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KMID : 1164220170290010049
Journal of Korean Society for Radiotherapeutic Technology
2017 Volume.29 No. 1 p.49 ~ p.56
Evaluation of Usefulness of Iterative Metal Artifact Reduction(IMAR) Algorithm In Proton Therapy Planning
Han Young-Gil

Jang Yo-Jong
Kang Dong-Hyuk
Kim Sun-Young
Lee Doo-Hyeon
Abstract
Purpose: To evaluate the accuracy of the Iterative Metal Artifact Reduction (IMAR) algorithm in correcting CT (computed tomography) images distorted due to a metal artifact and to evaluate the usefulness when proton therapy plan was plan using the images on which IMAR algorithm was applied.

Materials and Methods: We used a CT simulator to capture the images when metal was not inserted in the CIRS model 062 Phantom and when metal was inserted in it and Artifact occurred. We compared the differences in the CT numbers from the images without metal, with a metal artifact, and with IMAR algorithm by setting ROI 1 and ROI 2 at the same position in the phantom. In addition, CT numbers of the tissue equivalents located near the metal were compared. For the evaluation of Rando Phantom, CT was taken by inserting a titanium rod into the spinal region of the Rando phantom modelling a patient who underwent spinal implant surgery. In addition, the same proton therapy plan was established for each image, and the differences in Range at three sites were compared.

Results: In the evaluation of CIRS Phantom, the CT numbers were -6.5 HU at ROI 1 and -10.5 HU at ROI 2 in the absence of metal. In the presence of metal, Fe, Ti, and W were -148.1, -45.1 and -151.7 HU at ROI 1, respectively, and when the IMAR algorithm was applied, it increased to -0.9, -2.0, -1.9 HU. In the presence of metal, they were 171.8, 63.9 and 177.0 HU at ROI 2 and after the application of IMAR algorithm they decreased to 10.0 6,7 and 8.1 HU. The CT numbers of the tissue equivalents were corrected close to the original CT numbers except those in the lung located farthest. In the evaluation of the Rando Phantom, the mean CT numbers were 9.9, -202.8, and 35.1 HU at ROI 1, and 9.0, 107.1, and 29 HU at ROI 2 in the absence, presence of metal, and in the application of IMAR algorithm. The difference between the absence of metal and the range of proton beam in the therapy was reduced on the average by 0.26 cm at point 1, 0.20 cm at point 2, and 0.12 cm at point 3 when the IMAR algorithm was applied.

Conclusion: By applying the IMAR algorithm, the CT numbers were corrected close to the original ones obtained in the absence of metal. In the beam profile of the proton therapy, the difference in Range after applying the IMAR algorithm was reduced by 0.01 to 3.6 mm. There were slight differences as compared to the images absence of metal but it was thought that the application of the IMAR algorithm could result in less error compared with the conventional therapy.
KEYWORD
Iterative Metal Artifact Reduction, IMAR, Metal Artifact, Proton Therapy
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