Phantom based evaluation of CT to CBCT image registration for proton therapy dose recalculation
The ability to perform dose recalculation on the anatomy of the day is important in the context of adaptive proton therapy. The objective of this study was to investigate the use of deformable image registration (DIR) and cone beam CT (CBCT) imaging to generate the daily stopping power distribution...
Ausführliche Beschreibung
Autor*in: |
Landry, Guillaume [verfasserIn] |
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Artikel |
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Englisch |
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2015 |
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Radiotherapy Planning, Computer-Assisted - methods |
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Systematik: |
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Übergeordnetes Werk: |
Enthalten in: Physics in medicine and biology - Bristol : IOP Publ., 1956, 60(2015), 2, Seite 595 |
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Übergeordnetes Werk: |
volume:60 ; year:2015 ; number:2 ; pages:595 |
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OLC1966078641 |
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520 | |a The ability to perform dose recalculation on the anatomy of the day is important in the context of adaptive proton therapy. The objective of this study was to investigate the use of deformable image registration (DIR) and cone beam CT (CBCT) imaging to generate the daily stopping power distribution of the patient. We investigated the deformation of the planning CT scan (pCT) onto daily CBCT images to generate a virtual CT (vCT) using a deformable phantom designed for the head and neck (H & N) region. The phantom was imaged at a planning CT scanner in planning configuration, yielding a pCT and in deformed, treatment day configuration, yielding a reference CT (refCT). The treatment day configuration was additionally scanned at a CBCT scanner. A Morphons DIR algorithm was used to generate a vCT. The accuracy of the vCT was evaluated by comparison to the refCT in terms of corresponding features as identified by an adaptive scale invariant feature transform (aSIFT) algorithm. Additionally, the vCT CT numbers were compared to those of the refCT using both profiles and regions of interest and the volumes and overlap (DICE coefficients) of various phantom structures were compared. The water equivalent thickness (WET) of the vCT, refCT and pCT were also compared to evaluate proton range differences. Proton dose distributions from the same initial fluence were calculated on the refCT, vCT and pCT and compared in terms of proton range. The method was tested on a clinical dataset using a replanning CT scan acquired close in time to a CBCT scan as reference using the WET evaluation. Results from the aSIFT investigation suggest a deformation accuracy of 2-3 mm. The use of the Morphon algorithm did not distort CT number intensity in uniform regions and WET differences between vCT and refCT were of the order of 2% of the proton range. This result was confirmed by proton dose calculations. The patient results were consistent with phantom observations. In conclusion, our phantom study suggests the vCT approach is adequate for proton dose recalculation on the basis of CBCT imaging. | ||
650 | 4 | |a Radiotherapy Planning, Computer-Assisted - methods | |
650 | 4 | |a Cone-Beam Computed Tomography - methods | |
650 | 4 | |a Proton Therapy - methods | |
700 | 1 | |a Dedes, George |4 oth | |
700 | 1 | |a Zöllner, Christoph |4 oth | |
700 | 1 | |a Handrack, Josefine |4 oth | |
700 | 1 | |a Janssens, Guillaume |4 oth | |
700 | 1 | |a Orban de Xivry, Jonathan |4 oth | |
700 | 1 | |a Reiner, Michael |4 oth | |
700 | 1 | |a Paganelli, Chiara |4 oth | |
700 | 1 | |a Riboldi, Marco |4 oth | |
700 | 1 | |a Kamp, Florian |4 oth | |
700 | 1 | |a Söhn, Matthias |4 oth | |
700 | 1 | |a Wilkens, Jan J |4 oth | |
700 | 1 | |a Baroni, Guido |4 oth | |
700 | 1 | |a Belka, Claus |4 oth | |
700 | 1 | |a Parodi, Katia |4 oth | |
