Sébastien Brousmiche

The Reconstruction Toolkit (RTK), an open-source cone-beam CT reconstruction toolkit based on the Insight Toolkit (ITK)

Purpose: To develop an open-source toolkit for fast cone-beam CT reconstruction based on the Insight Toolkit. Methods: We have started the Reconstruction Toolkit (RTK, http://www.openrtk.org), an open-source toolkit for cone-beam CT reconstruction, based on the Insight Toolkit (ITK, http://www.itk.org/) and using GPU code extracted from Plastimatch (http://www.plastimatch.org/). RTK is developed by an open consortium (see affiliations) under the non- contaminating Apache 2.0 license. The quality of the platform is daily checked with regression tests in partnership with Kitware which already supports ITK. Results: Several features are already available: Elekta, Varian and IBA inputs, multi-threaded Feldkamp-David-Kress reconstruction on CPU and GPU, Parker short scan weighting, multi-threaded CPU and GPU forward projectors, etc. Each feature is either accessible through command line tools or C++ classes that can be included in independent software. A MIDAS community (http://midas3.kitware.com) has been opened to provide CatPhan datasets of several vendors (Elekta, Varian and IBA). RTK will be used in the upcoming cone-beam CT scanner developed by IBA for proton therapy rooms. Many features are under development: new input format support, iterative reconstruction, hybrid Monte Carlo / deterministic CBCT simulation, etc. Conclusions: RTK has been built to freely share tomographic reconstruction development between researchers and is open for new contributions.

Pulsed 1.5-

In this paper, we present the development of an axial aircraft wake vortex light detection and ranging (LIDAR) sensor, working in Mie scattering regime, based on pulsed 1.5-mu m high-brightness large-core fiber amplifier. An end-to-end Doppler heterodyne LIDAR simulator is used for the LIDAR design. The simulation includes the observation geometry, the wake vortex velocity image, the scanning pattern, the LIDAR instrument, the wind turbulence outside the vortex, and the signal processing. An innovative high-brightness pulsed 1.5-mum laser source is described, based on a master oscillator power fiber amplifier (MOPFA) architecture with a large-core fiber. The obtained beam quality is excellent (M 2 = 1.3), and achieved pulsed energy is 120 muJ with a pulse repetition frequency of 12 kHz and a pulse duration of 800 ns. A Doppler heterodyne LIDAR is developed based on this laser source with a high-isolation free-space circulator. The LIDAR includes a real-time display of the wind field. Wind dispersion is postprocessed. Field tests carried out at Orly airport in April 2008 are reported. Axial aircraft wake vortex signatures have been successfully observed and acquired at a range of 1.2 km with axial resolution of 75 m for the first time with fiber laser source.

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Multiple Coulomb scattering (MCS) is the largest contributor to blurring in proton imaging. In this work, we developed a maximum likelihood least squares estimator that improves proton radiographys spatial resolution. The water equivalent thickness (WET) through projections defined from the source to the detector pixels were estimated such that they maximizes the likelihood of the energy loss of every proton crossing the volume. The length spent in each projection was calculated through the optimized cubic spline path estimate. The proton radiographies were produced using Geant4 simulations. Three phantoms were studied here: a slanted cube in a tank of water to measure 2D spatial resolution, a voxelized head phantom for clinical performance evaluation as well as a parametric Catphan phantom (CTP528) for 3D spatial resolution. Two proton beam configurations were used: a parallel and a conical beam. Proton beams of 200 and 330 MeV were simulated to acquire the radiography. Spatial resolution is increased from 2.44 lp cm-1 to 4.53 lp cm-1 in the 200 MeV beam and from 3.49 lp cm-1 to 5.76 lp cm-1 in the 330 MeV beam. Beam configurations do not affect the reconstructed spatial resolution as investigated between a radiography acquired with the parallel (3.49 lp cm-1 to 5.76 lp cm-1) or conical beam (from 3.49 lp cm-1 to 5.56 lp cm-1). The improved images were then used as input in a photon tomography algorithm. The proton CT reconstruction of the Catphan phantom shows high spatial resolution (from 2.79 to 5.55 lp cm-1 for the parallel beam and from 3.03 to 5.15 lp cm-1 for the conical beam) and the reconstruction of the head phantom, although qualitative, shows high contrast in the gradient region. The proposed formulation of the optimization demonstrates serious potential to increase the spatial resolution (up by 65[Formula: see text]) in proton radiography and greatly accelerate proton computed tomography reconstruction.

m LIDAR for Axial Aircraft Wake Vortex Detection Based on High-Brightness Large-Core Fiber Amplifier

