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Dose Prediction in Proton Cancer Therapy based on Density Maps from Dual-energy CT Using Joint Statistical Image

Maria Medrano1, Xinyuan Chen2, Tao Ge1

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|December 22, 2025
PubMed
Summary

Accurate proton therapy range prediction is improved using a novel joint statistical image reconstruction method (JSIR-BVM). This method reduces dose prediction errors compared to standard single-energy CT (SECT), enhancing treatment safety and accuracy for patients.

Keywords:
dual-energy computed tomographymodel-based image reconstructionproton therapystatistical image reconstruction

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Area of Science:

  • Medical Physics
  • Radiotherapy
  • Image Reconstruction

Background:

  • Proton therapy requires accurate range prediction for conformal dose delivery.
  • Current methods using single-energy CT (SECT) rely on safety margins due to range uncertainties.
  • Dual-energy CT (DECT) methods exist, but their clinical impact on planning is undemonstrated.

Purpose of the Study:

  • To integrate and evaluate a joint statistical image reconstruction (JSIR) method with a basis-vector model (BVM) for proton therapy planning.
  • To compare the dose-prediction accuracy of JSIR-BVM against standard SECT in simulated and clinical scenarios.
  • To assess the impact of JSIR-BVM on reducing dose prediction errors in proton therapy.

Main Methods:

  • Developed a workflow to interface JSIR-BVM derived density maps with a commercial Monte Carlo proton therapy planning system.
  • Compared dose-prediction errors using JSIR-BVM and SECT stoichiometric calibration in simulated and clinical patient cases.
  • Quantified errors based on the volume receiving 80% of the prescription dose within a 5 mm distal ring around the planning target volume.

Main Results:

  • JSIR-BVM showed significantly lower dose prediction errors (2.6%) compared to SECT (6.8%) in a simulated case.
  • For a clinical head-and-neck cancer patient, JSIR-BVM resulted in mean errors of 2.35%, while SECT showed 13.86%.
  • SECT demonstrated a nontrivial risk of dose overshooting to surrounding tissues.

Conclusions:

  • The JSIR-BVM method offers a significant improvement in proton range prediction accuracy for treatment planning.
  • Interfacing JSIR-BVM with clinical planning systems can reduce dose prediction errors, enhancing treatment safety.
  • This approach holds promise for more precise and effective proton therapy delivery.