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PQ20160617 (DE-627)OLC1966078641 (DE-599)GBVOLC1966078641 (PRQ)p1197-a2c78abac102fdc49f80046a2459248ea32f8ae6dc0a934f93ffb43bf34d408b0 (KEY)0053250920150000060000200595phantombasedevaluationofcttocbctimageregistrationf DE-627 ger DE-627 rakwb eng 570 540 530 DNB BIODIV fid WA 15000 AVZ rvk 44.31 bkl 42.12 bkl Landry, Guillaume verfasserin aut Phantom based evaluation of CT to CBCT image registration for proton therapy dose recalculation 2015 Text txt rdacontent ohne Hilfsmittel zu benutzen n rdamedia Band nc rdacarrier The ability to perform dose recalculation on the anatomy of the day is important in the context of adaptive proton therapy. The objective of this study was to investigate the use of deformable image registration (DIR) and cone beam CT (CBCT) imaging to generate the daily stopping power distribution of the patient. We investigated the deformation of the planning CT scan (pCT) onto daily CBCT images to generate a virtual CT (vCT) using a deformable phantom designed for the head and neck (H & N) region. The phantom was imaged at a planning CT scanner in planning configuration, yielding a pCT and in deformed, treatment day configuration, yielding a reference CT (refCT). The treatment day configuration was additionally scanned at a CBCT scanner. A Morphons DIR algorithm was used to generate a vCT. The accuracy of the vCT was evaluated by comparison to the refCT in terms of corresponding features as identified by an adaptive scale invariant feature transform (aSIFT) algorithm. Additionally, the vCT CT numbers were compared to those of the refCT using both profiles and regions of interest and the volumes and overlap (DICE coefficients) of various phantom structures were compared. The water equivalent thickness (WET) of the vCT, refCT and pCT were also compared to evaluate proton range differences. Proton dose distributions from the same initial fluence were calculated on the refCT, vCT and pCT and compared in terms of proton range. The method was tested on a clinical dataset using a replanning CT scan acquired close in time to a CBCT scan as reference using the WET evaluation. Results from the aSIFT investigation suggest a deformation accuracy of 2-3 mm. The use of the Morphon algorithm did not distort CT number intensity in uniform regions and WET differences between vCT and refCT were of the order of 2% of the proton range. This result was confirmed by proton dose calculations. The patient results were consistent with phantom observations. In conclusion, our phantom study suggests the vCT approach is adequate for proton dose recalculation on the basis of CBCT imaging. Radiotherapy Planning, Computer-Assisted - methods Cone-Beam Computed Tomography - methods Proton Therapy - methods Dedes, George oth Zöllner, Christoph oth Handrack, Josefine oth Janssens, Guillaume oth Orban de Xivry, Jonathan oth Reiner, Michael oth Paganelli, Chiara oth Riboldi, Marco oth Kamp, Florian oth Söhn, Matthias oth Wilkens, Jan J oth Baroni, Guido oth Belka, Claus oth Parodi, Katia oth Enthalten in Physics in medicine and biology Bristol : IOP Publ., 1956 60(2015), 2, Seite 595 (DE-627)129503991 (DE-600)208857-5 (DE-576)014907305 0031-9155 nnns volume:60 year:2015 number:2 pages:595 http://www.ncbi.nlm.nih.gov/pubmed/25548912 GBV_USEFLAG_A SYSFLAG_A GBV_OLC FID-BIODIV SSG-OLC-PHY SSG-OLC-CHE GBV_ILN_22 GBV_ILN_70 GBV_ILN_170 GBV_ILN_4012 GBV_ILN_4219 GBV_ILN_4306 WA 15000 44.31 AVZ 42.12 AVZ AR 60 2015 2 595 |
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PQ20160617 (DE-627)OLC1966078641 (DE-599)GBVOLC1966078641 (PRQ)p1197-a2c78abac102fdc49f80046a2459248ea32f8ae6dc0a934f93ffb43bf34d408b0 (KEY)0053250920150000060000200595phantombasedevaluationofcttocbctimageregistrationf DE-627 ger DE-627 rakwb eng 570 540 530 DNB BIODIV fid WA 15000 AVZ rvk 44.31 bkl 42.12 bkl Landry, Guillaume verfasserin aut Phantom based evaluation of CT to CBCT image registration for proton therapy dose recalculation 2015 Text txt rdacontent ohne Hilfsmittel zu benutzen n rdamedia Band nc rdacarrier The ability to perform dose recalculation on the anatomy of the day is important in the context of adaptive proton therapy. The objective of this study was to investigate the use of deformable image registration (DIR) and cone beam CT (CBCT) imaging to generate the daily stopping power distribution of the patient. We investigated the deformation of the planning CT scan (pCT) onto daily CBCT images to generate a virtual CT (vCT) using a deformable phantom designed for the head and neck (H & N) region. The phantom was imaged at a planning CT scanner in planning configuration, yielding a pCT and in deformed, treatment day configuration, yielding a reference CT (refCT). The treatment day configuration was additionally scanned at a CBCT scanner. A Morphons DIR algorithm was used to generate a vCT. The accuracy of the vCT was evaluated by comparison to the refCT in terms of corresponding features as identified by an adaptive scale invariant feature transform (aSIFT) algorithm. Additionally, the vCT CT numbers were compared to those of the refCT using both profiles and regions of