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Updated: Dec 7, 2025

Proton Therapy Delivery and Its Clinical Application in Select Solid Tumor Malignancies
Published on: February 6, 2019
Scattering proton CT
N Krah1,2, C T Quiñones1, J M Létang1
1Univ Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, F-69373, LYON, France.
Abstract:
Proton computed tomography (CT) is an imaging modality investigated mainly in the context of proton therapy as a complement to x-ray CT. It uses protons with high enough energy to fully traverse the imaged object. Common prototype systems measure each proton's position and direction upstream and downstream of the object as well as the energy loss which can be converted into the water equivalent thickness. A reconstruction algorithm then produces a map of the relative stopping power in the object. As an alternative to energy-loss proton CT, it has been proposed to reconstruct a map of the object's scattering power based on the protons' angular dispersion which can be estimated from the measured directions. As in energy-loss proton CT, reconstruction should best be performed considering the non-linear shape of proton trajectories due to multiple Coulomb scattering (MCS), but no algorithm to achieve this is so far available in the literature. In this work, we propose a filtered backprojection algorithm with distance-driven binning to account for the protons' most likely path. Furthermore, we present a systematic study of scattering proton CT in terms of inherent noise and spatial resolution and study the artefacts which arise from the physics of MCS. Our analysis is partly based on analytical models and partly on Monte Carlo simulations. Our results show that the proposed algorithm performs well in reconstructing relative scattering power maps, i.e. scattering power relative to that of water. Spatial resolution is improved by almost a factor of three compared to straight line projection and is comparable to energy-loss proton CT. Image noise, on the other hand, is inherently much higher. For example, in a water cylinder of 20 cm diameter, representative of a human head, noise in the central image pixel is about 40 times higher in scattering proton CT than in energy-loss proton CT. Relative scattering power in dense regions such as bone inserts is systematically underestimated by a few percent, depending on beam energy and phantom geometry.
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