Pearson Erik, Pan Xiaochuan, Pelizzari Charles
Department of Radiation and Cellular Oncology, The University of Chicago, Chicago, IL, USA.
Present Address: Princess Margaret Cancer Center, UHN, Toronto, ON, Canada.
J Xray Sci Technol. 2016 Mar 17;24(3):361-77. doi: 10.3233/XST-160550.
Patient dose from image guidance in radiotherapy is small compared to the treatment dose. However, the imaging beam is untargeted and deposits dose equally in tumor and healthy tissues. It is desirable to minimize imaging dose while maintaining efficacy.
Image guidance typically does not require full image quality throughout the patient. Dynamic filtration of the kV beam allows local control of CT image noise for high quality around the target volume and lower quality elsewhere, with substantial dose sparing and reduced scatter fluence on the detector.
The dynamic Intensity-Weighted Region of Interest (dIWROI) technique spatially varies beam intensity during acquisition with copper filter collimation. Fluence is reduced by 95% under the filters with the aperture conformed dynamically to the ROI during cone-beam CT scanning. Preprocessing to account for physical effects of the collimator before reconstruction is described.
Reconstructions show image quality comparable to a standard scan in the ROI, with higher noise and streak artifacts in the outer region but still adequate quality for patient localization. Monte Carlo modeling shows dose reduction by 10-15% in the ROI due to reduced scatter, and up to 75% outside.
The presented technique offers a method to reduce imaging dose by accepting increased image noise outside the ROI, while maintaining full image quality inside the ROI.
与治疗剂量相比,放射治疗中图像引导产生的患者剂量较小。然而,成像束是无靶向的,会在肿瘤组织和健康组织中均匀沉积剂量。在保持疗效的同时尽量减少成像剂量是很有必要的。
图像引导通常并不需要患者全身的图像都具备完整的图像质量。千伏级光束的动态滤波能够局部控制CT图像噪声,使靶区周围图像质量较高,其他区域图像质量较低,从而大幅减少剂量并降低探测器上的散射注量。
动态感兴趣区强度加权(dIWROI)技术在采集过程中通过铜滤过准直使光束强度在空间上发生变化。在锥束CT扫描期间,滤过器下方的注量降低95%,孔径动态符合感兴趣区。描述了在重建前考虑准直器物理效应的预处理方法。
重建图像显示,感兴趣区内的图像质量与标准扫描相当,外部区域噪声较高且有条状伪影,但仍具备足够的患者定位质量。蒙特卡罗模拟显示,由于散射减少,感兴趣区内的剂量降低了10% - 15%,外部区域剂量降低高达75%。
所提出的技术提供了一种通过接受感兴趣区外增加的图像噪声来减少成像剂量的方法,同时保持感兴趣区内的完整图像质量。