interest and the volumes and overlap (DICE coefficients) of various phantom structures were compared. The water equivalent thickness (WET) of the vCT, refCT and pCT were also compared to evaluate proton range differences. Proton dose distributions from the same initial fluence were calculated on the refCT, vCT and pCT and compared in terms of proton range. The method was tested on a clinical dataset using a replanning CT scan acquired close in time to a CBCT scan as reference using the WET evaluation. Results from the aSIFT investigation suggest a deformation accuracy of 2-3 mm. The use of the Morphon algorithm did not distort CT number intensity in uniform regions and WET differences between vCT and refCT were of the order of 2% of the proton range. This result was confirmed by proton dose calculations. The patient results were consistent with phantom observations. In conclusion, our phantom study suggests the vCT approach is adequate for proton dose recalculation on the basis of CBCT imaging. Radiotherapy Planning, Computer-Assisted - methods Cone-Beam Computed Tomography - methods Proton Therapy - methods Dedes, George oth Zöllner, Christoph oth Handrack, Josefine oth Janssens, Guillaume oth Orban de Xivry, Jonathan oth Reiner, Michael oth Paganelli, Chiara oth Riboldi, Marco oth Kamp, Florian oth Söhn, Matthias oth Wilkens, Jan J oth Baroni, Guido oth Belka, Claus oth Parodi, Katia oth Enthalten in Physics in medicine and biology Bristol : IOP Publ., 1956 60(2015), 2, Seite 595 (DE-627)129503991 (DE-600)208857-5 (DE-576)014907305 0031-9155 nnns volume:60 year:2015 number:2 pages:595 http://www.ncbi.nlm.nih.gov/pubmed/25548912 GBV_USEFLAG_A SYSFLAG_A GBV_OLC FID-BIODIV SSG-OLC-PHY SSG-OLC-CHE GBV_ILN_22 GBV_ILN_70 GBV_ILN_170 GBV_ILN_4012 GBV_ILN_4219 GBV_ILN_4306 WA 15000 44.31 AVZ 42.12 AVZ AR 60 2015 2 595 |
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PQ20160617 (DE-627)OLC1966078641 (DE-599)GBVOLC1966078641 (PRQ)p1197-a2c78abac102fdc49f80046a2459248ea32f8ae6dc0a934f93ffb43bf34d408b0 (KEY)0053250920150000060000200595phantombasedevaluationofcttocbctimageregistrationf DE-627 ger DE-627 rakwb eng 570 540 530 DNB BIODIV fid WA 15000 AVZ rvk 44.31 bkl 42.12 bkl Landry, Guillaume verfasserin aut Phantom based evaluation of CT to CBCT image registration for proton therapy dose recalculation 2015 Text txt rdacontent ohne Hilfsmittel zu benutzen n rdamedia Band nc rdacarrier The ability to perform dose recalculation on the anatomy of the day is important in the context of adaptive proton therapy. The objective of this study was to investigate the use of deformable image registration (DIR) and cone beam CT (CBCT) imaging to generate the daily stopping power distribution of the patient. We investigated the deformation of the planning CT scan (pCT) onto daily CBCT images to generate a virtual CT (vCT) using a deformable phantom designed for the head and neck (H & N) region. The phantom was imaged at a planning CT scanner in planning configuration, yielding a pCT and in deformed, treatment day configuration, yielding a reference CT (refCT). The treatment day configuration was additionally scanned at a CBCT scanner. A Morphons DIR algorithm was used to generate a vCT. The accuracy of the vCT was evaluated by comparison to the refCT in terms of corresponding features as identified by an adaptive scale invariant feature transform (aSIFT) algorithm. Additionally, the vCT CT numbers were compared to those of the refCT using both profiles and regions of interest and the volumes and overlap (DICE coefficients) of various phantom structures were compared. The water equivalent thickness (WET) of the vCT, refCT and pCT were also compared to evaluate proton range differences. Proton dose distributions from the same initial fluence were calculated on the refCT, vCT and pCT and compared in terms of proton range. The method was tested on a clinical dataset using a replanning CT scan acquired close in time to a CBCT scan as reference using the WET evaluation. Results from the aSIFT investigation suggest a deformation accuracy of 2-3 mm. The use of the Morphon algorithm did not distort CT number intensity in uniform regions and WET differences between vCT and refCT were of the order of 2% of the proton range. This result was confirmed by proton dose calculations. The patient results were consistent with phantom observations. In conclusion, our phantom study suggests the vCT approach is adequate for proton dose recalculation on the basis of CBCT imaging. Radiotherapy Planning, Computer-Assisted - methods Cone-Beam Computed Tomography - methods Proton Therapy - methods