Extended localization and adaptive dose calculation using HU corrected cone beam CT: Phantom study

BACKGROUND AND AIM

The practicability of computing dose calculation on cone beam CT (CBCT) has been widely investigated. In most clinical scenarios, the craniocaudal scanning length of CBCT is found to be inadequate for localization. This study aims to explore extended tomographic localization and adaptive dose calculation strategies using Hounsfield unit (HU) corrected CBCT image sets.

MATERIALS AND METHODS

Planning CT (pCT) images of the Rando phantom (T12-to-midthigh) were acquired with pelvic-protocol using Biograph CT-scanner. Similarly, half-fan CBCT were acquired with fixed parameters using Clinac2100C/D linear accelerator integrated with an on-board imager with 2-longitudinal positions of the table. For extended localization and dose calculation, two stitching strategies viz., one with "penumbral-overlap" (S1) and the other with "no-overlap" (S2) and a local HU-correction technique were performed using custom-developed MATLAB scripts. Fluence modulated treatment plans computed on pCT were mapped with stitched CBCT and the dosimetric analyses such as dose-profile comparison, 3D-gamma (γ) evaluation and dose-volume histogram (DVH) comparison were performed.

RESULTS

Localizing scanning length of CBCT was extended by up to 15 cm and 16 cm in S1 and S2 strategies, respectively. Treatment plan mapping resulted in minor variations in the volumes of delineated structures and the beam centre co-ordinates. While the former showed maximum variations of -1.4% and -1.6%, the latter showed maximum of 1.4 mm and 2.7 mm differences in anteroposterior direction in S1 and S2 protocols, respectively. Dosimetric evaluations viz., dose profile and DVH comparisons were found to be in agreement with one another. In addition, γ-evaluation results showed superior pass-rates (≥98.5%) for both 3%/3 mm dose-difference (DD) and distance-to-agreement (DTA) and 2%/2 mm DD/DTA criteria with desirable dosimetric accuracy.

CONCLUSION

Cone beam tomographic stitching and local HU-correction strategies developed to facilitate extended localization and dose calculation enables routine adaptive re-planning while circumventing the need for repeated pCT.

Algorithm for X-ray scatter, beam-hardening, and beam profile correction in diagnostic (kilovoltage) and treatment (megavoltage) cone beam CT

Quantitative reconstruction of cone beam X-ray computed tomography (CT) datasets requires accurate modeling of scatter, beam-hardening, beam profile, and detector response. Typically, commercial imaging systems use fast empirical corrections that are designed to reduce visible artifacts due to incomplete modeling of the image formation process. In contrast, Monte Carlo (MC) methods are much more accurate but are relatively slow. Scatter kernel superposition (SKS) methods offer a balance between accuracy and computational practicality. We show how a single SKS algorithm can be employed to correct both kilovoltage (kV) energy (diagnostic) and megavoltage (MV) energy (treatment) X-ray images. Using MC models of kV and MV imaging systems, we map intensities recorded on an amorphous silicon flat panel detector to water-equivalent thicknesses (WETs). Scattergrams are derived from acquired projection images using scatter kernels indexed by the local WET values and are then iteratively refined using a scatter magnitude bounding scheme that allows the algorithm to accommodate the very high scatter-to-primary ratios encountered in kV imaging. The algorithm recovers radiological thicknesses to within 9% of the true value at both kV and megavolt energies. Nonuniformity in CT reconstructions of homogeneous phantoms is reduced by an average of 76% over a wide range of beam energies and phantom geometries.