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Optimisation of CT scan parameters to increase the accuracy of gross tumour volume identification in brain radiotherapy

Published online by Cambridge University Press:  15 June 2020

Kosar Estak
Affiliation:
Department of Radiology, School of Paramedicine, Tabriz University of Medical Sciences, Tabriz, Iran
Mohammad Mohammadzadeh
Affiliation:
Department of Radiology and Radiotherapy, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
Nahideh Gharehaghaji
Affiliation:
Department of Radiology, School of Paramedicine, Tabriz University of Medical Sciences, Tabriz, Iran
Tohid Mortezazadeh
Affiliation:
Department of Medical Physics, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
Rahim Khatyal
Affiliation:
Department of Radiology, School of Paramedicine, Tabriz University of Medical Sciences, Tabriz, Iran
Davood Khezerloo*
Affiliation:
Department of Radiology, School of Paramedicine, Tabriz University of Medical Sciences, Tabriz, Iran
*
Author for correspondence: Davood Khezerloo, Assistant Professor of Medical Physics, Department of Radiology, School of Paramedicine, Tabriz University of Medical Sciences, Tabriz, Iran. Tel/Fax: +984133356911. E-mail: [email protected].

Abstract

Aim:

This study aimed to optimise computed tomography (CT) simulation scan parameters to increase the accuracy for gross tumour volume identification in brain radiotherapy. For this purpose, high-contrast scan protocols were assessed.

Materials and methods:

A CT accreditation phantom (ACR Gammex 464) was used to optimise brain CT scan parameters on a Toshiba Alexion 16-row multislice CT scanner. Dose, tube voltage, tube current–time and CT dose index (CTDI) were varied to create five image quality enhancement (IQE) protocols. They were assessed in terms of contrast-to-noise ratio (CNR), signal-to-noise ratio (SNR) and noise level and compared with a standard clinical protocol. Finally, the ability of the selected protocols to identify low-contrast objects was examined based on a subjective method.

Results:

Among the five IQE protocols, the one with the highest tube current–time product (250 mA) and lowest tube voltage (100 kVp) showed higher CNR, while another with a tube current–time product of 150 mA and a tube voltage of 135 kVp had improved SNR and lower noise level compared to the standard protocol. In contouring low-contrast objects, the protocol with the highest milliampere and lowest peak kilovoltage exhibited the lowest error rate (1%) compared to the standard protocol (25%).

Findings:

CT image quality should be optimised using the high-dose parameters created in this study to provide better soft tissue contrast. This could lead to an accurate identification of gross tumour volume recognition in the planning of radiotherapy treatment.

Type
Original Article
Copyright
© The Author(s), 2020. Published by Cambridge University Press