Dedes, George oth Zöllner, Christoph oth Handrack, Josefine oth Janssens, Guillaume oth Orban de Xivry, Jonathan oth Reiner, Michael oth Paganelli, Chiara oth Riboldi, Marco oth Kamp, Florian oth Söhn, Matthias oth Wilkens, Jan J oth Baroni, Guido oth Belka, Claus oth Parodi, Katia oth Enthalten in Physics in medicine and biology Bristol : IOP Publ., 1956 60(2015), 2, Seite 595 (DE-627)129503991 (DE-600)208857-5 (DE-576)014907305 0031-9155 nnns volume:60 year:2015 number:2 pages:595 http://www.ncbi.nlm.nih.gov/pubmed/25548912 GBV_USEFLAG_A SYSFLAG_A GBV_OLC FID-BIODIV SSG-OLC-PHY SSG-OLC-CHE GBV_ILN_22 GBV_ILN_70 GBV_ILN_170 GBV_ILN_4012 GBV_ILN_4219 GBV_ILN_4306 WA 15000 44.31 AVZ 42.12 AVZ AR 60 2015 2 595 |
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PQ20160617 (DE-627)OLC1966078641 (DE-599)GBVOLC1966078641 (PRQ)p1197-a2c78abac102fdc49f80046a2459248ea32f8ae6dc0a934f93ffb43bf34d408b0 (KEY)0053250920150000060000200595phantombasedevaluationofcttocbctimageregistrationf DE-627 ger DE-627 rakwb eng 570 540 530 DNB BIODIV fid WA 15000 AVZ rvk 44.31 bkl 42.12 bkl Landry, Guillaume verfasserin aut Phantom based evaluation of CT to CBCT image registration for proton therapy dose recalculation 2015 Text txt rdacontent ohne Hilfsmittel zu benutzen n rdamedia Band nc rdacarrier The ability to perform dose recalculation on the anatomy of the day is important in the context of adaptive proton therapy. The objective of this study was to investigate the use of deformable image registration (DIR) and cone beam CT (CBCT) imaging to generate the daily stopping power distribution of the patient. We investigated the deformation of the planning CT scan (pCT) onto daily CBCT images to generate a virtual CT (vCT) using a deformable phantom designed for the head and neck (H & N) region. The phantom was imaged at a planning CT scanner in planning configuration, yielding a pCT and in deformed, treatment day configuration, yielding a reference CT (refCT). The treatment day configuration was additionally scanned at a CBCT scanner. A Morphons DIR algorithm was used to generate a vCT. The accuracy of the vCT was evaluated by comparison to the refCT in terms of corresponding features as identified by an adaptive scale invariant feature transform (aSIFT) algorithm. Additionally, the vCT CT numbers were compared to those of the refCT using both profiles and regions of interest and the volumes and overlap (DICE coefficients) of various phantom structures were compared. The water equivalent thickness (WET) of the vCT, refCT and pCT were also compared to evaluate proton range differences. Proton dose distributions from the same initial fluence were calculated on the refCT, vCT and pCT and compared in terms of proton range. The method was tested on a clinical dataset using a replanning CT scan acquired close in time to a CBCT scan as reference using the WET evaluation. Results from the aSIFT investigation suggest a deformation accuracy of 2-3 mm. The use of the Morphon algorithm did not distort CT number intensity in uniform regions and WET differences between vCT and refCT were of the order of 2% of the proton range. This result was confirmed by proton dose calculations. The patient results were consistent with phantom observations. In conclusion, our phantom study suggests the vCT approach is adequate for proton dose recalculation on the basis of CBCT imaging. Radiotherapy Planning, Computer-Assisted - methods Cone-Beam Computed Tomography - methods Proton Therapy - methods Dedes, George oth Zöllner, Christoph oth Handrack, Josefine oth Janssens, Guillaume oth Orban de Xivry, Jonathan oth Reiner, Michael oth Paganelli, Chiara oth Riboldi, Marco oth Kamp, Florian oth Söhn, Matthias oth Wilkens, Jan J oth Baroni, Guido oth Belka, Claus oth Parodi, Katia oth Enthalten in Physics in medicine and biology Bristol : IOP Publ., 1956 60(2015), 2, Seite 595 (DE-627)129503991 (DE-600)208857-5 (DE-576)014907305 0031-9155 nnns volume:60 year:2015 number:2 pages:595 http://www.ncbi.nlm.nih.gov/pubmed/25548912 GBV_USEFLAG_A SYSFLAG_A GBV_OLC FID-BIODIV SSG-OLC-PHY SSG-OLC-CHE GBV_ILN_22 GBV_ILN_70 GBV_ILN_170 GBV_ILN_4012 GBV_ILN_4219 GBV_ILN_4306 WA 15000 44.31 AVZ 42.12 AVZ AR 60 2015 2 595 |
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Enthalten in Physics in medicine and biology 60(2015), 2, Seite 595 volume:60 year:2015 number:2 pages:595 |
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Landry, Guillaume @@aut@@ Dedes, George @@oth@@ Zöllner, Christoph @@oth@@ Handrack, Josefine @@oth@@ Janssens, Guillaume @@oth@@ Orban de Xivry, Jonathan @@oth@@ Reiner, Michael @@oth@@ Paganelli, Chiara @@oth@@ Riboldi, Marco @@oth@@ Kamp, Florian @@oth@@ Söhn, Matthias @@oth@@ Wilkens, Jan J @@oth@@ Baroni, Guido @@oth@@ Belka, Claus @@oth@@ Parodi, Katia @@oth@@ |
