Relative Electron Density Research Articles

Accuracy of Electron Density and Planning Dosimetry in a Novel High-Quality CBCT Imaging System

A high-quality Cone-Beam Computed Tomography (CBCT) imaging system has been FDA approved for imaging guidance and dose calculation in radiotherapy. This study aims to evaluate the accuracy of the relative electron density in CBCT images acquired in this CBCT imaging system in a phantom study and its dosimetric impact on treatment planning in a patient study. Astoichiometric CT calibration was performed with a CIRS phantom (SunNuclear, Model 062M) to generate the HU-electron density curve for two tube voltages, 125kVp and 140 kVp, respectively. The phantom has a longitudinal length of 26.5 cm and is equipped with interchangeable inserts of various compositions, supplied by the vendor. Measurements were taken with solid water plates added to both ends of the phantom to allow adequate scattering and repeated for various clinical protocols with different combinations of tube voltages and exposures. The accuracy of the relative electron density of the CBCT imaging system was verified by comparing the calculated electron density from the Hounsfield Units (HU) measurements obtained from a Gammex phantom to the relative electron densities provided in vendor's specifications. To benchmark the relative electron density of the CBCT imaging system against a standard helical CT simulator, ten clinical plans that were created on CT simulation images were copied and recalculated on the CBCT images acquired immediately after the CT simulation, the latter of which was a standard procedure in current radiotherapy care for all patients who had given their consent to participate in the IRB-approved imaging study. The dose grids used in these calculations were 2.5mm x 2.5mm x 3mm. The Gamma passing rate was calculated using a standard 3mm/3% criterion with a 10% threshold. Ourresults showed the difference between the averaged CBCT calibration curves acquired at tube voltages of 125 kVP and 140 kVp was less than 2%. The mean discrepancy of the relative electron densities from vendor's specification was 0.0045 with a range between -0.02 and 0.04. Relative electron densities in all inserts were within 2% from the vendor's specifications except the cortical bone insert. Gamma passing rate was between 96.02% and 98.49% with mean value of 97.4% and a standard deviation of 0.95%. We consider this reflects the fact that the CT simulation and CBCT imaging were performed in separated rooms, which resulted in slight anatomical deformation that could negatively impact the Gamma passing rate. The CBCT imaging system provides sufficient accuracy of electron density for dose calculation, and the dose distribution calculated on the CBCT images is clinically equivalent to those calculated on helical CT images. The enhanced imaging quality of CBCT could further extend the role of imaging guidance to planning for adaptive radiotherapy, potentially reducing the need for re-simulation and interruptions in the radiotherapy course.

Influence of Contrast Materials on Dose Accuracy of MR-Linac in Patients with SBRT Liver Cancer

Objective: Intravenous injection of contrast agent during CT scanning can improve the accuracy of target area contouring, however the contrast agent will cause dose bias due to the high relative electron density. This study aims to explore the influence of contrast agent on the accuracy of dose calculation of the planning system during SBRT based on MRI-Linac for liver cancer treatment. Methods: In this study, 20 patients undergoing stereotactic body radiation therapy (SBRT) for liver cancer were selected, and their complete unenhanced CT, contrast-enhanced CT, and corresponding structures were imported into Monaco V.5.4. The target and organs at risk (OARs) in the unenhanced CT and contrast-enhanced CT were additionally contoured according to the target contouring guidelines and OARs were ranked. The average relative electron densities of OARs (lung, spinal cord, heart, rib, etc.) were calculated with Monaco TPS. The reference plan is based on unenhanced CT for plan calculation (plan1). To compare the dosimetry errors caused by the synthetic CT, the average relative electron density of all structures in unenhanced CT was forced and the plans were recalculated (plan2). To investigate dosimetric differences caused by the changes of relative electron density due to the contrast agent, the average relative electron density of all structures in contrast-enhanced CT was forced and the plans were recalculated(plan3). The dosimetric differences in groups A (plan 1 and plan2), B (plan 1 and plan3), and C (plan2 and plan3) were compared, respectively. There were not significant difference between three groups in the affected lung, heart, liver, blood, all within 3%. However, differences were significantly different in the group B. The maximum deviation of spinal cord Dmax reached 4.78%. In addition, the deviation of the dose parameters in the target area was small, except that the maximum deviation of the CI value in group B was 3.23%. For SBRT planning of liver cancer based on magnetic resonance accelerator, synthetic CT has little influence on the calculation of planned dose. The dose difference caused by contrast materials is also relatively small, although the deviation of the CI value of the target area exceeds 3%, which is also within the clinical acceptance range. However, the deviation of the maximum value of the spinal cord is relatively large, exceeding the clinically acceptable range. Therefore, when optimizing the SBRT plan for liver cancer, attention should be paid to important organs such as the spinal cord, and should be avoided as far as possible when setting the fields.

