ArticleJournal of applied clinical medical physics2022
Dosimetric evaluation of cone-beam CT-based synthetic CTs in pediatric patients undergoing intensity-modulated proton therapy.
Article in Journal of applied clinical medical physics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.
- A systematic review of volumetric image guidance in proton therapy.Physical and engineering sciences in medicine · 2023Pooled it
- Optimizing QACT Frequency in Proton Therapy: Analysis of Standard Guidelines Across Treatment Sites.International journal of particle therapy · 2025Article
- Interim Analysis of Pro-Grid: A Phase 1 Proton Spatially Fractionated Radiation Therapy Trial.Advances in radiation oncology · 2025Article
- Optimizing QACT Frequency and Setup Uncertainty in Cranial Proton Therapy for Normal Tissue Sparing.International journal of particle therapy · 2025Article
- Unsupervised Deep Learning for Synthetic CT Generation from CBCT Images for Proton and Carbon Ion Therapy for Paediatric Patients.Sensors (Basel, Switzerland) · 2024Article
- Use of Virtual CT and On-Treatment MRI to Reduce Radiation Dose and Anesthesia Exposure Associated With the Adaptive Workflow in Pediatric Patients Treated With Intensity Modulated Proton Therapy.Advances in radiation oncology · 2024Article
- Article
- CBCT-Based Dose Monitoring and Adaptive Planning Triggers in Head and Neck PBS Proton Therapy.Cancers · 2023Article
- Daily Head and Neck Treatment Assessment for Optimal Proton Therapy Planning Robustness.Cancers · 2023Article
- Clinical evaluation of synthetic computed tomography methods in adaptive proton therapy of lung cancer patients.Physics and imaging in radiation oncology · 2023Article
- Dosimetric evaluation of cone-beam CT-based synthetic CTs in pediatric patients undergoing intensity-modulated proton therapy.Journal of applied clinical medical physics · 2022Article
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo evaluate dosimetric changes detected using synthetic computed tomography (sCT) derived from online cone-beam CTs (CBCT) in pediatric patients treated using intensity-modulated proton therapy (IMPT).
methodsTen pediatric patients undergoing IMPT and aligned daily using proton gantry-mounted CBCT were identified for retrospective analysis with treated anatomical sites fully encompassed in the CBCT field of view. Dates were identified when the patient received both a CBCT and a quality assurance CT (qCT) for routine dosimetric evaluation. sCTs were generated based on a deformable registration between the initial plan CT (pCT) and CBCT. The clinical IMPT plans were re-computed on the same day qCT and sCT, and dosimetric changes due to tissue change or response from the initial plan were computed using each image. Linear regression analysis was performed to determine the correlation between dosimetric changes detected using the qCT and the sCT. Gamma analysis was also used to compare the dose distributions computed on the qCT and sCT.
resultsThe correlation coefficients (p-values) between qCTs and sCTs for changes detected in target coverage, overall maximum dose, and organ at risk dose were 0.97 (< .001), 0.84 (.002) and 0.91 (< .001), respectively. Mean ± SD gamma pass rates of the sCT-based dose compared to the qCT-based dose at 3%/3 mm, 3%/2 mm, and 2%/2 mm criteria were 96.5%±4.5%, 93.2%±6.3%, and 91.3%±7.8%, respectively. Pass rates tended to be lower for targets near lung.
conclusionWhile insufficient for re-planning, sCTs provide approximate dosimetry without administering additional imaging dose in pediatric patients undergoing IMPT. Dosimetric changes detected using sCTs are correlated with changes detected using clinically-standard qCTs; however, residual differences in dosimetry remain a limitation. Further improvements in sCT image quality may both improve online dosimetric evaluation and reduce imaging dose for pediatric patients by reducing the need for routine qCTs.
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