Dosimetric accuracy of proton therapy for chordoma patients with titanium implants

Verburg, J; Seco, Joao

doi:10.1118/1.4810942

Cited by 49 publications

(39 citation statements)

References 47 publications

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“…As shown before, inaccurate tissue characterization as a result of metal artifacts presence is expected to change the calculated proton range in the treatment geometry, resulting in changes in the deposited dose distribution. 25 As calculated on the uncorrected CT, the proton range along the beam central axis is 135.7 mm. However, when the same beam line is calculated on the corrected CT, the range along beam central axis becomes 125.0 mm, which is more than 1 cm different from that calculated on the uncorrected CT.…”

Section: C Dosimetric Effectsmentioning

confidence: 98%

Clinical evaluation of the iterative metal artifact reduction algorithm for CT simulation in radiotherapy

Paidi²,

et al. 2015

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IMAR correction algorithm could be readily implemented in an existing clinical workflow upon commercial release. While residual errors still exist in IMAR corrected images, these images present with better overall conspicuity of the patient/phantom geometry and offer more accurate CT numbers for improved local dosimetry. The variety of different scenarios included herein attest to the utility of the evaluated IMAR for a wide range of radiotherapy clinical scenarios.

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Section: C Dosimetric Effectsmentioning

confidence: 98%

Clinical evaluation of the iterative metal artifact reduction algorithm for CT simulation in radiotherapy

Paidi²,

et al. 2015

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“…An important application of general purpose Monte Carlo codes is to benchmark clinical dose calculation methods. [39][40][41] Here, we show a comparison between MCAUTO simulations and pencil beam dose calculations for patients with head and neck cancer. The pencil beam algorithm by Hong et al 42 is currently used in our clinic.…”

Section: Dose Calculationmentioning

confidence: 99%

Automated Monte Carlo Simulation of Proton Therapy Treatment Plans

Verburg

Grassberger

Dowdell

et al. 2016

Technol Cancer Res Treat

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Simulations of clinical proton radiotherapy treatment plans using general purpose Monte Carlo codes have been proven to be a valuable tool for basic research and clinical studies. They have been used to benchmark dose calculation methods, to study radiobiological effects, and to develop new technologies such as in vivo range verification methods. Advancements in the availability of computational power have made it feasible to perform such simulations on large sets of patient data, resulting in a need for automated and consistent simulations. A framework called MCAUTO was developed for this purpose. Both passive scattering and pencil beam scanning delivery are supported. The code handles the data exchange between the treatment planning system and the Monte Carlo system, which requires not only transfer of plan and imaging information but also translation of institutional procedures, such as output factor definitions. Simulations are performed on a high-performance computing infrastructure. The simulation methods were designed to use the full capabilities of Monte Carlo physics models, while also ensuring consistency in the approximations that are common to both pencil beam and Monte Carlo dose calculations. Although some methods need to be tailored to institutional planning systems and procedures, the described procedures show a general road map that can be easily translated to other systems.

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“…15 Verburg and Seco reported that errors in the beam range caused by titanium spine implants were also dictated by the geometry of the implant and proton beam orientation relative to the implant and artifacts. 16 In their phantom study, proton beams traversing through metal implants and bright streak artifacts or parallel to the artifacts resulted in large range errors from 1 to 10 mm. On the other hand, beams perpendicular to metal artifacts caused insignificant effect on the dose calculations.…”

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confidence: 98%

An additional tilted‐scan‐based CT metal‐artifact‐reduction method for radiation therapy planning

Kim

Pua

Lee

et al. 2018

J Applied Clin Med Phys

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PurposeAs computed tomography (CT) imaging is the most commonly used modality for treatment planning in radiation therapy, metal artifacts in the planning CT images may complicate the target delineation and reduce the dose calculation accuracy. Although current CT scanners do provide certain correction steps, it is a common understanding that there is not a universal solution yet to the metal artifact reduction (MAR) in general. Particularly noting the importance of MAR for radiation treatment planning, we propose a novel MAR method in this work that recruits an additional tilted CT scan and synthesizes nearly metal‐artifact‐free CT images.MethodsThe proposed method is based on the facts that the most pronounced metal artifacts in CT images show up along the x‐ray beam direction traversing multiple metallic objects and that a tilted CT scan can provide complementary information free of such metal artifacts in the earlier scan. Although the tilted CT scan would contain its own metal artifacts in the images, the artifacts may manifest in a different fashion leaving a chance to concatenate the two CT images with the metal artifacts much suppressed. We developed an image processing technique that uses the structural similarity (SSIM) for suppressing the metal artifacts. On top of the additional scan, we proposed to use an existing MAR method for each scan if necessary to further suppress the metal artifacts.ResultsThe proposed method was validated by a simulation study using the pelvic region of an XCAT numerical phantom and also by an experimental study using the head part of the Rando phantom. The proposed method was found to effectively reduce the metal artifacts. Quantitative analyses revealed that the proposed method reduced the mean absolute percentages of the error by up to 86% and 89% in the simulation and experimental studies, respectively.ConclusionsIt was confirmed that the proposed method, using complementary information acquired from an additional tilted CT scan, can provide nearly metal‐artifact‐free images for the treatment planning.

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Dosimetric accuracy of proton therapy for chordoma patients with titanium implants

Cited by 49 publications

References 47 publications

Clinical evaluation of the iterative metal artifact reduction algorithm for CT simulation in radiotherapy

Clinical evaluation of the iterative metal artifact reduction algorithm for CT simulation in radiotherapy

Automated Monte Carlo Simulation of Proton Therapy Treatment Plans

An additional tilted‐scan‐based CT metal‐artifact‐reduction method for radiation therapy planning

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