Dickmann, J., Kamp, F., Hillbrand, M., Corradini, S., Belka, C., Schulte, R. W., Parodi, K., Dedes, G. and Landry, G. (2021). Fluence-modulated proton CT optimized with patient-specific dose and variance objectives for proton dose calculation. Phys. Med. Biol., 66 (6). BRISTOL: IOP PUBLISHING LTD. ISSN 1361-6560

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Abstract

Particle therapy treatment planning requires accurate volumetric maps of the relative stopping power, which can directly be acquired using proton computed tomography (pCT). With fluence-modulated pCT (FMpCT) imaging fluence is concentrated in a region-of-interest (ROI), which can be the vicinity of the treatment beam path, and imaging dose is reduced elsewhere. In this work we present a novel optimization algorithm for FMpCT which, for the first time, calculates modulated imaging fluences for joint imaging dose and image variance objectives. Thereby, image quality is maintained in the ROI to ensure accurate calculations of the treatment dose, and imaging dose is minimized outside the ROI with stronger minimization penalties given to imaging organs-at-risk. The optimization requires an initial scan at uniform fluence or a previous x-ray CT scan. We simulated and optimized FMpCT images for three pediatric patients with tumors in the head region. We verified that the target image variance inside the ROI was achieved and demonstrated imaging dose reductions outside of the ROI of 74% on average, reducing the imaging dose from 1.2 to 0.3 mGy. Such dose savings are expected to be relevant compared to the therapeutic dose outside of the treatment field. Treatment doses were re-calculated on the FMpCT images and compared to treatment doses re-recalculated on uniform fluence pCT scans using a 1% criterion. Passing rates were above 98.3% for all patients. Passing rates comparing FMpCT treatment doses to the ground truth treatment dose were above 88.5% for all patients. Evaluation of the proton range with a 1 mm criterion resulted in passing rates above 97.5% (FMpCT/pCT) and 95.3% (FMpCT/ground truth). Jointly optimized fluence-modulated pCT images can be used for proton dose calculation maintaining the full dosimetric accuracy of pCT but reducing the required imaging dose considerably by three quarters. This may allow for daily imaging during particle therapy ensuring a safe and accurate delivery of the therapeutic dose and avoiding excess dose from imaging.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Dickmann, J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kamp, F.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hillbrand, M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Corradini, S.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Belka, C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schulte, R. W.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Parodi, K.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Dedes, G.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Landry, G.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-592636
DOI: 10.1088/1361-6560/abe3d2
Journal or Publication Title: Phys. Med. Biol.
Volume: 66
Number: 6
Date: 2021
Publisher: IOP PUBLISHING LTD
Place of Publication: BRISTOL
ISSN: 1361-6560
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
Engineering, Biomedical; Radiology, Nuclear Medicine & Medical ImagingMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/59263

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