Inter-fractional Assessment during MR-guided Online Adaptive Radiotherapy for Glioblastoma

Magnetic resonance image (MRI) guided radiation therapy has the potential to improve outcomes for glioblastoma by adapting to tumor changes during radiation therapy. This study aimed to assess the feasibility and potential benefits of MR-guided online adaptive radiotherapy (MRgOART) for patients with glioblastoma. Twenty consecutive patients with glioblastoma were treated with MRgOART of 60 Gy in 30 fractions by the 1.5 T MR-Linac. The MRgOART fractions employed daily MR scans and the contours were utilized to create each adapted plan. The gross tumor volume (GTV) and clinical target volume (CTV) were delineated on MRI of pre-treatment simulation (Fx0) and all fractions (Fx1, Fx2, Fx3 ... Fx30) to evaluate the inter-fractional changes. These changes were quantified using absolute/relative volume (∆V), Dice similarity coefficient (DSC) and Hausdorff distance (HD) metrics. The reference treatment plans were generated using step-and-shoot IMRT and utilized 7-9 beam groups on original CT. Before the treatment, a synthetic CT (sCT) quality assurance (QA) process was performed to assess the dose accuracy of bulk relative electron density (rED) assignment for online MRI based treatment plan in terms of gamma analysis, point dose comparison and dose volume histogram (DVH) parameters. Then, the online adaptative treatment plans were obtained by re-optimizing based on the contours on daily pre-treatment MRI by "adapt to shape" workflow. Non-adaptive plans for each patient were generated by recalculating the dose from the reference plans on daily online MRI by "adapt to position" workflow. GTV and CTV coverage and organ at risk (OAR) constraints were used to compare non-adaptive and adaptive plans. For both criteria, the 1%/1mm (98.58%±0.15%) and 2%/2mm (99.88%±0.18%) gamma passing rate results were always clinically acceptable in sCT QA process. The differences on point dose and DVH parameters between the plans based on sCT and original CT were less than 1%. A total of 20 patients with 600 fractions were evaluated. The results showed that large inter-fractional changes for GTV limited the efficacy of radiation therapy (DSC: 0.78±0.08, HD: 20.94±3.64mm, ∆V: 2.92%±6.36%). The inter-fractional CTV changes were smaller (DSC: 0.91±0.04, HD: 15.31±3.09mm, ∆V: 1.41%±1.29%). GTV coverage of non-adaptive plans was below the prescribed coverage in 228/600 fractions (38%), with 90 (15%) failing by more than 10%. For CTV coverage of non-adaptive plans, the changes were less than 5%. Online adaptative plans improved GTV and CTV coverage significantly (p<0.001) to 99%. The adaptive plans also had lower dose to whole brain than non-adaptive plans (p<0.001). Significant inter-fractional tumor changes could be found during radiotherapy in patients with glioblastoma treated by the 1.5 T MR-Linac. Daily MR-guided re-optimization of treatment plans corrected for day-to-day anatomical variations and resulted in adequate target coverage in all fractions.

Develop and Evaluate a Dose Calculation Strategy Using Electron Density Maps from Spectral CT

