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Dual-energy CT imaging of orbits during episcleral brachytherapy with Ru-106 plaques: A phantom study on its potential for plaque position verification |
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| Institution: | 1. University of Crete, Medical School, Department of Medical Physics, 71003 Heraklion, Crete, Greece;2. University of Crete, Medical School, Department of Ophthalmology, 71003 Heraklion, Crete, Greece;3. Medical Physicist, University Hospital of Heraklion, Department of Medical Physics, P.O. Box 1352, 71110 Heraklion, Crete, Greece;4. University of Crete, Medical School, Department of Radiology, 71003 Heraklion, Crete, Greece;1. Department of Radiation Oncology, University of Toronto, Toronto, Canada;2. Department of Radiation Physics, Princess Margaret Cancer Center, Toronto, Canada;3. Department of Radiation Oncology, University of Michigan Health System, Ann Arbor, MI 48109, USA;1. Department of Radiation Oncology, University Hospital of Martinique, Fort-de-France, France;2. Department of Radiation Oncology, Bergonie Institute, Bordeaux, France;3. Department of Surgical Urology, University Hospital of Martinique, Fort-de-France, France;1. Division of Radiological Sciences, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden;2. Department of Medical Physics, Karolinska University Hospital, Stockholm, Sweden;3. Department of Oncology, Karolinska Institutet, Stockholm, Sweden;4. Swedish Radiation Safety Authority, Stockholm, Sweden;5. Department of Medical and Health Sciences and Center for Medical Image Science and Visualization, Linköping University, Linköping, Sweden;1. Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT;2. Department of Radiation Oncology, University of Southern California Keck School of Medicine, Los Angeles, CA;3. Department of Ophthalmology, Yale University School of Medicine, New Haven, CT;4. Department of Ophthalmology, Duke University School of Medicine, Durham, NC;1. A.O.U. Careggi, Firenze, Italy;2. Università degli Studi di Firenze, Firenze, Italy;3. Ospedale Pediatrico Bambino Gesù, Roma, Italy |
| Abstract: | PurposeTo investigate the potential of dual energy CT (DECT) to suppress metal artifacts and accurately depict episcleral brachytherapy Ru-106 plaques after surgical placement.MethodsAn anthropomorphic phantom simulating the adult head after surgical placement of a Ru-106 plaque was employed. Nine DECT acquisition protocols for orbital imaging were applied. Monochromatic 140 keV images were generated using iterative reconstruction and an available metal artifact reduction algorithm. Generated image datasets were graded by four observers regarding the ability to accurate demarcate the Ru-106 plaque. Objective image quality and visual grading analysis (VGA) was performed to compare different acquisition protocols. The DECT imaging protocol which allowed accurate plaque demarcation at minimum exposure was identified. The eye-lens dose from orbital DECT, with and without the use of radioprotective bismuth eye-shields, was determined using Monte Carlo methods.ResultsAll DECT acquisition protocols were judged to allow clear demarcation of the plaque borders despite some moderate streaking/shading artifacts. The differences between mean observers’ VGA scores for the 9 DECT imaging protocols were not statistically significant (p > 0.05). The eye-lens dose from the proposed low-exposure DECT protocol was found to be 20.1 and 22.8 mGy for the treated and the healthy eye, respectively. Bismuth shielding was found to accomplish >40% reduction in eye-lens dose without inducing shielding-related artifacts that obscure plaque delineation.ConclusionsDECT imaging of orbits after Ru-106 plaque positioning for ocular brachytherapy was found to allow artifact-free delineation of plaque margins at relatively low patient exposure, providing the potential for post-surgery plaque position verification. |
| Keywords: | CT Artifacts Radioisotope Plaque Therapy SECT"} {"#name":"keyword" "$":{"id":"k0025"} "$$":[{"#name":"text" "_":"single energy CT DECT"} {"#name":"keyword" "$":{"id":"k0035"} "$$":[{"#name":"text" "_":"dual energy CT ASiR"} {"#name":"keyword" "$":{"id":"k0045"} "$$":[{"#name":"text" "_":"adaptive statistical iterative reconstruction MAR"} {"#name":"keyword" "$":{"id":"k0055"} "$$":[{"#name":"text" "_":"metal artefact reduction CTDI"} {"#name":"keyword" "$":{"id":"k0065"} "$$":[{"#name":"text" "_":"CT dose index VGA"} {"#name":"keyword" "$":{"id":"k0075"} "$$":[{"#name":"text" "_":"visual grading analysis |
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