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Title: SU-E-CAMPUS-J-06: The Impact of CT-Scan Energy On Range Uncertainty in Proton Therapy Planning

Purpose: To investigate the impact of tube potential (kVp) on the CTnumber (HU) to proton stopping power ratio (PSPR) conversion table; the range uncertainty and the dosimetric change introduced by a mismatch in kVp between the CT and the HU to PSPR table used to calculate dose are analyzed. Methods: A CIRS CT-ED phantom was scanned with a Philips Brilliance 64-slice scanner under 90kVp and 120kVp tube potentials. Two HU to PSPR curves were then created. Using Eclipse (Varian) a treatment plan was created for a single beam in a water phantom (HU=0) passing through a wedge-shaped heterogeneity (HU=1488). The dose was recalculated by changing only the HU to PSPR table used in the dose calculation. The change in range (the distal 90% isodose line) relative to a distal structure was recorded as a function of heterogeneity thickness in the beam. To show the dosimetric impact of a mismatch in kVp between the CT and the HU to PSPR table, we repeated this procedure using a clinical plan comparing DVH data. Results: The HU to PSPR tables diverge for low-density bone and higher density structures. In the phantom plan, the divergence of the tables results in a change in rangemore » of ~1mm per cm of bone in the beam path for the HU used. For the clinical plan, a mismatch in kVp showed a 28% increase in mean dose to the brainstem along with a 10% increase in maximum dose to the brainstem center. Conclusion: A mismatch in kVp between the CT and the HU to PSPR table can introduce significant uncertainty in the proton beam range. For dense bone, the measured range uncertainty is about 1mm per cm of bone in the beam. CT-scan energy verification should be employed, particularly when high-density media is in the proton beam path.« less
Authors:
 [1] ;  [2] ;  [3] ;  [4]
  1. University of Missouri-Columbia, St. Louis, MO (United States)
  2. Washington University School of Medicine, Saint Louis, MO (United States)
  3. Washington University School of Medicine, St. Louis, MO (United States)
  4. Washington University, Saint Louis, MO (United States)
Publication Date:
OSTI Identifier:
22402284
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Physics; Journal Volume: 41; Journal Issue: 6; Other Information: (c) 2014 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; CAT SCANNING; PHANTOMS; PLANNING; PROTON BEAMS; RADIATION DOSES; RADIOTHERAPY; SKELETON; STOPPING POWER