SU-F-J-198: A Cross-Platform Adaptation of An a Priori Scatter Correction Algorithm for Cone-Beam Projections to Enable Image- and Dose-Guided Proton Therapy




Cone-beam CT (CBCT) imaging may enable image- and dose-guided proton therapy, but is challenged by image artefacts. The aim of this study was to demonstrate the general applicability of a previously developed a priori scatter correction algorithm to allow CBCT-based proton dose calculations.


The a priori scatter correction algorithm used a plan CT (pCT) and raw cone-beam projections acquired with the Varian On-Board Imager. The projections were initially corrected for bow-tie filtering and beam hardening and subsequently reconstructed using the Feldkamp-Davis-Kress algorithm (rawCBCT). The rawCBCTs were intensity normalised before a rigid and deformable registration were applied on the pCTs to the rawCBCTs. The resulting images were forward projected onto the same angles as the raw CB projections. The two projections were subtracted from each other, Gaussian and median filtered, and then subtracted from the raw projections and finally reconstructed to the scatter-corrected CBCTs. For evaluation, water equivalent path length (WEPL) maps (from anterior to posterior) were calculated on different reconstructions of three data sets (CB projections and pCT) of three parts of an Alderson phantom. Finally, single beam spot scanning proton plans (0–360 deg gantry angle in steps of 5 deg; using PyTRiP) treating a 5 cm central spherical target in the pCT were re-calculated on scatter-corrected CBCTs with identical targets.


The scatter-corrected CBCTs resulted in sub-mm mean WEPL differences relative to the rigid registration of the pCT for all three data sets. These differences were considerably smaller than what was achieved with the regular Varian CBCT reconstruction algorithm (1–9 mm mean WEPL differences). Target coverage in the re-calculated plans was generally improved using the scatter-corrected CBCTs compared to the Varian CBCT reconstruction.


We have demonstrated the general applicability of a priori CBCT scatter correction, potentially opening for CBCT-based image/dose-guided proton therapy, including adaptive strategies.

Research agreement with Varian Medical Systems, not connected to the present project.