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References

Khan, F M, Gibbons, J P, Sperduto, P W. Khan’s Treatment Planning in Radiation Oncology. Philadelphia, PA: Lippincott Williams & Wilkins, 2016.Google Scholar
Mahmoudi, R, Jabbari, N, Khalkhali, H R. Energy dependence of measured CT numbers on substituted materials used for CT number calibration of radiotherapy treatment planning systems. PloS One 2016; 11(7): e0158828.CrossRefGoogle ScholarPubMed
Chen, A M, Farwell, D G, Luu, Q, Donald, P J, Perks, J, Purdy, J A. Evaluation of the planning target volume in the treatment of head and neck cancer with intensity-modulated radiotherapy: what is the appropriate expansion margin in the setting of daily image guidance? Int J Radiat Oncol Biol Phys. 2011; 81(4): 943949.CrossRefGoogle ScholarPubMed
Jaffray, D A, Das, S, Jacobs, P M, Jeraj, R, Lambin, P. How advances in imaging will affect precision radiation oncology. Int J Radiat Oncol Biol Phys 2018; 101(2): 292298.CrossRefGoogle ScholarPubMed
Chen, G-P, Noid, G, Tai, A et al. Improving CT quality with optimized image parameters for radiation treatment planning and delivery guidance. Phys Imag Radiat Oncol 2017; 4: 611.CrossRefGoogle Scholar
Mortezazadeh, T, Gholibegloo, E, Khoobi, M, Alam, N R, Haghgoo, S, Mesbahi, A. In vitro and in vivo characteristics of doxorubicin-loaded cyclodextrine-based polyester modified gadolinium oxide nanoparticles: a versatile targeted theranostic system for tumour chemotherapy and molecular resonance imaging. J Drug Target 2019: 114.Google ScholarPubMed
Gholibegloo, E, Mortezazadeh, T, Salehian, F et al. Folic acid decorated magnetic nanosponge: An efficient nanosystem for targeted curcumin delivery and magnetic resonance imaging. J Colloid Interface Sci 2019; 556: 128139.CrossRefGoogle ScholarPubMed
Farace, P, Giri, M, Meliado, G et al. Clinical target volume delineation in glioblastomas: pre-operative versus post-operative/pre-radiotherapy MRI. Br J Radiol 2011; 84(999): 271278.Google ScholarPubMed
Chandarana, H, Wang, H, Tijssen, R, Das, I J. Emerging role of MRI in radiation therapy. J Magn Reson Imaging 2018; 48(6): 14681478.CrossRefGoogle ScholarPubMed
Zaidi, H, El Naqa, I. PET-guided delineation of radiation therapy treatment volumes: a survey of image segmentation techniques. Eur J Nucl Med Mol Imaging 2010; 37(11): 21652187.CrossRefGoogle ScholarPubMed
Debus, C, Waltenberger, M, Floca, R et al. Impact of 18 F-FET PET on target volume definition and tumor progression of recurrent high grade glioma treated with carbon-ion radiotherapy. Sci Rep 2018; 8(1): 72017213.Google ScholarPubMed
Mortezazadeh, T, Gholibegloo, E, Riyahi Alam, N, Haghgoo, S, Musa, A, Khoobi, M. Glucosamine conjugated gadolinium (III) oxide nanoparticles as a novel targeted contrast agent for cancer diagnosis in MRI. J Biomed Phys Eng 2020; 10(1): 25.Google Scholar
Verdun, F R, Racine, D, Ott, J G et al. Image quality in CT: from physical measurements to model observers. Phys Medica 2015; 31(8): 823843.CrossRefGoogle ScholarPubMed
Hevezi, J M, Mahesh, M. Optimizing CT dose and image quality for radiotherapy patients. J Am Coll Radiol 2012; 9(2): 152.CrossRefGoogle ScholarPubMed
Murphy, M J, Balter, J, Balter, S et al. The management of imaging dose during image‐guided radiotherapy: report of the AAPM Task Group 75. Med Phys 2007; 34(10): 40414063.CrossRefGoogle ScholarPubMed
Maricle, S, Mathews, B, Yakoubian, S. Imaging dose in radiotherapy: an institution-based study. Med Phys 2013; 40 (6): 157.CrossRefGoogle Scholar
Valentin, J. The 2007 Recommendations of the International Commission on Radiological Protection. Oxford: Elsevier; 2007.Google Scholar
Ding, G X, Alaei, P, Curran, B et al. Image guidance doses delivered during radiotherapy: quantification, management, and reduction: report of the AAPM Therapy Physics Committee Task Group 180. Med Phys 2018; 45(5):e84e99.CrossRefGoogle ScholarPubMed
Seibert, J A. Tradeoffs between image quality and dose. Pediatr Radiol 2004; 34(3): S183S195.CrossRefGoogle ScholarPubMed
Bor, D, Birgul, O, Onal, U, Olgar, T. Investigation of grid performance using simple image quality tests. J Med Phys 2016; 41(1): 2128.Google ScholarPubMed
Alaei, P, Spezi, E. Imaging dose from cone beam computed tomography in radiation therapy. Phys Medica 2015; 31(7): 647658.CrossRefGoogle ScholarPubMed
Hernandez-Giron, I, Calzado, A, Geleijns, J, Joemai, R, Veldkamp, W. Low contrast detectability performance of model observers based on CT phantom images: kVp influence. Phys Medica 2015; 31(7): 798807.CrossRefGoogle Scholar
Verdun, F, Racine, D, Ott, J et al. Image quality in CT: from physical measurements to model observers. Phys Medica 2015; 31(8): 823843.CrossRefGoogle ScholarPubMed
Tomic, N, Papaconstadopoulos, P, Aldelaijan, S, Rajala, J, Seuntjens, J, Devic, S. Image quality for radiotherapy CT simulators with different scanner bore size. Phys Medica 2018; 45: 6571.CrossRefGoogle ScholarPubMed
Davis, A T, Palmer, A L, Nisbet, A. Can CT scan protocols used for radiotherapy treatment planning be adjusted to optimize image quality and patient dose? A systematic review. Br J Radiol 2017; 90(1076): 20160406.CrossRefGoogle ScholarPubMed
Samei, E, Bakalyar, D, Boedeker, K L et al. Performance evaluation of computed tomography systems: summary of AAPM Task Group 233. Med Phys 2019; e735e756. doi: 10.1002/mp.13763.CrossRefGoogle Scholar
Li, H, Yu, L, Anastasio, M A et al. Automatic CT simulation optimization for radiation therapy: a general strategy. Med Phys 2014; 41(3): 031913.CrossRefGoogle ScholarPubMed
Westerly, D C, Schefter, T E, Kavanagh, B D et al. High‐dose MVCT image guidance for stereotactic body radiation therapy. Med Phys 2012; 39(8): 48124819.CrossRefGoogle ScholarPubMed
Mansour, Z, Mokhtar, A, Sarhan, A, Ahmed, M, El-Diasty, T. Quality control of CT image using American College of Radiology (ACR) phantom. Egypt J Radiol Nucl Med 2016; 47(4): 16651671.CrossRefGoogle Scholar
Elbakri, I A, Kirkpatrick, I D. Dose-length product to effective dose conversion factors for common computed tomography examinations based on Canadian clinical experience. Can Assoc Radiol J. 2013; 64(1): 1517.CrossRefGoogle ScholarPubMed
Thitaikumar, A, Krouskop, T A, Ophir, J. Signal-to-noise ratio, contrast-to-noise ratio and their trade-offs with resolution in axial-shear strain elastography. Phys Med Biol 2006; 52(1): 13.CrossRefGoogle ScholarPubMed
Shuryak, I, Hall, E J, Brenner, D J. Optimized hypofractionation can markedly improve tumor control and decrease late effects for head and neck cancer. Int J Radiat Oncol Biol Phys 2019; 104(2): 272278.CrossRefGoogle ScholarPubMed
Ween, B, Kristoffersen, D T, Hamilton, G A, Olsen, D R. Image quality preferences among radiographers and radiologists: a conjoint analysis. Radiography 2005; 11(3): 191197.CrossRefGoogle Scholar
Karmazyn, B, Liang, Y, Klahr, P, Jennings, S G. Effect of tube voltage on CT noise levels in different phantom sizes. AJR Am J Roentgenol 2013; 200(5): 10011015.CrossRefGoogle Scholar
Boas, F E, Fleischmann, D. CT artifacts: causes and reduction techniques. Imaging in Medicine 2012; 4(2): 229240.CrossRefGoogle Scholar
Farhood, B, Raei, B, Ameri, H et al. A review of incidence and mortality of colorectal, lung, liver, thyroid, and bladder cancers in Iran and compared to other countries. Contemp Oncol 2019; 23(1): 7.Google ScholarPubMed