The conventional method of estimating relative electron density using Hounsfield Units (HUs) is prone to errors resulting from various factors such as energy spectrum, exposure, scanner/patient conditions, etc. Specific calibration is needed for each acquisition protocol. To overcome these limitations, dual energy CT has been extensively researched for its accuracy in dose calculation using tube potential switching techniques. A dual layer design offers a different approach to acquire spectral images using single data acquisitions. This study aims to develop and evaluate a dose calculation method using electron density maps generated directly from a dual layer detector scanner. A phantom with tissue equivalent inserts was scanned using different scanner configurations on a dual layer detector scanner. The electron density of 17 inserts ranged from 0.668 - 5.663 × 1023 m-23. The energy dependent attenuation curves were generated and translated into values of Compton and photoelectric components, which were used to calculate ED values. The ED values were compared to normal values provided by the vendor for each insert. The generated ED maps were normalized to the ED of water and used as the input for dose calculations without CT images. Dosimetry plans were generated on the phantom for two different field sizes (10 × 10 cm2 and 3 × 3 cm2) at gantry angles of 0 and 90 degrees using a 6 MV Monte Carlo engine. The dose distributions were compared between the conventional HU to ED calibration approach with CT images and the direct calculation using the calculated ED map. The results showed that compared to the conventional HU to ED map, the ED map generated from spectral CT had a relative ED that was about 0.02 lower and was more uniform, with smaller standard deviations. The ED map was closer to the nominal value in low-density regions, while the HU converted ED map was closer to the nominal value in high-density regions. The dose distributions between the two ED approaches were almost identical, with a maximum deviation of around 1% for both field sizes at deeper depths. In conclusion, a dual layer detector scanner can provide an accurate estimation of ED maps. We showed that the dose calculation using the generated ED map is highly accurate using a phantom. This method provides an alternative strategy for dose calculation that eliminates the need for HU to ED calibration and enables the use of the ED map directly.

Split-filter dual energy computed tomography radiotherapy: From calibration to image guidance

Background and purposeDual-energy computed tomography (DECT) is an emerging technology in radiotherapy (RT). Here, we investigate split-filter DECT throughout the RT treatment chain as compared to single-energy CT (SECT). Materials and methodsDECT scans were acquired with a tin-gold split-filter at 140 kV resulting in a low- and high-energy CT reconstruction (recon). Ten cancer patients (four head-and-neck (HN)​, three rectum​, two anal/pelvisand one abdomen) were DECT scanned without and with iodine administered. A cylindrical and an anthropomorphic HN phantom were scanned with DECT and 120 kV SECT. The DECT images generated were: 120 kV SECT-equivalent (CTmix), virtual monoenergetic images (VMIs), iodine map, virtual non-contrast (VNC), effective atomic number (Zeff), and relative electron density (ρe,w). The clinical utility of these recons was investigated for calibration, delineation, dose calculation and image-guided RT (IGRT). ResultsA calibration curve for 75 keV VMI had a root-mean-square-error (RMSE) of 34 HU in closest agreement with the RSME of SECT calibration. This correlated with a phantom-based dosimetric agreement to SECT of γ1%1mm > 98%. A 40 keV VMI recon was most promising to improve tumor delineation accuracy with an average evaluation score of 1.6 corresponding to “partial improvement”. The dosimetric impact of iodine was in general < 2%. For this setup, VNC vs. non-contrast CTmix based dose calculations are considered equivalent. SECT- and DECT-based IGRT was in agreement within the setup uncertainty. ConclusionsDECT-based RT could be a feasible alternative to SECT providing additional recons to support the different steps of the RT workflow.

Towards simulation-free MR-linac treatment: utilizing male pelvis PSMA-PET/CT and population-based electron density assignments

Objective. This study aimed to investigate the dosimetric impact of using population-based relative electron density (RED) overrides in lieu of simulation computerized tomography (CT) in a magnetic resonance linear accelerator (MRL) workflow for male pelvis patients. Additionally, the feasibility of using prostate specific membrane antigen positron emission tomography/CT (PSMA-PET/CT) scans to assess patients’ eligibility for this proposed workflow was examined. Approach. In this study, 74 male pelvis patients treated on an Elekta Unity 1.5 T MRL were retrospectively selected. The patients’ individual RED values for 8 organs of interest were extracted from their simulation-CT images to establish population-based RED values. These values were used to generate individual (IndD) and population-based (PopD) RED dose plans, representing current and proposed MRL workflows, respectively. Lastly, this study compared RED values obtained from CT and PET-CT scanners in a phantom and a subset of patients. Results. Population-based RED values were mostly within two standard deviations of ICRU Report 46 values. PopD plans were comparable to IndD plans, with the average %difference magnitudes of 0.5%, 0.6%, and 0.6% for mean dose (all organs), D0.1cm 3 (non-target organs) and D95%/D98% (target organs), respectively. Both phantom and patient PET-CT derived RED values had high agreement with corresponding CT-derived values, with correlation coefficients ≥ 0.9. Significance. Population-based RED values were considered suitable in a simulation-free MRL treatment workflow. Utilizing these RED values resulted in similar dosimetric uncertainties as per the current workflow. Initial findings also suggested that PET-CT scans may be used to assess prospective patients’ eligibility for the proposed workflow. Future investigations will evaluate the clinical feasibility of implementing this workflow for prospective patients in the clinical setting. This is aimed to reduce patient burden during radiotherapy and increase department efficiencies.

