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SU‐E‐CAMPUS‐J‐06: The Impact of CT‐Scan Energy On Range Uncertainty in Proton Therapy Planning
Author(s) -
Grantham K,
Li H,
Zhao T,
Klein E
Publication year - 2014
Publication title -
medical physics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.473
H-Index - 180
eISSN - 2473-4209
pISSN - 0094-2405
DOI - 10.1118/1.4889026
Subject(s) - imaging phantom , nuclear medicine , hounsfield scale , proton therapy , dosimetry , radiation treatment planning , range (aeronautics) , scanner , image guided radiation therapy , sagittal plane , beam (structure) , physics , mathematics , medical imaging , computed tomography , medicine , materials science , optics , radiation therapy , radiology , composite material
Purpose: To investigate the impact of tube potential (kVp) on the CTnumber (HU) to proton stopping power ratio (PSPR) conversion table; the range uncertainty and the dosimetric change introduced by a mismatch in kVp between the CT and the HU to PSPR table used to calculate dose are analyzed. Methods: A CIRS CT‐ED phantom was scanned with a Philips Brilliance 64‐slice scanner under 90kVp and 120kVp tube potentials. Two HU to PSPR curves were then created. Using Eclipse (Varian) a treatment plan was created for a single beam in a water phantom (HU=0) passing through a wedge‐shaped heterogeneity (HU=1488). The dose was recalculated by changing only the HU to PSPR table used in the dose calculation. The change in range (the distal 90% isodose line) relative to a distal structure was recorded as a function of heterogeneity thickness in the beam. To show the dosimetric impact of a mismatch in kVp between the CT and the HU to PSPR table, we repeated this procedure using a clinical plan comparing DVH data. Results: The HU to PSPR tables diverge for low‐density bone and higher density structures. In the phantom plan, the divergence of the tables results in a change in range of ~1mm per cm of bone in the beam path for the HU used. For the clinical plan, a mismatch in kVp showed a 28% increase in mean dose to the brainstem along with a 10% increase in maximum dose to the brainstem center. Conclusion: A mismatch in kVp between the CT and the HU to PSPR table can introduce significant uncertainty in the proton beam range. For dense bone, the measured range uncertainty is about 1mm per cm of bone in the beam. CT‐scan energy verification should be employed, particularly when high‐density media is in the proton beam path.