Consensus guide on CT-based prediction of stopping-power ratio using a Hounsfield look-up table for proton therapy

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Nils Peters - , Department of Radiotherapy and Radiooncology, TUD Dresden University of Technology, Harvard University (Author)
  • Vicki Trier Taasti - , Maastricht University (Author)
  • Benjamin Ackermann - , Heidelberg University  (Author)
  • Alessandra Bolsi - , Paul Scherrer Institute (Author)
  • Christina Vallhagen Dahlgren - , The Skandion Clinic (Author)
  • Malte Ellerbrock - , Heidelberg University  (Author)
  • Francesco Fracchiolla - , Autonomous Province of Trento (Author)
  • Carles Gomà - , University of Barcelona (Author)
  • Joanna Góra - , MedAustron (Author)
  • Patricia Cambraia Lopes - , HollandPTC (Author)
  • Ilaria Rinaldi - , Maastricht University (Author)
  • Koen Salvo - , AZ Sint-Maarten (Author)
  • Ivanka Sojat Tarp - , Aarhus University (Author)
  • Alessandro Vai - , CNAO National Center for Oncological Hadrontherapy (Author)
  • Thomas Bortfeld - , Harvard University (Author)
  • Antony Lomax - , Paul Scherrer Institute (Author)
  • Christian Richter - , OncoRay - National Center for Radiation Research in Oncology, Department of Radiotherapy and Radiooncology, TUD Dresden University of Technology, Helmholtz-Zentrum Dresden-Rossendorf, University Hospital Carl Gustav Carus Dresden, German Cancer Research Center (DKFZ) (Author)
  • Patrick Wohlfahrt - , Harvard University (Author)

Abstract

Background and purpose: Studies have shown large variations in stopping-power ratio (SPR) prediction from computed tomography (CT) across European proton centres. To standardise this process, a step-by-step guide on specifying a Hounsfield look-up table (HLUT) is presented here. Materials and methods: The HLUT specification process is divided into six steps: Phantom setup, CT acquisition, CT number extraction, SPR determination, HLUT specification, and HLUT validation. Appropriate CT phantoms have a head- and body-sized part, with tissue-equivalent inserts in regard to X-ray and proton interactions. CT numbers are extracted from a region-of-interest covering the inner 70% of each insert in-plane and several axial CT slices in scan direction. For optimal HLUT specification, the SPR of phantom inserts is measured in a proton beam and the SPR of tabulated human tissues is computed stoichiometrically at 100 MeV. Including both phantom inserts and tabulated human tissues increases HLUT stability. Piecewise linear regressions are performed between CT numbers and SPRs for four tissue groups (lung, adipose, soft tissue, and bone) and then connected with straight lines. Finally, a thorough but simple validation is performed. Results: The best practices and individual challenges are explained comprehensively for each step. A well-defined strategy for specifying the connection points between the individual line segments of the HLUT is presented. The guide was tested exemplarily on three CT scanners from different vendors, proving its feasibility. Conclusion: The presented step-by-step guide for CT-based HLUT specification with recommendations and examples can contribute to reduce inter-centre variations in SPR prediction.

Details

Original languageEnglish
Article number109675
JournalRadiotherapy and oncology
Volume184
Publication statusPublished - Jul 2023
Peer-reviewedYes

External IDs

PubMed 37084884
ORCID /0000-0003-4261-4214/work/146644856
WOS 001010874600001

Keywords

DFG Classification of Subject Areas according to Review Boards

Keywords

  • Hounsfield look-up table, Proton range prediction, Proton therapy, Single-energy CT, Stoichiometric calibration, Stopping-power ratio, Hounsfield look -up table, Stopping -power ratio, Single -energy CT, Protons, Tomography, X-Ray Computed/methods, Humans, Proton Therapy/methods, Calibration, Consensus, Phantoms, Imaging