Relative Local Electron Density Tuning in Metal-Covalent Organic Frameworks for Boosting CO2 Photoreduction.

The high electron density and efficient charge carrier separation are two important factors to affect photocatalytic activity, especially for the CO2 photoreduction reaction. However, the systematic studies on the structure-functional relationship regarding the above two factors based on precisely structure model are rarely reported. Herein, as a proof-of-concept, we developed a new strategy on the evaluation of local electron density by controlling the relative electron-deficient (ED) and electron-rich (ER) intensity of monomer at a molecular level based on three rational-designed vinylene-linked sp2 carbon-covalent organic frameworks (COFs). As expected, the as-prepared vinylene-linked sp2 carbon-conjugated metal-covalent organic framework (MCOFs) (VL-MCOF-1) with molecular junction exhibited excellent activities for CO2-to-HCOOH conversion (283.41 μmol g-1 h-1) and high selectivity of 97.1%, much higher than the VL-MCOF-2 and g-C34N6-COF, which is due to the synergistic effect of the multi-electronic metal clusters (Cu3(PyCA)3) (PyCA = pyrazolate-4-carboxaldehyde) as strong ER roles and cyanopyridine units as ED roles and active sites, as well as the boosted photo-induced charge separation efficiency of vinyl connection and increased light utilization ability. These results not only provide a strategy for regulating the electron-density distribution of photocatalysts at the molecular level but also offers profound insights for metal clusters-based COFs to effective CO2 conversion.

Relative Local Electron Density Tuning in Metal‐Covalent Organic Frameworks for Boosting CO2Photoreduction

AbstractThe high local electron density and efficient charge carrier separation are two important factors to affect photocatalytic activity, especially for the CO2photoreduction reaction. However, the systematic studies on the structure‐functional relationship regarding the above two factors based on precisely structure model are rarely reported. Herein, as a proof‐of‐concept, we developed a new strategy on the evaluation of local electron density by controlling the relative electron‐deficient (ED) and electron‐rich (ER) intensity of monomer at a molecular level based on three rational‐designed vinylene‐linked sp2carbon‐covalent organic frameworks (COFs). As expected, the as‐prepared vinylene‐linked sp2carbon‐conjugated metal‐covalent organic framework (MCOFs) (VL‐MCOF‐1) with molecular junction exhibited excellent activities for CO2‐to‐HCOOH conversion (283.41 μmol g−1 h−1) and high selectivity of 97.1 %, much higher than the VL‐MCOF‐2 and g‐C34N6‐COF, which is due to the synergistic effect of the multi‐electronic metal clusters (Cu3(PyCA)3) (PyCA=pyrazolate‐4‐carboxaldehyde) as strong ER roles and cyanopyridine units as ED roles and active sites, as well as the boosted photo‐induced charge separation efficiency of vinyl connection and increased light utilization ability. These results not only provide a strategy for regulating the electron‐density distribution of photocatalysts at the molecular level but also offers profound insights for metal clusters‐based COFs to effective CO2conversion.

Regression fitting megavoltage depth dose curves to determine material relative electron density in radiotherapy.

