Assessment of three dead detector correction methods for cone-beam computed tomography.

PURPOSE: Dead detectors due to manufacturing defects or radiation damage in the electronic portal imaging devices (EPIDs) used for cone-beam computed tomography (CBCT) can lead to image degradation and ring artifacts. In this work three dead detector correction methods were assessed using megavoltage CBCT (MVCBCT) as a test system, with the goals of assessing the relative effectiveness of the three methods and establishing the conditions for which they fail. METHODS: MVCBCT projections acquired with four linacs at 8 and 60 MU (monitor units) were degraded with varying percentages (2%-95%) of randomly distributed dead single detectors (RDSs), randomly distributed dead detector clusters (RDCs) of 2 mm diameter, and nonrandomly distributed dead detector disks (NRDDs) of varying diameter (4-16 mm). Correction algorithms were bidirectional linear interpolation (BLI), quad-directional linear interpolation (QLI), and a Laplacian solution (LS) method. Correction method failure was defined to occur if ring artifacts were present in the reconstructed phantom images from any linac or if the modulation transfer function (MTF) for any linac dropped below baseline with a p value, calculated with the two sample t test, of less than 0.01. RESULTS: All correction methods failed at the same or lower RDC/RDS percentages and NRDD diameters for the 60 MU as for the 8 MU cases. The LS method tended to outperform or match the BLI and QLI methods. If ring artifacts anywhere in the images were considered unacceptable, the LS method failed for 60 MU at >33% RDS, >2% RDC, and >4 mm NRDD. If ring artifacts within 4 mm longitudinally of the phantom section interfaces were considered acceptable, the LS method failed for 60 MU at >90% RDS, >80% RDC, and >4 mm NRDD. LS failed due to MTF drop for 60 MU at >50% RDS, >25% RDC, and >4 mm NRDD. CONCLUSIONS: The LS method is superior to the BLI and QLI methods, and correction algorithm effectiveness decreases as imaging dose increases. All correction methods failed first due to ring artifacts and second due to MTF drop. If ring artifacts in axial slices within a 4 mm longitudinal distance from phantom section interfaces are acceptable, statistically significant loss in spatial resolution does not occur until over 25% of the EPID is covered in randomly distributed dead detectors, or NRDDs of 4 mm diameter are present.

Estimating differences in volumetric flat bone growth in pediatric patients by radiation treatment method.

PURPOSE: To estimate potential differences in volumetric bone growth in children with sarcoma treated with intensity-modulated (IMRT) and conformal (CRT) radiation therapy using an empiric dose-effect model. METHODS AND MATERIALS: A random coefficient model was used to estimate potential volumetric bone growth of 36 pelvic bones (ischiopubis and ilium) from 11 patients 4 years after radiotherapy. The model incorporated patient age, pretreatment bone volume, integral dose >35 Gy, and time since completion of radiation therapy. Three dosimetry plans were entered into the model: the actual CRT/IMRT plan, a nontreated comparable IMRT/CRT plan, and an idealized plan in which dose was delivered only to the planning target volume. The results were compared with modeled normal bone growth. RESULTS: The model predicted that by using the idealized, IMRT, and CRT approaches, patients would maintain 93%, 87%, and 84%, respectively (p = 0.06), of their expected normal growth. Patients older than 10 years would maintain 98% of normal growth, regardless of treatment method. Those younger than 10 years would maintain 87% (idealized), 76% (IMRT), or 70% (CRT) of their expected growth (p = 0.015). Post hoc testing (Tukey) revealed that the CRT and IMRT approaches differed significantly from the idealized one but not from each other. CONCLUSIONS: Dose-effect models facilitate the comparison of treatment methods and potential interventions. Although treatment methods do not alter the growth of flat bones in older pediatric patients, they may significantly impact bone growth in children younger than age 10 years, especially as we move toward techniques with high conformity and sharper dose gradient.