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Accuracy of Dual-Energy CT-Derived Relative Electron Density for Proton Therapy Dose Calculation

J Mullins

J Mullins1*, M Bues2 , X Duan1 , J Kruse1 , M Herman1 , (1) Mayo Clinic, Rochester, MN, (2) Mayo Clinic Arizona, Phoenix, AZ


SU-E-J-19 Sunday 3:00PM - 6:00PM Room: Exhibit Hall

Purpose: To determine the suitability of dual-energy CT (DECT) to calculate relative electron density (RED) of tissues for accurate proton therapy dose calculation.

Methods: DECT images of RED tissue surrogates were acquired at 80 and 140 kVp. Samples (RED=0.19-2.41) were imaged in a water-equivalent phantom in a variety of configurations. REDs were calculated using the DECT numbers and inputs of the high and low energy spectral weightings. DECT-derived RED was compared between geometric configurations and for variations in the spectral inputs to assess the sensitivity of RED accuracy versus expected values.

Results: RED accuracy was dependent on accurate spectral input influenced by phantom thickness and radius from the phantom center. Material samples located at the center of the phantom generally showed the best agreement to reference RED values, but only when attenuation of the surrounding phantom thickness was accounted for in the calculation spectra. Calculated RED changed by up to 10% for some materials when the sample was located at an 11 cm radius from the phantom center. Calculated REDs under the best conditions still differed from reference values by up to 5% in bone and 14% in lung.

Conclusion: DECT has previously been used to differentiate tissue types based on RED and Z for binary tissue-type segmentation. To improve upon the current standard of empirical conversion of CT number to RED for treatment planning dose calculation, DECT methods must be able to calculate RED to better than 3% accuracy throughout the image. The DECT method is sensitive to the accuracy of spectral inputs used for calculation, as well as to spatial position in the anatomy. Effort to address adjustments to the spectral calculation inputs based on position and phantom attenuation will be required before DECT-determined RED can achieve a consistent level of accuracy for application in dose calculation.

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