The relative electron density (RED) parameter is ubiquitous throughout radiotherapy for clinical dosimetry and treatment planning purposes as it provides a more accurate description of the relevant radiological properties over mass density alone. RED is in practice determined indirectly from calibrated CT Hounsfield Units (HU). While CT images provide useful 3D information, the spectral differences between CT and clinical LINAC beams may impact the validity of the CT-ED calibration, especially in the context of novel tissue-mimicking materials where deviations from biologically typical atomic number to atomic weight ratios 〈Z/A〉 occur and/or high-Z materials are present. A theoretical basis for determining material properties directly in a clinical beam spectrum via an electron-density equivalent pathlength (eEPL) method has been previously established. An experimental implementation of this approach is introduced whereby material-specific measured percentage depth dose curves (PDDs) are regressed to a PDD measured in a reference material (water), providing an inference of 〈Z/A〉, which when combined with the physical density provides a determination of RED. This method is validated over a range of tissue-mimicking materials and compared against the standard CT output, as well as compositional information obtained from the manufacturer's specifications. The measured PDD regression method shows consistent results against both manufacturer-provided and CT-derived values between 0.9 and 1.15 RED. Outside of this soft-tissue range a trend was observed whereby the 〈Z/A〉 determined becomes unrealistic indicating the method is no longer reporting RED alone and the assumptions around the eEPL model are constrained. Within the soft-tissue RED range of validity, the regression method provides a practical and robust characterisation for unknown materials in the clinical setting and may be used to improve on the CT derived RED where high Z material components are suspected.

A comparison of measured and treatment planning system out-of-field dose for a 1.5 T MR linac.

Objective&#xD;Dose due to the electron streaming effect (ESE) is a significant contribution to out-of-field dose on the Elekta Unity MR-Linac. The aim of this work is to provide a systematic comparison of calculated and measured streaming dose for this system. &#xD;Approach&#xD;Beams 1.0 × 1.0 cm2 to 5.0 × 5.0 cm2, gantry 90.0°, 1000 MU, were incident on an in-house phantom. At the beam entrance and exit surfaces of the phantom, ESE was generated in the Y-direction (IEC 61217). EBT3 film, orientated within the X-Z plane and at 14.0 mm depth in a solid water block, was used to determine ESE dose 5.0 cm beyond the phantom. The experimental arrangement was simulated in the Monaco v5.4 treatment planning system (TPS), utilising a CT phantom dataset with differing relative electron densities (RED) for the surrounding air. Horizontal (X direction) and vertical (Z direction) film dose profiles were compared to the corresponding TPS profiles. &#xD;Main results&#xD;For each field, the maximum ESE dose was observed at the beam exit, the magnitude of which decreases with decreasing field size. For the 5.0 × 5.0 cm2 field, the exit and entry ESE doses were 19.6 % and 7.0 % of the Dmax dose to water, respectively. Across horizontal profiles, differences (simulated - measured) were reduced with smaller fields and lower RED. The maximum absolute profile difference was 1.7 % of the Dmax dose to water for optimal RED and isocentre location. In vertical profiles an offset consistent with the Lorentz force was observed relative to the X-Y isoplane.&#xD;Significance&#xD;For the fields investigated, maximum absolute differences (simulated - measured)  5.2 % occurred in peak regions of ESE, at the beam entrance and exit from the phantom. Generally, there is good agreement between Monaco simulated and measured ESE. Simulated out-of-field dose is sensitive to the RED assigned to air structures and unforced RED optimises OFD calculation accuracy.&#xD.

Monte Carlo model of a prototype flat-panel detector for multi-energy applications in radiotherapy.

