Improving radiation physics, tumor visualisation, and treatment quantification in radiotherapy with spectral or dual‐energy CT

Kruis, Matthijs F.

doi:10.1002/acm2.13468

Cited by 31 publications

(27 citation statements)

References 234 publications

(243 reference statements)

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“…Beyond the computational aspects of DECT-based treatment planning discussed in this work, DECT imaging is expected to provide various opportunities to improve the accuracy of multiple parts of the radiotherapy chain. DECT has been suggested to improve image quality and reduce metal artifacts ( 51 ), to improve tumor staging, delineation, and characterization ( 52 , 53 ), and to contribute to improved normal tissue characterization and personalized treatment through physiological quantification ( 46 ). Furthermore, DECT also shows potential for improved dose calculations for treatment modalities other than particle therapy, such as brachytherapy and conventional photon-based teletherapy ( 51 ).…”

Section: Discussionmentioning

confidence: 99%

“…The strengths and limitations of the different DECT or spectral CT acquisition techniques currently available have been described in previous works ( 7 , 44 – 46 ) and are summarized in Supplementary Table 1 , with a focus on applications to particle therapy treatment planning. Additionally, Supplementary Table 2 lists selected publications on the different DECT or spectral CT acquisition techniques to provide an overview of the current state of research.…”

Section: Discussionmentioning

confidence: 99%

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Potential of a Second-Generation Dual-Layer Spectral CT for Dose Calculation in Particle Therapy Treatment Planning

et al. 2022

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In particle therapy treatment planning, dose calculation is conducted using patient-specific maps of tissue ion stopping power ratio (SPR) to predict beam ranges. Improving patient-specific SPR prediction is therefore essential for accurate dose calculation. In this study, we investigated the use of the Spectral CT 7500, a second-generation dual-layer spectral computed tomography (DLCT) system, as an alternative to conventional single-energy CT (SECT) for patient-specific SPR prediction. This dual-energy CT (DECT)-based method allows for the direct prediction of SPR from quantitative measurements of relative electron density and effective atomic number using the Bethe equation, whereas the conventional SECT-based method consists of indirect image data-based prediction through the conversion of calibrated CT numbers to SPR. The performance of the Spectral CT 7500 in particle therapy treatment planning was characterized by conducting a thorough analysis of its SPR prediction accuracy for both tissue-equivalent materials and common non-tissue implant materials. In both instances, DLCT was found to reduce uncertainty in SPR predictions compared to SECT. Mean deviations of 0.7% and 1.6% from measured SPR values were found for DLCT- and SECT-based predictions, respectively, in tissue-equivalent materials. Furthermore, end-to-end analyses of DLCT-based treatment planning were performed for proton, helium, and carbon ion therapies with anthropomorphic head and pelvic phantoms. 3D gamma analysis was performed with ionization chamber array measurements as the reference. DLCT-predicted dose distributions revealed higher passing rates compared to SECT-predicted dose distributions. In the DLCT-based treatment plans, measured distal-edge evaluation layers were within 1 mm of their predicted positions, demonstrating the accuracy of DLCT-based particle range prediction. This study demonstrated that the use of the Spectral CT 7500 in particle therapy treatment planning may lead to better agreement between planned and delivered dose compared to current clinical SECT systems.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Potential of a Second-Generation Dual-Layer Spectral CT for Dose Calculation in Particle Therapy Treatment Planning

et al. 2022

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“…With the emergence of multitarget tracking and optimization, the selection of two parts of the image cannot meet the needs of identifying information. Multiple thresholds are used to segment the image into multiple targets, which is conducive to the calculation of segmentation and reducing the complexity [18][19][20]. Among diverse image segmentation algorithms, the particle swarm optimization (PSO) algorithm is preferred due to its simplicity, having multiple thresholds, and being widely utilized for image segmentation in recent years.…”

Section: Introductionmentioning

confidence: 99%

Observation of Clinical Efficacy of Anisodamine and Chlorpromazine in the Treatment of Intractable Hiccup after Stroke

