SU‐F‐18C‐04: A Combination of Monoenergetic Reconstruction and Stoichiometric Calibration for Tissue Characterization Using Dual Energy Computed Tomography

Purpose: Dual energy computed tomography (DECT) pre‐reconstruction methods require the prior knowledge of the X‐ray source spectrum to allow extracting physical parameters needed for radiation therapy dose calculation, such as electron density (ED) and the effective atomic number (EAN). While DECT stoichiometric calibration may provide reliable performance for typical radiation therapy clinical conditions, it is yet to be adapted to prereconstruction methods. The presence of noise and inaccurate spectrum description may lead to systematic errors and artifacts which compromise the accuracy of treatment planning. Methods: A new technique is investigated which consists in applying a DECT stoichiometric calibration method to a set of monoenergetic images obtained with a DECT prereconstruction method. To evaluate the performance of this extended method, a simulation environment is developed to generate DECT scans under well controlled conditions, to reconstruct monoenergetic images of a tissue‐equivalent phantom from transformed sinograms and to extract ED and EAN maps using a DECT formalism. Result: Under simulated clinical conditions, the accuracy in determining ED with the extended method versus a pre‐reconstruction method alone is shown to be better than 0.35% versus 0.5%, respectively. In the presence of a realistic noise level, EAN determination presents a relative mean error that drops from 2.5% to 0.5% once the calibration is applied. Considering a spectrum alteration by a 1 mm Cu layer, EAN errors are up to 30% for the pre‐reconstruction method alone versus less than 3% for the extended method. Conclusion: This study shows that combining pre‐reconstruction DECT methods with a stoichiometric calibration considerably improves the accuracy and reliability of tissue characterization for radiation therapy in a clinical context. The presented method could potentially be adapted as gold standard for dose calculation methods based on DECT.