The uncertainties in water equivalent thickness (WET) and accuracy of dose estimation using a virtual CT (vCT), generated from deforming the planning CT (pCT) onto the daily cone-beam CT (CBCT), were comprehensively evaluated in the context of lung malignancies and passive scattering proton therapy. The validation methodology utilized multiple CBCT datasets to generate the vCTs of twenty lung cancer patients. A correction step was applied to the vCTs to account for anatomical modifications that could not be modeled by deformation alone. The CBCT datasets included a regular CBCT (rCBCT) and synthetic CBCTs created from the rCBCT and rescan CT (rCT), which minimized the variation in setup between the vCT and the gold-standard image (i.e., rCT). The uncertainty in WET was defined as the voxelwise difference in WET between vCT and rCT, and calculated in 3D (planning target volume, PTV) and 2D (distal and proximal surfaces). The uncertainty in WET based dose warping was defined as the difference between the warped dose and a forward dose recalculation on the rCT. The overall root mean square (RMS) uncertainty in WET was 3.6 ± 1.8, 2.2 ± 1.4 and 3.3 ± 1.8 mm for the distal surface, proximal surface and PTV, respectively. For the warped dose, the RMS uncertainty of the voxelwise dose difference was 6% ± 2% of the maximum dose (%mD), using a 20% cut-off. The rCBCT resulted in higher uncertainties due to setup variability with the rCT; the uncertainties reported with the two synthetic CBCTs were similar. The vCT followed by a correction step was found to be an accurate alternative to rCT.

A maximum likelihood method for high resolution proton radiography/proton CT.

PURPOSE The aim of this work is to propose a general and simple procedure for the calibration and validation of kilo-voltage cone-beam CT (kV CBCT) models against experimental data. METHODS The calibration and validation of the CT model is a two-step procedure: the source model then the detector model. The source is described by the direction dependent photon energy spectrum at each voltage while the detector is described by the pixel intensity value as a function of the direction and the energy of incident photons. The measurements for the source consist of a series of dose measurements in air performed at each voltage with varying filter thicknesses and materials in front of the x-ray tube. The measurements for the detector are acquisitions of projection images using the same filters and several tube voltages. The proposed procedure has been applied to calibrate and assess the accuracy of simple models of the source and the detector of three commercial kV CBCT units. If the CBCT system models had been calibrated differently, the current procedure would have been exclusively used to validate the models. Several high-purity attenuation filters of aluminum, copper, and silver combined with a dosimeter which is sensitive to the range of voltages of interest were used. A sensitivity analysis of the model has also been conducted for each parameter of the source and the detector models. RESULTS Average deviations between experimental and theoretical dose values are below 1.5% after calibration for the three x-ray sources. The predicted energy deposited in the detector agrees with experimental data within 4% for all imaging systems. CONCLUSIONS The authors developed and applied an experimental procedure to calibrate and validate any model of the source and the detector of a CBCT unit. The present protocol has been successfully applied to three x-ray imaging systems. The minimum requirements in terms of material and equipment would make its implementation suitable in most clinical environments.

A comprehensive evaluation of the accuracy of CBCT and deformable registration based dose calculation in lung proton therapy

Purpose: To demonstrate that the discontinuous nature of the CT number to stopping power ratio (SPR) calibration curve, combined with the presence of uncorrelated zero-mean Gaussian CT noise, leads to non-negligible and tissue-dependent systematic errors in SPRs and proton range, typically not taken into account in usual safety margins for proton therapy. Methods: Increased systematic errors with noise standard deviation have first been observed in proton range Monte-Carlo simulations with stoichiometric calibrations, whereas only zero-mean random errors were expected. Their existence has then been proved analytically for arbitrary calibration curves and material distributions along the proton path and validated through continuous slowing down approximation (CSDA) simulations. Their importance relative to the other sources of uncertainty has then been estimated in head-and-neck, lung, and pelvis patient data for multiple beam orientations. CT noise has first been reduced using a double-pass median filtering approach and a Gaussian noise has then been added to obtain total standard deviations between 10 to 40 HU. Results: This study provides close form equations for the systematic error and uncertainty on SPR and proton range due to uncorrelated noise. They have shown to accurately match CSDA simulation results with realistic calibration curves and material distributions. Depending on the tissue distribution and the position of the discontinuities along the curve the resulting effect on range varies but has shown never to cancel out completely as opposed to common beliefs. The analysis performed on patient data with clinical calibration curves has confirmed that fact with estimated systematic range errors of 0.2–0.5% and uncertainties (4 σ) between 0.5 and 1% with typical CT noise levels. Conclusion: A new source of SPR and range systematic errors has been highlighted and proved not to be negligible compared to the 3.5% uncertainty reference value used for safety margin design This study is linked to a public partnership between UCL and IBA funded by the Walloon region under convention number 1017266 and 1217662

Technical Note: Procedure for the calibration and validation of kilo-voltage cone-beam CT models

Purpose: The material relative stopping power (RSP) uncertainty is the highest contributor to the range uncertainty in proton therapy. The purpose of this work is to develop a robust and systematic method that yields accurate, patient specific, RSP by combining 1) pre-treatment x-ray CT and 2) daily proton radiograph of the patient. Methods: The method is formulated as a linear least-square optimization problem (min||Ax-B||2). The parameter A represents the pathlength crossed by the proton in each material. The RSPs for the materials (water equivalent thickness (WET)/physical thickness) are denoted by x. B is the proton radiograph expressed as WET crossed. The problem is minimized using a convex-conic optimization algorithm with xi

TH‐CD‐BRA‐04: Assessing How Stochastic CT Noise Can Lead to Systematic Proton Range Errors

