# QUANTITATIVE DUAL-ENERGY CT IMAGING FOR CANCER IMAGING AND RADIATION THERAPY APPLICATIONS

> **NIH NIH R01** · WASHINGTON UNIVERSITY · 2020 · $452,790

## Abstract

Project Summary/Abstract
Quantitative dual-energy CT imaging for cancer imaging and radiation therapy applications
Optimal planning and delivery of proton therapy and brachytherapy dose distributions for cancer treatment
require accurate knowledge of the radiological properties (photon cross sections and charged-particle stopping
powers) of tissue near the target volume and organs at risk. For proton therapy, uncertainties in stopping power
maps measured by conventional single-energy computed tomography (CT) imaging necessitate use of range
uncertainty margins of ±3.5% that hinder sparing of adjacent organs at risk, thereby compromising treatment
effectiveness. Current 125I, 103Pd, and electronic brachytherapy planning practice ignore deviations of tissue
composition from liquid water, giving rise to 10%-100% dose delivery errors. While model-based dose-
calculation engines are available, methods for accurate in vivo characterization of tissue inhomogeneities are
urgently needed to eliminate these large dose specification uncertainties. In principle, dual-energy CT can
provide more accurate material composition information, but to date clinical implementation has been limited by
sensitivity to CT noise and artifacts.
 We have developed iterative dual-energy x-ray CT image reconstruction algorithms, incorporating realistic
models of CT acquisition physics and measurement noise. Our promising preliminary results demonstrate tissue
cross section maps that are more accurate and have lower uncertainty than either post-reconstruction dual-
energy CT mapping processes or state-of-the-art single-energy stoichiometric tissue property mapping. We
hypothesize that treatment plans based on these more accurate in vivo tissue cross section will decrease dose
delivery uncertainty and improve plan optimality, leading to measureable reductions in normal tissue
complications relative to tumor control achieved. We propose to conduct a virtual clinical trial based on modified
treatment plans to demonstrate these improvements.
 Our proposal consists of three specific aims: 1) To implement and validate clinically usable dual-energy CT
cross-section mapping processes for conventional multi-slice CT imaging systems used for radiotherapy
simulation and treatment verification; 2) To evaluate intra-organ and inter-patient variations in radiological
quantities and utilize these data to evaluate dose-delivery errors for proton therapy and low-energy
brachytherapy; 3) To conduct a prospective virtual clinical trial to assess the impact of dual-energy CT tissue
property mapping on plan quality, dose-delivery accuracy, and simulated patient outcomes for locally advanced
lung and head-and-neck cancer patients treated with proton therapy.
 Our team of experienced collaborators will quantify the achievable accuracy for clinical tissue composition
obtained by the combination of dual-energy CT and advanced reconstruction algorithms, and estimate how
incorporation of this information...

## Key facts

- **NIH application ID:** 9939481
- **Project number:** 5R01CA212638-04
- **Recipient organization:** WASHINGTON UNIVERSITY
- **Principal Investigator:** JOSEPH A O'SULLIVAN
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $452,790
- **Award type:** 5
- **Project period:** 2017-03-01 → 2022-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9939481

## Citation

> US National Institutes of Health, RePORTER application 9939481, QUANTITATIVE DUAL-ENERGY CT IMAGING FOR CANCER IMAGING AND RADIATION THERAPY APPLICATIONS (5R01CA212638-04). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/9939481. Licensed CC0.

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