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Background: We used a MapCHECK so ware-based dimensional dose distribu on comparison method capable of evalua ng point-to-point geometrical dose differences in volume to determine whether doses obtained from an enhanced computed tomography (CT)-based treatment plan, which be%er defines the target regions and organs at risk, differs from doses obtained from plain CT and then evaluated the feasibility of treatment planning via enhanced CT. Materials and Methods: Forty-three randomly selected pa ents underwent plain and subsequent enhanced CT with the same se+ngs. Treatment plans developed for the two scans were iden cal in terms of planning parameters (e.g., isocentre, gantry angle, segments) and monitor units (MU) used for dose calcula on. Horizontal and ver cal dose distribu on planes across the same isocentre were selected from two types of plan; a two-dimensional dose distribu on analysis was used to determine the Distance-To-Agree (DTA) pass ra os of corresponding dose distribu on planes. Results: Obtained doses at the head and neck (H&N) and pelvic sites did not differ greatly between enhanced and plain CT. However, enhanced CT significantly influenced doses to the lower thoracic oesophagus. A corrected pass ra o that was achieved by non-pass points in lower isodose areas excluded from the sta s cal analysis had be%er clinical outcome. Conclusion: Radia on plans with mul -fields and mul -angles can reduce the influence of enhanced CT on torso cases and may even negate its influence on H&N cases. Enhanced CT can be directly used for planning unless the target region contains the lower oesophagus and its surrounding blood vessel whose high density requires correc on.

international journal of radiation research

The feasibility of direct treatment planning via contrast-enhanced computed tomography: an evaluation of dose differences based on the dimensional dose distribution comparison method