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SU-F-J-71: Improving CT Quality for Radiation Therapy Planning and Delivery Guidance Using a Non-Linear Contrast Enhancement Technique. Med Phys 2016 Jun;43(6):3422



Pubmed ID



PURPOSE: Advanced image post-processing techniques which enhance soft-tissue contrast in CT have not been widely employed for RT planning or delivery guidance. The purpose of this work is to assess the soft-tissue contrast enhancement from non-linear contrast enhancing filters and its impact in RT. The contrast enhancement reduces patient alignment uncertainties.

METHODS: Non-linear contrast enhancing methods, such as Best Contrast (Siemens), amplify small differences in X-ray attenuation between two adjacent structure without significantly increasing noise. Best Contrast (BC) separates a CT into two frequency bands. The low frequency band is modified by a non-linear scaling function before recombination with the high frequency band. CT data collected using a CT-on-rails (Definition AS Open, Siemens) during daily CT-guided RT for 6 prostate cancer patients and an image quality phantom (The Phantom Laboratory) were analyzed. Images acquired with a standard protocol (120 kVp, 0.6 pitch, 18 mGy CTDIvol) were processed before comparison to the unaltered images. Contrast and noise were measured in the the phantom. Inter-observer variation was assessed by placing prostate contours on the 12 CT study sets, 6 enhanced and 6 unaltered, in a blinded study involving 8 observers.

RESULTS: The phantom data demonstrate that BC increased the contrast between the 1.0% supra-slice element and the background substrate by 46.5 HU while noise increased by only 2.3 HU. Thus the contrast to noise ratio increased from 1.28 to 6.71. Furthermore, the variation in centroid position of the prostate contours was decreased from 1.3±0.4 mm to 0.8±0.3 mm. Thus the CTV-to-PTV margin was reduced by 1.1 mm. The uncertainty in delineation of the prostate/rectum edge decreased by 0.5 mm.

CONCLUSION: As demonstrated in phantom and patient scans the BC filter accentuates soft-tissue contrast. This enhancement leads to reduced inter-observer variation, which should improve RT planning and delivery. Supported by Siemens.

Author List

Noid G, Tai A, Li X


An Tai PhD Associate Professor in the Radiation Oncology department at Medical College of Wisconsin

jenkins-FCD Prod-480 9a4deaf152b0b06dd18151814fff2e18f6c05280