Effect of CT number stopping power conversion uncertainties on dose distributions
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1 Effect of CT number stopping power conversion uncertainties on dose distributions Stella Flampouri Roelf Slopsema, Daniel Yeung, Zuofeng Li 23 May 2007 PTCOG
2 Intro Treatment planning system dose calculations are based on CT images of the patients CT numbers are converted to relative proton stopping power via a calibration curve Proton range in patient is calculated by integration of tissue relative stopping power along the beam path Uncertainties on the calibration curves translate into uncertainties on the calculated proton range and dose distributions
3 Calibration curve Determined according to the Schneider et al (1996) recipe Based on a electron density phantom Hounsfield numbers measured for a range of phantom arrangements and CT parameters The stoichiometric method applied for the calculation of Hounsfield numbers Relative stopping power (RSP) measured and calculated for all tissue substitutes Tissue-wise linear fits provided the calibration curve
4 Calibration curve - Phantom CIRS Electron density phantom (M062) Modular phantom made of solid water Head (~18 cm WE diameter) Body (~30.5 cm WE diameter) Large body (~39 cm WE diameter) 20 Tissue equivalent plugs (d=~3 cm, h=~8 cm) CIRS provided density and composition for the specific inserts Insert density was also measured
5 Tissue equivalent materials 2.5 Relative Stopping Power a ICRU-44 Tissues Hounsfield Number
6 Tissue equivalent materials 2.5 ICRU-44 Tissues Relative Stopping Power a CIRS Original Materials Hounsfield Number
7 Tissue equivalent materials 2.5 ICRU-44 Tissues Relative Stopping Power a CIRS Tissue Substitutes CIRS Original Bone Substitutes Hounsfield Number
8 Tissue equivalent materials 2.5 ICRU-44 Tissues CIRS Tissue Substitutes Relative Stopping Power a CIRS Original Bone Substitutes 3.4% 0.4% 7.4% Hounsfield Number
9 Relative stopping power calculations RSP depends on physical density, elementary composition and mean excitation energy RSP = m ωi Z ρm i Α i w ω jz ρw Α j j i j ln ln k( E) β Im k( E) β Iw 2 2 Density and composition are difficult to find Mean excitation energy has small effect Example: Lucite 1% Density change 1% RSP I meas =74 ev, I calc =70.9 ev 4% I 0.7% RSP
10 Relative stopping power measurements
11 Relative stopping power measurements
12 Relative stopping power measurements RSP = R water L R insert insert
13 Relative stopping power measurements Measurements repeated few times Various proton ranges, airgaps, etc Proton range ( R ) for all full inserts within water R insert 0.5 mm for all measurements Assuming 0.1 mm uncertainty in the insert length L insert Uncertainty in RSP for all inserts <1% Inhale Lung (0.2 g/cm 3 ): 0.62% RSP Muscle (1.06 g/cm 3 ): 0.63% RSP Bone (2.06 g/cm 3 ): 0.65% RSP Max difference between measurement and calculation: 0.7%
14 Hounsfield number Scanner and energy
15 Hounsfield number Recon
16 Hounsfield number Phantom size
17 Hounsfield number Phantom size 500: 4% RSP 1000: 8% RSP 1500:12% RSP
18 Calibration phantom size effect on proton range Big Bore, 140 kv Realative Stopping Power Large phantom, Average position Full head phantom, Average position CT #
19 Calibration phantom size effect on proton range Big Bore, 140 kv Realative Stopping Power Large phantom, Average position Full head phantom, Average position CT #
20 Calibration phantom size effect on proton range Big Bore, 140 kv Realative Stopping Power Large phantom, Average position Full head phantom, Average position CT #
21 Calibration phantom size effect on proton range (2.1 mm) (3.5 mm) Big Bore, 140 kv Realative Stopping Power Large phantom, Average position Full head phantom, Average position CT #
22 Calibration phantom size effect on dosemap Calibration curve based on large body phantom Calibration curve based on head phantom
23 Calibration phantom size effect on dosemap Calibration curve based on large body phantom Calibration curve based on head phantom
24 Calibration phantom size effect on dosemap
25 Calibration phantom size effect on dosemap
26 Calibration phantom size effect on dosemap
27 Calibration phantom size effect on dosemap
28 Calibration phantom size effect on dosemap
29 So We investigated parameters that influence the CT# - relative proton stopping power conversion curve We found that variation on the CT# due to beam hardening effects has a major contribution on the uncertainty of the calibration curve Depending on the size of the phantom used for the creation of the curve the water equivalent range for a prostate posterior oblique field could vary by 3.5mm This effect was less severe for other cases
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