The incorporation of multi-energy capabilities into radiotherapy flat-panel detectors offers advantages including enhanced soft tissue visualization by reduction of signal from overlapping anatomy such as bone in 2D image projections; creation of virtual monoenergetic images for 3D contrast enhancement, metal artefact reduction and direct acquisition of relative electron density. A novel dual-layer on-board imager offering dual energy processing capabilities is being designed. As opposed to other dual-energy implementation techniques which require separate acquisition with two different x-ray spectra, the dual-layer detector design enables simultaneous acquisition of high and low energy images with a single exposure. A computational framework is required to optimize the design parameters and evaluate detector performance for specific clinical applications. In this study, we report on the development of a Monte Carlo (MC) model of the imager including model validation. The stack-up of the dual-layer imager (DLI) was implemented in GEANT4 Application for Tomographic Emission (GATE). The DLI model has an active area of 43×43 cm2 , with top and bottom Cesium Iodide (CsI) scintillators of 600 and 800μm thickness, respectively. Measurement of spatial resolution and imaging of dedicated multi-material dual-energy (DE) phantoms were used to validate the model. The modulation transfer function (MTF) of the detector was calculated for a 120 kVp x-ray spectrum using a 0.5mm thick tantalum edge rotated by 2.5o . For imaging validation, the DE phantom was imaged using a 140 kVp x-ray spectrum. For both validation simulations, corresponding measurements were done using an initial prototype of the imager. Agreement between simulations and measurement was assessed using normalized root mean square error (NRMSE) and 1D profile difference for the MTF and phantom images respectively. Further comparison between measurement and simulation was made using virtual monoenergetic images (VMIs) generated from basis material images derived using precomputed look-up tables. The MTF of the bottom layer of the dual-layer model shows values decreasing more quickly with spatial frequency, compared to the top layer, due to the thicker bottom scintillator thickness and scatter from the top layer. A comparison with measurement shows NRMSE of 0.013 and 0.015 as well as identical MTF50 of 0.8 mm1 and 1.0 mm1 for the top and bottom layer respectively. For the DE imaging of the DE-phantom, although a maximum deviation of 3.3% is observed for the 10mm aluminum and Teflon inserts at the top layer, the agreement for all other inserts is less than 2.2% of the measured value at both layers. Material decomposition of simulated scatter-free DE images gives an average accuracy in PMMA and aluminum composition of 4.9% and 10.3% for 11-30mm PMMA and 1-10mm aluminum objects respectively. A comparison of decomposed values using scatter containing measured and simulated DE images shows good agreement within statistical uncertainty. Validation using both MTF and phantom imaging shows good agreement between simulation and measurements. With the present configuration of the digital prototype, the model can generate material decomposed images and virtual monoenergetic images.

An electronic structure investigation of excited state intramolecular proton transfer in amino-benzazole derivatives: Relative energies and electron density descriptors

An electronic structure study of the excited-state intramolecular proton transfer (ESIPT) process of six amino-benzazole derivatives (4-AHBI, 4-AHBO, 4-AHBT, 5-AHBI, 5-AHBO, and 5-AHBT) based on Density Functional Theory (DFT) is carried out in gas phase and also in dichloromethane. The energies, geometries and electronic excitations are initially evaluated, being followed by electron density descriptor investigations done to provide a better understanding of the hydrogen bond (HB) strength of enol (N···H–O), EI, and keto (O···H–N), KI, forms of these molecules. First, one can notice that the solvent effect is fundamental to explain the ESIPT process in 5-AHBO and 5-AHBT due partially to a covalent character increment of these N–H bonds in KI, while gas phase results obtained in the first excited state indicate that the enol tautomer is instead more stable than the keto one. The time-dependent DFT (TDDFT) values achieved support a reevaluation of the experimental data available, showing that ESIPT is really observed for all these compounds in dichloromethane. The most important effect of the solvent on HBs seems to be a destabilization of O···H interactions in the KI form, which is observed in both the electronic states (S0 and S1). The electronic excitation also appears to induce a weakening of O···H bonds in the KI tautomer along with some strengthening of N···H interactions in EI. Thus, this HB force variation profile does not favor the ESIPT occurrence and one must consider instead the effect of changes in the covalent bonds on excitation to understand why the KI tautomer becomes more stable than EI in the S1 state, such as supported by evidence regarding the weakening of the O–H bonds and the strengthening of the N–H ones driven by the electronic transition.

A body mass index-based method for “MR-only” abdominal MR-guided adaptive radiotherapy

PurposeDose calculation for MR-guided radiotherapy (MRgRT) at the 0.35 T MR-Linac is currently based on deformation of planning CTs (defCT) acquired for each patient. We present a simple and robust bulk density overwrite synthetic CT (sCT) method for abdominal treatments in order to streamline clinical workflows. MethodFifty-six abdominal patient treatment plans were retrospectively evaluated. All patients had been treated at the MR-Linac using MR datasets for treatment planning and plan adaption and defCT for dose calculation. Bulk density CTs (4M-sCT) were generated from MR images with four material compartments (bone, lung, air, soft tissue). The relative electron densities (RED) for bone and lung were extracted from contoured CT structure average REDs. For soft tissue, a correlation between BMI and RED was evaluated. Dose was recalculated on 4M-sCT and compared to dose distributions on defCTs assessing dose differences in the PTV and organs at risk (OAR). ResultsMean RED of bone was 1.17 ± 0.02, mean RED of lung 0.17 ± 0.05. The correlation between BMI and RED for soft tissue was statistically significant (p < 0.01). PTV dose differences between 4M-sCT and defCT were Dmean: −0.4 ± 1.0%, D1%: −0.3 ± 1.1% and D95%: −0.5 ± 1.0%. OARs showed D2%: −0.3 ± 1.9% and Dmean: −0.1 ± 1.4% differences. Local 3D gamma index pass rates (2%/2mm) between dose calculated using 4M-sCT and defCT were 96.8 ± 2.6% (range 89.9–99.6%). ConclusionThe presented method for sCT generation enables precise dose calculation for MR-only abdominal MRgRT.

