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Related Experiment Video

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Approaches to reducing photon dose calculation errors near metal implants.

Jessie Y Huang1, David S Followill1, Rebecca M Howell1

  • 1Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas 77030 and Graduate School of Biomedical Sciences, The University of Texas Health Science Center Houston, Houston, Texas 77030.

Medical Physics
|September 3, 2016
PubMed
Summary

Metal kernels and computed tomography (CT) artifact reduction methods were studied to improve dose calculation accuracy near metal implants. Metal kernels showed limited clinical benefit, while o-mar CT artifact reduction was most consistent, though mars requires caution with certain implants.

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Area of Science:

  • Medical Physics
  • Radiotherapy
  • Image Processing

Background:

  • Dose calculation errors in radiotherapy near metal implants stem from algorithm limitations and imaging artifacts.
  • Accurate dose calculation is crucial for effective cancer treatment and patient safety.

Purpose of the Study:

  • To evaluate metal-based energy deposition kernels in convolution/superposition (C/S) dose calculation.
  • To assess the efficacy of computed tomography (CT) metal artifact reduction (MAR) methods in improving dose calculation accuracy.

Main Methods:

  • Investigated titanium and silver kernels in a C/S algorithm.
  • Compared dose calculations using baseline CT imaging and three MAR methods (o-mar, gemstone spectral imaging (gsi), and gsi with metal artifact reduction software (mars)).
  • Validated findings using geometric phantoms and anthropomorphic phantoms with clinical implants (spinal hardware, dental fillings).

Main Results:

  • Metal kernels improved accuracy upstream but decreased it downstream of implants, with minimal impact (<1.0%) in clinical cases.
  • o-mar demonstrated consistent performance, improving accuracy or having little impact.
  • gsi was ineffective for severe artifacts; gsi with mars yielded mixed results, sometimes increasing errors.

Conclusions:

  • Metal kernels offer limited improvement for clinical dose calculations near implants.
  • o-mar is a reliable choice for CT simulation imaging.
  • The mars algorithm necessitates caution, particularly with titanium or large implants, due to potential artifact distortion and increased errors.