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Landry, Guillaume |
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phantom based evaluation of ct to cbct image registration for proton therapy dose recalculation |
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Phantom based evaluation of CT to CBCT image registration for proton therapy dose recalculation |
abstract |
The ability to perform dose recalculation on the anatomy of the day is important in the context of adaptive proton therapy. The objective of this study was to investigate the use of deformable image registration (DIR) and cone beam CT (CBCT) imaging to generate the daily stopping power distribution of the patient. We investigated the deformation of the planning CT scan (pCT) onto daily CBCT images to generate a virtual CT (vCT) using a deformable phantom designed for the head and neck (H & N) region. The phantom was imaged at a planning CT scanner in planning configuration, yielding a pCT and in deformed, treatment day configuration, yielding a reference CT (refCT). The treatment day configuration was additionally scanned at a CBCT scanner. A Morphons DIR algorithm was used to generate a vCT. The accuracy of the vCT was evaluated by comparison to the refCT in terms of corresponding features as identified by an adaptive scale invariant feature transform (aSIFT) algorithm. Additionally, the vCT CT numbers were compared to those of the refCT using both profiles and regions of interest and the volumes and overlap (DICE coefficients) of various phantom structures were compared. The water equivalent thickness (WET) of the vCT, refCT and pCT were also compared to evaluate proton range differences. Proton dose distributions from the same initial fluence were calculated on the refCT, vCT and pCT and compared in terms of proton range. The method was tested on a clinical dataset using a replanning CT scan acquired close in time to a CBCT scan as reference using the WET evaluation. Results from the aSIFT investigation suggest a deformation accuracy of 2-3 mm. The use of the Morphon algorithm did not distort CT number intensity in uniform regions and WET differences between vCT and refCT were of the order of 2% of the proton range. This result was confirmed by proton dose calculations. The patient results were consistent with phantom observations. In conclusion, our phantom study suggests the vCT approach is adequate for proton dose recalculation on the basis of CBCT imaging. |
abstractGer |
The ability to perform dose recalculation on the anatomy of the day is important in the context of adaptive proton therapy. The objective of this study was to investigate the use of deformable image registration (DIR) and cone beam CT (CBCT) imaging to generate the daily stopping power distribution of the patient. We investigated the deformation of the planning CT scan (pCT) onto daily CBCT images to generate a virtual CT (vCT) using a deformable phantom designed for the head and neck (H & N) region. The phantom was imaged at a planning CT scanner in planning configuration, yielding a pCT and in deformed, treatment day configuration, yielding a reference CT (refCT). The treatment day configuration was additionally scanned at a CBCT scanner. A Morphons DIR algorithm was used to generate a vCT. The accuracy of the vCT was evaluated by comparison to the refCT in terms of corresponding features as identified by an adaptive scale invariant feature transform (aSIFT) algorithm. Additionally, the vCT CT numbers were compared to those of the refCT using both profiles and regions of interest and the volumes and overlap (DICE coefficients) of various phantom structures were compared. The water equivalent thickness (WET) of the vCT, refCT and pCT were also compared to evaluate proton range differences. Proton dose distributions from the same initial fluence were calculated on the refCT, vCT and pCT and compared in terms of proton range. The method was tested on a clinical dataset using a replanning CT scan acquired close in time to a CBCT scan as reference using the WET evaluation. Results from the aSIFT investigation suggest a deformation accuracy of 2-3 mm. The use of the Morphon algorithm did not distort CT number intensity in uniform regions and WET differences between vCT and refCT were of the order of 2% of the proton range. This result was confirmed by proton dose calculations. The patient results were consistent with phantom observations. In conclusion, our phantom study suggests the vCT approach is adequate for proton dose recalculation on the basis of CBCT imaging. |
