Experimental comparison of relative stopping power evaluation between proton CT and x-ray CT for pre-clinical proton irradiation studies of small animals

Abstract

Abstract Objective. Proton therapy experiments in small animals are useful not only for pre-clinical and translational studies, but also for the development of advanced technologies for high-precision proton therapy. While treatment planning for proton therapy is currently based on the stopping power of protons relative to water (i.e. the relative stopping power (RSP)), estimated by converting the CT number into RSP (Hounsfield unit (HU)-RSP conversion) in reconstructed x-ray computed tomography (XCT) images, the HU-RSP conversion causes uncertainties in RSP, which affect the accuracy of dose simulation in patients. Proton computed tomography (pCT) has attracted a great deal of attention due to its potential to reduce RSP uncertainties in clinical treatment planning. However, as the proton energies for irradiating small animals are much lower than those used clinically, the energy dependence of RSP may negatively affect pCT-based RSP evaluation. Here, we explored whether the low-energy pCT approach provided more accurate RSPs when planning proton therapy treatment for small animals. Approach. We evaluated the RSPs of 10 water- and tissue-equivalent materials with known constituent elements based on pCT measurements conducted at 73.6 MeV, then compared them with XCT-based and calculated RSPs to investigate energy dependence and achieve more accurate RSPs for treatment planning in small animals. Main results. Despite the low proton energy, the pCT approach for RSP evaluation yields a smaller root mean square deviation (1.9%) of RSP from the theoretical prediction, compared to conventional HU-RSP conversion with XCT (6.1%). Significance. Low-energy pCT is expected to improve the accuracy of proton therapy treatment planning in pre-clinical studies of small animals if the RSP variation that can be attributed to energy dependence is identical to the variation in the clinical proton energy region.