Dual-energy CT evaluation of 3D printed materials for radiotherapy applications

Objective. There is a continuous increase in 3D printing applications in several fields including medical imaging and radiotherapy. Although there are numerous advantages of using 3D printing for the development of customized phantoms, bolus, quality assurance devices and other clinical applications, material properties are not well known and printer settings can affect considerably the properties (e.g. density, isotropy and homogeneity) of the printed parts. This study aims to evaluate several materials and printer properties to identify a range of tissue-mimicking materials. Approach. Dual-energy CT was used to obtain the effective atomic number (Z eff) and relative electron density (RED) for thirty-one different materials including different colours of the same filament from the same manufacturer and the same type of filament from different manufacturers. In addition, a custom bone equivalent filament was developed and evaluated since a high-density filament with a composition similar to bone is not commercially available. Printing settings such as infill density, infill pattern, layer height and nozzle size were also evaluated. Main results. Large differences were observed for HU (288), RED (>10%) and Z eff (>50%) for different colours of the same filament due to the colour pigment. Results show a wide HU variation (−714 to 1104), RED (0.277 to 1.480) and Z eff (5.22 to 12.39) between the printed samples with some materials being comparable to commercial tissue-mimicking materials and good substitutes to a range of materials from lung to bone. Printer settings can result in directional dependency and significantly affect the homogeneity of the samples. Significance. The use of DECT to extract RED, and Z eff allows for quantitative imaging and dosimetry using 3D printed materials equivalent to certified tissue-mimicking tissues.

Usefulness of Electron Density Calculated from Dual Energy CT in Differential Diagnosis between Hepatocellular Carcinoma and Hepatic Hemangioma

The aim of this study were to compare electron density (ED), obtained by dual energy computed tomography (DECT), between hepatocellular carcinoma (HCC) and hemangioma, and to assess the differential diagnostic performance of ED between HCC and hemangioma. A total of 46 patients (27 men and 19 women; mean age, 65.7±14.0 years) diagnosed with HCC or hemangioma who underwent upper abdominal DECT between October 2021 and December 2022 were included. ED of each lesion was measured. Relative ED (rED), which is normalized by the ED of background liver parenchyma, was calculated. ED and rED of HCC and hemangioma were statistically analyzed. The HCC group showed significantly higher ED (48.1±5.2) and rED (80.0±7.3) than the hemangioma group (43.7±4.1, 69.7±7.2, respectively) (p<0.01). The area under the curve of rED was greater than that of ED, but no significant difference was found (p=0.153). ED may help in the differential diagnosis between HCC and hemangioma.

Performance of natural product-based materials as adhesives in the fabrication of mangrove wood composites

Biodegradable adhesives prepared using three different forms of soy protein-based products (defatted soy flour/soy protein concentrate/soy protein isolate), sodium hydroxide, and itaconic acid polyamidoamine-epichlorohydrin (IA-PAE) with 0 wt%–20 wt% substitution rates were utilized to enhance the production of mangrove wood composites. 1H nuclear magnetic resonance, differential scanning calorimetry, and ultra-high-resolution field emission scanning electron microscopy were employed to characterize the composite samples. Other measurements involved the determination of viscosity, pH, physical, mechanical, dimensional stability, CT numbers, and relative electron density parameters. The ideal curing conditions for the composite bio-adhesives were found to be 15 wt% IA-PAE, 602.50 ± 172.21–391.11 ± 105.82 mPa s, pH 11.0, 180 °C, and 18 min, respectively. The improved physiochemical characteristics of DSF, SPC, and SPI confirmed that NaOH/IA-PAE was integrated into the adhesive system and ameliorated the overall performance of the resulting composites. The results showed that all composite samples, except for those bonded with 0 wt% and 5 wt% IA-PAE, matched up with the quality specification stated in the JIS A-5908 and ASTM D1037. Samples D1, D2, and D3 exhibited optimum characteristics, demonstrating their uses in the development of low-toxicity and sustainable reference tissue substitute phantom in radiological areas.

