Influence of different air CT numbers for IVDT on the dose distribution in TomoTherapy MVCT

Abstract

This study aims to evaluate the effect of different air computed tomography (CT) numbers of the image value density table (IVDT) on the retrospective dose calculation of head‐and‐neck (HN) radiotherapy using TomoTherapy megavoltage CT (MVCT) images. The CT numbers of the inside and outside air and each tissue‐equivalent plug of the “Cheese” phantom were obtained from TomoTherapy MVCT. Two IVDTs with different air CT numbers were created and applied to MVCT images of the HN anthropomorphic phantom and recalculated by Planned Adaptive to verify dose distribution. We defined the recalculation dose with MVCT images using both inside and outside air of the IVDT as and , respectively. Treatment planning doses calculated on kVCT images were compared with those calculated on MVCT images using two different IVDT tables, namely, and . The difference between average MVCT numbers ±1 standard deviation on inside and outside air of the calibration phantom was 65 ± 36 HU. This difference in MVCT number of air exceeded the recommendation lung tolerance for dose calculation error of 2%. The dose differences between the planning target volume (PTV): D 98% , D 50% , D 2% and the organ at risk (OAR): D max , D mean recalculated by and using MVCT images were a maximum of 0.7% and 1.2%, respectively. Recalculated doses to the PTV and OAR with MVCT showed that was 0.5%–0.7% closer to the kVCT treatment planning dose than . This study showed that was more accurate than in recalculating the dose HN cases of MVCT using TomoTherapy.

Comparing Efficacy Between Robust and PTV Margin-based Optimizations for Interfractional Anatomical Variations in Prostate Tomotherapy

“…After correction, the beam data of the nominal robust and PTV plan were copied to each MVCT image, and the dose distributions were recalculated. Notably, in this study, three dose recalculation scenarios were considered because of the difference in the dose calculation accuracies of kVCT and MVCT (14,15). The dose for MVCT was approximately 2% higher than that for kVCT (14,17); therefore, the scenarios were dose correction of 1% (DC1%), DC2%, and DC3%.…”

“…Tomotherapy is equipped with a megavolt-CT (MVCT) system, and the acquisition of an MVCT image is a prerequisite before each treatment fraction (12). MVCT can be used for IGRT and dose recalculation (13)(14)(15). The present study aimed to compare the dosimetric consequences of robust and PTV-margin-based optimization to assess the efficacy of optimization technique on helical tomotherapy plans for prostate cancer in the presence of interfractional anatomical variations.…”