The relative stopping power (RSP) uncertainty is the largest contributor to the range uncertainty in proton therapy. The purpose of this work was to develop a systematic method that yields accurate and patient-specific RSPs by combining (1) pre-treatment x-ray CT and (2) daily proton radiography of the patient. The method was formulated as a penalized least squares optimization problem (argmin([Formula: see text])). The parameter A represents the cumulative path-length crossed by the proton in each material, separated by thresholding on the HU. The material RSPs (water equivalent thickness/physical thickness) are denoted by x. The parameter b is the list-mode proton radiography produced using Geant4 simulations. The problem was solved using a non-negative linear-solver with [Formula: see text]. A was computed by superposing proton trajectories calculated with a cubic or linear spline approach to the CT. The materials RSP assigned in Geant4 were used for reference while the clinical HU-RSP calibration curve was used for comparison. The Gammex RMI-467 phantom was first investigated. The standard deviation between the estimated material RSP and the calculated RSP is 0.45%. The robustness of the techniques was then assessed as a function of the number of projections and initial proton energy. Optimization with two initial projections yields precise RSP (⩽1.0%) for 330 MeV protons. 250 MeV protons have shown higher uncertainty (⩽2.0%) due to the loss of precision in the path estimate. Anthropomorphic phantoms of the head, pelvis, and lung were subsequently evaluated. Accurate RSP has been obtained for the head ([Formula: see text]), the lung ([Formula: see text]) and the pelvis ([Formula: see text]). The range precision has been optimized using the calibration curves obtained with the algorithm, yielding a mean [Formula: see text] difference to the reference of 0.11  ±0.09%, 0.28  ±  0.34% and [Formula: see text] in the same order. The solutions accuracy is limited by the assumed HU/RSP bijection, neglecting inherent degeneracy. The proposed formulation of the problem with prior knowledge x-ray CT demonstrates potential to increase the accuracy of present RSP estimates.

SU-C-204-04: Patient Specific Proton Stopping Powers Estimation by Combining Proton Radiography and Prior-Knowledge X-Ray CT Information

Proton range random and systematic uncertainties are the major factors undermining the advantages of proton therapy, namely, a sharp dose falloff and a better dose conformality for lower doses in normal tissues. The influence of CT artifacts such as beam hardening or scatter can easily be understood and estimated due to their large-scale effects on the CT image, like cupping and streaks. In comparison, the effects of weakly-correlated stochastic noise are more insidious and less attention is drawn on them partly due to the common belief that they only contribute to proton range uncertainties and not to systematic errors thanks to some averaging effects. A new source of systematic errors on the range and relative stopping powers (RSP) has been highlighted and proved not to be negligible compared to the 3.5% uncertainty reference value used for safety margin design. Hence, we demonstrate that the angular points in the HU-to-RSP calibration curve are an intrinsic source of proton range systematic error for typical levels of zero-mean stochastic CT noise. Systematic errors on RSP of up to 1% have been computed for these levels. We also show that the range uncertainty does not generally vary linearly with the noise standard deviation. We define a noise-dependent effective calibration curve that better describes, for a given material, the RSP value that is actually used. The statistics of the RSP and the range continuous slowing down approximation (CSDA) have been analytically derived for the general case of a calibration curve obtained by the stoichiometric calibration procedure. These models have been validated against actual CSDA simulations for homogeneous and heterogeneous synthetical objects as well as on actual patient CTs for prostate and head-and-neck treatment planning situations.

Pre-treatment patient-specific stopping power by combining list-mode proton radiography and x-ray CT

Purpose To simulate the impact of CBCT flat panel misalignment on the image quality, the calculated correction vectors in 3D image guided proton therapy and to determine if these calibration errors can be caught in our QA process. Methods The X-ray source and detector geometrical calibration (flexmap) file of the CBCT system in the AdaPTinsight software (IBA proton therapy) was edited to induce known changes in the rotational and translational calibrations of the imaging panel. Translations of up to ±10 mm in the x, y and z directions (see supplemental) and rotational errors of up to ±3° were induced. The calibration files were then used to reconstruct the CBCT image of a pancreatic patient and CatPhan phantom. Correction vectors were calculated for the patient using the software’s auto match system and compared to baseline values. The CatPhan CBCT images were used for quantitative evaluation of image quality for each type of induced error. Results Translations of 1 to 3 mm in the x and y calibration resulted in corresponding correction vector errors of equal magnitude. Similar 10mm shifts were seen in the y-direction; however, in the x-direction, the image quality was too degraded for a match. These translational errors can be identified through differences in isocenter from orthogonal kV images taken during routine QA. Errors in the z-direction had no effect on the correction vector and image quality.Rotations of the imaging panel calibration resulted in corresponding correction vector rotations of the patient images. These rotations also resulted in degraded image quality which can be identified through quantitative image quality metrics. Conclusion Misalignment of CBCT geometry can lead to incorrect translational and rotational patient correction vectors. These errors can be identified through QA of the imaging isocenter as compared to orthogonal images combined with monitoring of CBCT image quality.