSP table to minimize the residual energy difference between the simulation with clinical RSP and with theoretical RSP. The possibility of a systematic material dependent error is investigated by comparing measured RSP to theoretical RSP as calculated from the three models. Results: Using 10,000 iterations on GD algorithm, RSP differences between theoretical values and clinical RSP have converged (<1%) for each error introduced. Results produced with ICRU49 have the smallest average difference (0.021%) to the measured RSP. Janni (1.168%) and Bischel (−0.372%) database shows larger systematic errors. Conclusion: Based on these results, ray-tracing optimisation using information from proton radiography and X-ray CT demonstrates a potential to improve the proton range accuracy in a clinical environment.« less
  • Purpose: To test the radiation delivery robustness of the first MR-IGRT system using a commercial cylindrical diode array detector (ArcCHECK) and an ionization thimble chamber (Exradin A18). Methods: The MR-IGRT system is composed of three evenly spaced Co-60 sources on a rotating gantry located between two magnet halves. The collimator for each source consists of 30 doubly-focused leaf pairs that allow the system to deliver both conformal and intensity modulated (IMRT) treatment plans. The system's delivery robustness was tested over a span of 6 months from September 2013 through February 2014. This was achieved by repeatedly delivering 10 patient plans.more » These plans consisted of 2 conformal prostates, 2 IMRT prostates, 2 IMRT head and neck, 2 IMRT breast, 1 IMRT pancreas, and 1 IMRT bladder. The plans were generated with the system's treatment planning software. Once the plans were generated, quality assurance plans were created on a digital ArcCHECK dataset. The ArcCHECK used for testing was specially designed to be MR-compatible by moving the power supply outside of the magnetic field. The A18 ionization chamber was placed in a custom plastic plug insert in the center of the ArcCHECK. Gamma analysis was used with the ArcCHECK for relative dose evaluating both 3%/3mm and 2%/2mm. Absolute point dose was compared between ion chamber measurement and treatment plan. Results: The ArcCHECK passing rate remained constant over the 6 month period. The average passing rate for 3%/3mm and 2%/2mm analysis was 98.6% ± 0.7 and 88.8% ± 2.9, respectively. The ion chamber measurements showed little variation with an average percent difference between planned dose verses measured dose of 0.9% ± 0.7. Conclusion: Minimal differences were noted in the delivery of the 10 patient plans. Over a period that included acceptance testing, commissioning, and clinical deliveries, the MR-IGRT system remained consistent in radiation delivery.« less