Accuracy in proton range prediction is critical in proton therapy to ensure conformal tumor dose. Our lab proposed a joint statistical image reconstruction method (JSIR) based on a basis vector model (BVM) for estimation of stopping power ratio maps and demonstrated that it outperforms competing Dual Energy CT (DECT) methods. However, no study has been performed on the clinical utility of our method. Here, we study the resulting dose prediction error, the difference between the dose delivered to tissue based on the more accurate JSIR-BVM method and the planned dose based on Single Energy CT (SECT).
Proton radiotherapy has the potential to provide clinically effective treatment and highly conformal dose delivery when the rapid dose falloff at the end of its proton-beam range is correctly aligned to the distal margin of the clinical target volume. However, in current clinical practice an additional 2-3.5% safety margin must be added to the proton range to account for uncertainties in the estimation of proton-beam range when using stopping-power ratios (SPRs) derived from single-energy CT scans. Several approaches have been proposed to estimate stopping power by using dual-energy CT (DECT) and have been shown through theoretical analysis to outperform single-energy CT (SECT) under the presence of tissue composition and density variations. Our lab previously proposed a joint statistical image reconstruction (JSIR) method built on a basis-vector model (BVM) tissue parameterization for SPR estimation, which was shown to perform comparatively better than other DECT image- and sinogram-domain decomposition approaches on simulated as well as experimental data. This comparison, however, assumed theoretical SPR values calculated from the samples’ known compositions and densities as ground truth and used the mean excitation energy and effective electron density from ICRU reports along with a simplified version of the Bethe-Bloch equation to determine SPR reference values. Furthermore, CT scans were acquired with an assumed ideal point source at a narrow beam collimation; thus, the signal formation assumed by our JSIR process neglected scatter and off-focal radiation. In this paper, we verify the accuracy of our method by comparing the SPR values derived from JSIR-BVM to direct measurements of relative SPR, as well as present a preliminary study on the impact of fan-beam scatter radiation on JSIR-BVM SPR prediction accuracy.
Radiochromic films, owing to their high spatial resolution, are well-suited for radiation therapy dosimetry and quality assurance purposes. However, their spectroscopic response to radiotherapy beams has not been comprehensively investigated, except for a limited subset of beam qualities. In this work, we explore the spectral response of the EBT3 and EBT-XD radiochromic film models to different clinical radiation beam qualities including photons and protons. The spectral response of EBT3 and EBT-XD films showed two peaks at 585 nm and 635 nm for both photon and proton irradiation. Beyond a certain batch- and model-dependent dose threshold a saturation behavior was observed in the primary absorption peak. For beam qualities studied in this work, the spectral response of proton-irradiated films showed a systematic under-response compared to their photon-irradiated counterparts in both EBT-3 and EBTXD radiochromic films models.
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