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DECT Based Tissue Segmentation as Input to Monte Carlo Simulations for Proton Treatment Verification Using PET Imaging

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B Berndt

B Berndt1*, T Tessonnier1,2 , F Schwarz3 , J Bauer2,4 , M Wuerl1 , F Kamp3 , C Thieke3 , C Belka3 , F Verhaegen5 , M Reiser3 , W Sommer3 , G Dedes1 , G Landry1 , K Parodi1, (1) Ludwig-Maximilians-Universitaet Muenchen, Garching, Germany, (2) Universitaetsklinikum Heidelberg, Heidelberg, Germany, (3) LMU Munich, Munich, Germany, (4) Heidelberg Ion-Beam Therapy Center, Heidelberg, Germany, (5) Maastro Clinic, Maastricht, the Netherlands


TH-CD-202-5 (Thursday, August 4, 2016) 10:00 AM - 12:00 PM Room: 202

Purpose: To improve agreement of predicted and measured positron emitter yields in patients, after proton irradiation for PET-based treatment verification, using a novel dual energy CT (DECT) tissue segmentation approach, overcoming known deficiencies from single energy CT (SECT).

Methods: DECT head scans of 5 trauma patients were segmented and compared to existing decomposition methods with a first focus on the brain. For validation purposes, three brain equivalent solutions [water, white matter (WM) and grey matter (GM) – equivalent with respect to their reference carbon and oxygen contents and CT numbers at 90kVp and 150kVp] were prepared from water, ethanol, sucrose and salt. The activities of all brain solutions, measured during a PET scan after uniform proton irradiation, were compared to Monte Carlo simulations. Simulation inputs were various solution compositions obtained from different segmentation approaches from DECT, SECT scans, and known reference composition. Virtual GM solution salt concentration corrections were applied based on DECT measurements of solutions with varying salt concentration.

Results: The novel tissue segmentation showed qualitative improvements in %C for patient brain scans (ground truth unavailable). The activity simulations based on reference solution compositions agree with the measurement within 3-5% (4-8Bq/ml). These reference simulations showed an absolute activity difference between WM (20%C) and GM (10%C) to H2O (0%C) of 43 Bq/ml and 22 Bq/ml, respectively. Activity differences between reference simulations and segmented ones varied from -6 to 1 Bq/ml for DECT and -79 to 8 Bq/ml for SECT.

Conclusion: Compared to the conventionally used SECT segmentation, the DECT based segmentation indicates a qualitative and quantitative improvement. In controlled solutions, a MC input based on DECT segmentation leads to better agreement with the reference. Future work will address the anticipated improvement of quantification accuracy in patients, comparing different tissue decomposition methods with an MR brain segmentation.

Acknowledgement: DFG-MAP and HIT-Heidelberg

Funding Support, Disclosures, and Conflict of Interest: Deutsche Forschungsgemeinschaft (MAP) Bundesministerium fur Bildung und Forschung (01IB13001)

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