Development, Construction, and Evaluation of an Alternative Dosimetry Phantom for Computed Tomography.

This article aims to present the development, construction, and evaluation of an alternative computed tomography dose index (CTDI) phantom. Epoxy resin was mixed with an iodine-based contrast agent to produce radiological characteristics resembling polymethyl methacrylate (PMMA) as a standard CTDI phantom. As a preliminary study, testing was carried out using computed tomography images (80 and 120 kVp) on 12 variations of epoxy-iodine resin mixtures to obtain relative electron density (ρe) values and effective atomic numbers (Zeff) of the samples. The alternative CTDI phantoms were then constructed with a resin-iodine mixture using iodine concentrations that yield on closest ρe and Zeff values to those of PMMA. The evaluation was carried out by comparing dose measurement results at various energies between the alternative phantom and the International Electrotechnical Commission-standard CTDI phantom. At a concentration of 0.46%, the epoxy resin has ρe and Zeff with a deviation against PMMA of 0.12% and 1.58%, respectively, so that composition was chosen for the alternative CTDI phantom construction. The average dose discrepancy values were 5% and 1%, respectively, for the head and body phantoms in the tested tube voltages of 80 kVp, 100 kVp, 120 kVp, and 135 kVp. The Student's t-test result between the alternative and the standard phantoms also showed P < 0.05, indicating the comparability of the alternative CTDI phantom with the standard CTDI phantom.

Impact of In-House Bolus Thickness on The Percentage of Surface Dose for 10 and 12 MeV Electron Beams

The surface dose on electron irradiation which is received by the skin does not reach 100%, so a bolus is needed as a compensator material in order to reach or approach 100%. This study aims to create, test, and describe the effect of different thicknesses of boluses that are made of 3D printed TPU, silicone sealant and resin on equivalence with tissue and the percentage of surface dose produced. A bolus with a size of 15x15 cm2 and with variations in thickness of 0.3 cm, 0.5 cm, and 1 cm was imaged by a CT-Scan to analyze the CT-Number value and relative electron density using imageJ software. After that, the bolus was irradiated by a Linac with an energy of 10 MeV and 12 MeV to measure the surface dose using an advances marcus detector. The result of this study showed that 3D printed TPU, silicone sealant and resin are similar to some soft tissues. Silicone sealant has the highest flexibility of the two boluses. In addition, silicone sealant also produces the highest increase in the percentage of surface dose in phantom.

Evaluation of relative electron densities calculated by CT numbers in different techniques of dual-energy CT

Evaluation of relative electron densities calculated by CT numbers in different techniques of dual-energy CT

Improving the Accuracy of the Effective Atomic Number (EAN) and Relative Electron Density (RED) with Stoichiometric Calibration on PCD-CT Images

The photon counting detector (PCD) in computed tomography (CT) can count the number of incoming photons in order to obtain energy information for photons corresponding to user-defined thresholds. Research on the extraction of effective atomic number (EAN) and relative electron density (RED) using dual-energy CT (DECT) is currently underway. This study proposes a method for improving EAN and RED accuracy of tissue-equivalent materials by using PCD-CT-based stoichiometric calibration. After obtaining DECT images in energy bin (EB) and full spectrum (FS) modes for eight tissue-equivalent materials, the EAN was calculated with stoichiometric calibration. Using the EAN image, the RED image was acquired to evaluate the accuracy. The errors of both EAN and RED obtained with EB were within 4%. In particular, the accuracy of RED was higher than that of the FS method. Study results indicate that PCD-CT contributes to improving EAN and RED accuracy. Further studies will be aimed at reducing ring artifacts by pixel-correcting PCD images and improving stopping power ratio (SPR) measurements for dose calculation in particle therapy.