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Kim, D.H., Cho, S., Jo, K., Shin, E., Hong, C.S., Han, Y., Suh, T.S., Lim, D.H. and Choi, D.H. (2018) Proton Range Verification in Inhomogeneous Tissue: Treatment Planning System vs. Measurement vs. Monte Carlo Simulation. PLoS ONE, 13, e0193904.
https://doi.org/10.1371/journal.pone.0193904

has been cited by the following article:

• TITLE: Experimental Evaluation of CT Number Changes in 320-Row CBCT Volume Scan for Proton Range Calculation

  AUTHORS: Ryuta Hirai, Ryosuke Kohno, Yu Kumazaki, Tetsuo Akimoto, Hidetoshi Saitoh, Shingo Kato

  KEYWORDS: 320-Row CBCT Volume Scan, CT Number, Proton Range, Relative Stopping Power

  JOURNAL NAME: International Journal of Medical Physics, Clinical Engineering and Radiation Oncology, Vol.7 No.2, May 4, 2018

  ABSTRACT: We investigated the longitudinal positional dependence of CT number in 320-row Cone Beam Computed Tomography (CBCT) volume scan (320-row volume scan) using a simple geometric phantom (SGP) and a chest simulation phantom (CSP) in order to evaluate its effect on proton range calculation. The SGP consisted of lung substitute material (LSM) and a cylindrical phantom (CP) made of high-density polyethylene. The CSP was an anthropomorphic phantom similar to the human chest. The two phantoms were scanned using 320-row volume scan in various longitudinal positions from the central beam axis. In experiments using the SGP, an image blur at the boundary of the two materials became gradually evident when the LSM was placed far away from the beam central axis. The image blur of the phantom was consistent with the gradation in CT number. The maximum difference in CT numbers between the 64-row helical scan and 320-row volume scan at the boundary of the two materials was consistent with approximately 50% of the relative proton stopping power. In contrast, the CT number profile in each longitudinal position was fairly consistent and longitudinal positional dependence rarely occurred in the CSP experiments. Pass lengths of CT beams through areas with widely different electron densities were shorter, and thus did not significantly impact CT numbers. Based on findings from the CSP experiments, we considered 320-row volume scan to be feasible for proton range calculation in clinical settings, although the relatively large longitudinal positional dependence of CT number should be accounted for when doing so.