abstract_unstemmed |
The ability to perform dose recalculation on the anatomy of the day is important in the context of adaptive proton therapy. The objective of this study was to investigate the use of deformable image registration (DIR) and cone beam CT (CBCT) imaging to generate the daily stopping power distribution of the patient. We investigated the deformation of the planning CT scan (pCT) onto daily CBCT images to generate a virtual CT (vCT) using a deformable phantom designed for the head and neck (H & N) region. The phantom was imaged at a planning CT scanner in planning configuration, yielding a pCT and in deformed, treatment day configuration, yielding a reference CT (refCT). The treatment day configuration was additionally scanned at a CBCT scanner. A Morphons DIR algorithm was used to generate a vCT. The accuracy of the vCT was evaluated by comparison to the refCT in terms of corresponding features as identified by an adaptive scale invariant feature transform (aSIFT) algorithm. Additionally, the vCT CT numbers were compared to those of the refCT using both profiles and regions of interest and the volumes and overlap (DICE coefficients) of various phantom structures were compared. The water equivalent thickness (WET) of the vCT, refCT and pCT were also compared to evaluate proton range differences. Proton dose distributions from the same initial fluence were calculated on the refCT, vCT and pCT and compared in terms of proton range. The method was tested on a clinical dataset using a replanning CT scan acquired close in time to a CBCT scan as reference using the WET evaluation. Results from the aSIFT investigation suggest a deformation accuracy of 2-3 mm. The use of the Morphon algorithm did not distort CT number intensity in uniform regions and WET differences between vCT and refCT were of the order of 2% of the proton range. This result was confirmed by proton dose calculations. The patient results were consistent with phantom observations. In conclusion, our phantom study suggests the vCT approach is adequate for proton dose recalculation on the basis of CBCT imaging. |
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Phantom based evaluation of CT to CBCT image registration for proton therapy dose recalculation |
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Dedes, George Zöllner, Christoph Handrack, Josefine Janssens, Guillaume Orban de Xivry, Jonathan Reiner, Michael Paganelli, Chiara Riboldi, Marco Kamp, Florian Söhn, Matthias Wilkens, Jan J Baroni, Guido Belka, Claus Parodi, Katia |
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The objective of this study was to investigate the use of deformable image registration (DIR) and cone beam CT (CBCT) imaging to generate the daily stopping power distribution of the patient. We investigated the deformation of the planning CT scan (pCT) onto daily CBCT images to generate a virtual CT (vCT) using a deformable phantom designed for the head and neck (H & N) region. The phantom was imaged at a planning CT scanner in planning configuration, yielding a pCT and in deformed, treatment day configuration, yielding a reference CT (refCT). The treatment day configuration was additionally scanned at a CBCT scanner. A Morphons DIR algorithm was used to generate a vCT. The accuracy of the vCT was evaluated by comparison to the refCT in terms of corresponding features as identified by an adaptive scale invariant feature transform (aSIFT) algorithm. Additionally, the vCT CT numbers were compared to those of the refCT using both profiles and regions of interest and the volumes and overlap (DICE coefficients) of various phantom structures were compared. The water equivalent thickness (WET) of the vCT, refCT and pCT were also compared to evaluate proton range differences. Proton dose distributions from the same initial fluence were calculated on the refCT, vCT and pCT and compared in terms of proton range. The method was tested on a clinical dataset using a replanning CT scan acquired close in time to a CBCT scan as reference using the WET evaluation. Results from the aSIFT investigation suggest a deformation accuracy of 2-3 mm. The use of the Morphon algorithm did not distort CT number intensity in uniform regions and WET differences between vCT and refCT were of the order of 2% of the proton range. This result was confirmed by proton dose calculations. The patient results were consistent with phantom observations. 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