Abstract
BackgroundMetal artifacts caused by high‐density implants lead to incorrectly reconstructed Hounsfield units in computed tomography images. This can result in a loss of accuracy in dose calculation in radiation therapy. This study investigates the potential of the metal artifact reduction algorithms, Augmented Likelihood Image Reconstruction and linear interpolation, in improving dose calculation in the presence of metal artifacts.Materials and MethodsIn order to simulate a pelvis with a double‐sided total endoprosthesis, a polymethylmethacrylate phantom was equipped with two steel bars. Artifacts were reduced by applying the Augmented Likelihood Image Reconstruction, a linear interpolation, and a manual correction approach. Using the treatment planning system Eclipse™, identical planning target volumes for an idealized prostate as well as structures for bladder and rectum were defined in corrected and noncorrected images. Volumetric modulated arc therapy plans have been created with double arc rotations with and without avoidance sectors that mask out the prosthesis. The irradiation plans were analyzed for variations in the dose distribution and their homogeneity. Dosimetric measurements were performed using isocentric positioned ionization chambers.ResultsIrradiation plans based on images containing artifacts lead to a dose error in the isocenter of up to 8.4%. Corrections with the Augmented Likelihood Image Reconstruction reduce this dose error to 2.7%, corrections with linear interpolation to 3.2%, and manual artifact correction to 4.1%. When applying artifact correction, the dose homogeneity was slightly improved for all investigated methods. Furthermore, the calculated mean doses are higher for rectum and bladder if avoidance sectors are applied.ConclusionStreaking artifacts cause an imprecise dose calculation within irradiation plans. Using a metal artifact correction algorithm, the planning accuracy can be significantly improved. Best results were accomplished using the Augmented Likelihood Image Reconstruction algorithm.
Highlights
In radiotherapy, computed tomography (CT) images are used to calculate dose distributions within a heterogeneous tissue
Image correction with Augmented Likelihood Image Reconstruction (ALIR) reduces this error to 2.7%, a correction with linear interpolation to 3.2%
It is shown that image reconstruction and correction of artifacts with ALIR lead to a lower error in calculation compared to linear interpolation approach (LI) or a manual correction
Summary
In radiotherapy, computed tomography (CT) images are used to calculate dose distributions within a heterogeneous tissue. The method smears back the inconsistent projection values into the image by utilizing the back projection operation This results in streaking artifacts reducing the image quality.[3,4,5] Anatomical details may be superimposed by metal artifacts and are not distinguishable from each other. Metal artifacts caused by high-density implants lead to incorrectly reconstructed Hounsfield units in computed tomography images. This can result in a loss of accuracy in dose calculation in radiation therapy. Artifacts were reduced by applying the Augmented Likelihood Image Reconstruction, a linear interpolation, and a manual correction approach. Using a metal artifact correction algorithm, the planning accuracy can be
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