Wang

Zhu

Zhang

et al. 2022

BioMed Research International

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Objective. This study is aimed at investigating the clinical efficacy of anisodamine combined with chlorpromazine on intractable hiccups after stroke. Methods. 150 patients admitted to Affiliated Hospital of the Hebei University of Engineering from 2017 to 2021 were selected as the research objects, all of which received the computed tomography (CT) examination. During CT examination, intelligent algorithms were used to segment the images. An unsupervised multilayer image threshold segmentation algorithm was proposed by using Kullback-Leibler (K-L) divergence and the modified particle swarm optimization (MPSO) algorithm. All patients were divided into three groups, with each group of 50 patients. Patients in the control group (group A) took the calcium tablets, vitamin C tablets, and vitamin B1 tablets orally. Patients in the control group (group B) received the acupoint injection of anisodamine, and those in the observation group (group C) received the acupoint injection of anisodamine combined with chlorpromazine. The therapeutic effect and patient satisfaction of the three groups were compared. Results. The two-dimensional (2D) K-L divergence was applied for the multilayer segmentation of images, which was helpful to obtain accurate images. The MPSO algorithm was adopted to reduce the computational complexity. The total efficiency of group C was 98%, that of group B was 56%, and that of group A was 22%. The total efficiency and satisfaction rate of group C were signally better than those of group A and group B ( P < 0.05 ). Conclusion. The combination of 2D K-L divergence and MPSO algorithm could improve the accuracy of multilayer image segmentation and CT imaging. Acupoint injection of anisodamine combined with chlorpromazine had better efficacy than the injection of anisodamine alone for the treatment of intractable hiccups after stroke, with high safety and clinical promotion value.

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“…Its benefits are also well-known in radiation oncology, namely the improved dose calculation, disease visibility, and personalized treatment, being particularly useful for dose delivery techniques with a steeper dose gradient, such as brachytherapy and proton therapy. It provides more quantitative measurements compared with SECT and is less prone to image noise and beam hardening or metal artifacts, improving the accuracy of the calculated dose [ 60 , 61 , 62 ].…”

Section: Resultsmentioning

confidence: 99%

Pros and Cons of Dual-Energy CT Systems: “One Does Not Fit All”

2023

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Dual-energy computed tomography (DECT) uses different energy spectrum X-ray beams for differentiating materials with similar attenuation at a certain energy. Compared with single-energy CT, it provides images with better diagnostic performance and a potential reduction of contrast agent and radiation doses. There are different commercially available DECT technologies, with machines that may display two X-ray sources and two detectors, a single source capable of fast switching between two energy levels, a specialized detector capable of acquiring high- and low-energy data sets, and a filter splitting the beam into high- and low-energy beams at the output. Sequential acquisition at different tube voltages is an alternative approach. This narrative review describes the DECT technique using a Q&A format and visual representations. Physical concepts, parameters influencing image quality, postprocessing methods, applicability in daily routine workflow, and radiation considerations are discussed. Differences between scanners are described, regarding design, image quality variabilities, and their advantages and limitations. Additionally, current clinical applications are listed, and future perspectives for spectral CT imaging are addressed. Acknowledging the strengths and weaknesses of different DECT scanners is important, as these could be adapted to each patient, clinical scenario, and financial capability. This technology is undoubtedly valuable and will certainly keep improving.

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Improving radiation physics, tumor visualisation, and treatment quantification in radiotherapy with spectral or dual‐energy CT

Cited by 31 publications

References 234 publications

Potential of a Second-Generation Dual-Layer Spectral CT for Dose Calculation in Particle Therapy Treatment Planning

Potential of a Second-Generation Dual-Layer Spectral CT for Dose Calculation in Particle Therapy Treatment Planning

Observation of Clinical Efficacy of Anisodamine and Chlorpromazine in the Treatment of Intractable Hiccup after Stroke

Pros and Cons of Dual-Energy CT Systems: “One Does Not Fit All”

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