Abstract
Radiotherapy (RT) treatment planning is based on computed tomography (CT) images and traditionally uses the conventional Hounsfield unit (CHU) range. This HU range is suited for human tissue but inappropriate for metallic materials. To guarantee safety of patient carrying implants precise HU quantification is beneficial for accurate dose calculations in planning software. Some modern CT systems offer an extended HU range (EHU). This study focuses the suitability of these two HU ranges for the quantification of metallic components of active implantable medical devices (AIMD). CT acquisitions of various metallic and non-metallic materials aligned in a water phantom were investigated. From our acquisitions we calculated that materials with mass-density ρ > 3.0 g/cm3 cannot be represented in the CHU range. For these materials the EHU range could be used for accurate HU quantification. Since the EHU range does not effect the HU values for materials ρ < 3.0 g/cm3, it can be used as a standard for RT treatment planning for patient with and without implants.
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References
Gauter-Fleckenstein, B., Israel, C.W., Dorenkamp, M., Dunst, J., Roser, M., Schimpf, R., Steil, V., Schaefer, J., Hoeller, U., Wenz, F.: DEGRO/DGK guideline for radiotherapy in patients with cardiac implantable electronic devices. Strahlentherapie Onkologie 191, 393–404 (2015)
Zaremba, T.: Radiotherapy in Patients with Pacemakers and Implantable Cardioverter-Defibrillators. PhD Thesis, Aalborg University (2015)
Prisciandro, J.I., Makkar, A., Fox, C.J., Hayman, J.A., Horwood, F., Pelosi, L., Moran, J.M.: Dosimetric review of cardiac implantable electronic device patients receiving radiotherapy. Journal of Applied Clinical Medical Physics 16, 1–8 (2014)
Marbach, J.R., Sontag, M.R., Van Dyk, J., Wolbarst, A.B.: Management of Radiation Oncology Patients with Implanted Cardiac Pacemakers: Report of AAPM Task Group No.34. Medical Physics 21(1), 85–90 (1994)
Bourgouin, A., Varfalvy, N., Archambault, L.: Estimating and reducing dose received by cardiac devices for patients undergoing radiotherapy. Journal of Applied Clinical Medical Physics 16(6), 411–420 (2015)
Huang, J.Y., Followill, D.S., Wang, X.A., Kry, S.f.: Accuracy and sources of error out-of-field dose calculations by commercial treatment planning system for intensity-modulated radiation therapy treatments. Journal of Applied Clinical Medical Physics 14(2), 4139 (2015)
Howell, R.M., Scarboto, S.B., Kry, S.F., Yaldo, D.Z.: Accuracy of out-of-field dose calculations by a commercial treatment planning system. Physics in Medicine and Biology 55(23), 6999–7008 (2010)
Kairn, T., Crowe, S.B., Kenny, J., Mitchell, J., Burke, M., Schlect, D., Trapp, J.V.: Dosimetric effects of a high-density spinal implant. Journal of Physics: Conference Series, 7th International Conference on 3D Radiation Dosimetry 444, 1–4 (2008)
Mullins, J.P., Grams, M.P., Herman, M.G., Brinkmann, D.H., Antolak, J.A.: Treatment planning for metals using an extended CT number scale. Journal of Applied Clinical Medical Physics 17(6), 179–188 (2016)
Gossman, M.S., Graves-Calhoun, A.R., Wilkinson, J.D.: Establishing radiation therapy treatment planning effects involving implantable pacemakers and implantable cardioverter-defibrillator. Journal of Applied Clinical Medical Physics 11(1), 33–45 (2009)
Ese, Z., Kressmann, M., Kreutner, J., Schaefers, G., Erni, D., Zylka, W.: Influence of conventional and extended CT scale range on quantification of Hounsfield units of medical implants and metallic objects. tm-Technisches Messen 85(5), 343-350 (2018)
Hubbell, J.H.: Photon Cross Sections, Attenuation Coefficients, and Energy Absorption Coefficients From 10 keV to 100 GeV. Nat. Stand. Ref. Data. Ser., Nat. Bur. Stand. (U.S.), 29, 85 (1969)
Barrett, J.F., Keal, N.: Artifacts in CT: Recognition and Avoidance. RadioGraphics 24(6), 1679–1691 (2004)
Xin-ye, N., Liugang, G., Mingming, F., Tao, L.: Application of Metal Implant 16-Bit Imaging: New Technique in Radiotherapy. Technology in Cancer Research and Treatment 16(2), 188–194 (2017)
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This study is supported by the Federal Ministry for Economic Affairs and Energy on the basis of a decision by the German Bundestag, grant no. ZF4205702AW6. The authors declare that they have no conflict of interest.
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Ese, Z., Qamhiyeh, S., Kreutner, J., Schaefers, G., Erni, D., Zylka, W. (2019). CT Extended Hounsfield Unit Range in Radiotherapy Treatment Planning for Patients with Implantable Medical Devices. In: Lhotska, L., Sukupova, L., Lacković, I., Ibbott, G. (eds) World Congress on Medical Physics and Biomedical Engineering 2018. IFMBE Proceedings, vol 68/3. Springer, Singapore. https://doi.org/10.1007/978-981-10-9023-3_111
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DOI: https://doi.org/10.1007/978-981-10-9023-3_111
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