TH-CD-202-01: BEST IN PHYSICS (JOINT IMAGING-THERAPY): Evaluation of the Use of Direct Electron Density CT Images in Radiation Therapy

Abstract

Purpose: The current standard for calculation of photon and electron dose requires conversion of Hounsfield Units (HU) to Electron Density (ED) by applying a calibration curve specifically constructed for the corresponding CT tube voltage. This practice limits the use of the CT scanner to a single tube voltage and hinders the freedom in the selection of optimal tube voltage for better image quality. The objective of this study is to report a prototype CT reconstruction algorithm that provides direct ED images from the raw CT data independently of tube voltages used during acquisition. Methods: A tissue substitute phantom was scanned for Stoichiometric CT calibrations at tube voltages of 70kV, 80kV, 100kV, 120kV and 140kV respectively. HU images and direct ED images were acquired sequentially on a thoracic anthropomorphic phantom at the same tube voltages. Electron densities converted from the HU images were compared to ED obtained from the direct ED images. A 7-field treatment plan was made on all HU and ED images. Gamma analysis was performed to demonstrate quantitatively dosimetric change from the two schemes in acquiring ED. Results: The average deviation of EDs obtained from the direct ED images was −1.5%±2.1% from the EDs from HU images with the corresponding CT calibration curves applied. Gamma analysis on dose calculated on the direct ED images and the HU images acquired at the same tube voltage indicated negligible difference with lowest passing rate at 99.9%. Conclusion: Direct ED images require no CT calibration while demonstrate equivalent dosimetry compared to that obtained from standard HU images. The ability of acquiring direct ED images simplifies the current practice at a safer level by eliminating CT calibration and HU conversion from commissioning and treatment planning respectively. Furthermore, it unlocks a wider range of tube voltages in CT scanner for better imaging quality while maintaining similar dosimetric accuracy.