Open AccessDosimetric accuracy and radiobiological implications of ion computed tomography for proton therapy treatment planning
Author(s) -
Sebastian Meyer,
Florian Kamp,
Thomas Tessonnier,
Andrea Mairani,
Claus Belka,
David J. Carlson,
Chiara Gianoli,
Katia Parodi
Publication year - 2019
Publication title -
physics in medicine and biology/physics in medicine and biology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.312
H-Index - 191
eISSN - 1361-6560
pISSN - 0031-9155
DOI - 10.1088/1361-6560/ab0fdf
Subject(s) - proton therapy , proton , particle therapy , relative biological effectiveness , nuclear medicine , monte carlo method , radiation treatment planning , stopping power , materials science , range (aeronautics) , beam (structure) , detector , medical physics , physics , nuclear physics , medicine , radiation therapy , irradiation , optics , radiology , mathematics , statistics , composite material
Ion computed tomography (iCT) represents a potential replacement for x-ray CT (xCT) in ion therapy treatment planning to reduce range uncertainties, inherent in the semi-empirical conversion of xCT information into relative stopping power (RSP). In this work, we aim to quantify the increase in dosimetric accuracy associated with using proton-, helium- and carbon-CT compared to conventional xCT for clinical scenarios in proton therapy. Three cases imaged with active beam-delivery using an ideal single-particle-tracking detector were investigated using FLUKA Monte-Carlo (MC) simulations. The RSP accuracy of the iCTs was evaluated against the ground truth at similar physical dose. Next, the resulting dosimetric accuracy was investigated by using the RSP images as a patient model in proton therapy treatment planning, in comparison to common uncertainties associated with xCT. Finally, changes in relative biological effectiveness (RBE) with iCT particle type/spectrum were investigated by incorporating the repair-misrepair-fixation (RMF) model into FLUKA, to enable first insights on the associated biological imaging dose. Helium-CT provided the lowest overall RSP error, whereas carbon-CT offered the highest accuracy for bone and proton-CT for soft tissue. For a single field, the average relative proton beam-range variation was −1.00%, +0.09%, −0.08% and −0.35% for xCT, proton-, helium- and carbon-CT, respectively. Using a 0.5%/0.5mm gamma-evaluation, all iCTs offered comparable accuracy with a better than 99% passing rate, compared to 83% for xCT. The RMF model predictions for RBE for cell death relative to a diagnostic xCT spectrum were 0.82–0.85, 0.85–0.89 and 0.97–1.03 for proton-, helium-, and carbon-CT, respectively. The corresponding RBE for DNA double-strand break induction was generally below one. iCT offers great clinical potential for proton therapy treatment planning by providing superior dose calculation accuracy as well as lower physical and potentially biological dose exposure compared to xCT. For the investigated dose level and ideal detector, proton-CT and helium-CT yielded the best performance.