title: On proton CT reconstruction using MVCT-converted virtual proton projections.
abstract: OBJECTIVE
  To describe a novel methodology of converting megavoltage x-ray projections into virtual proton projections that are otherwise missing due to the proton range limit. These converted virtual proton projections can be used in the reconstruction of proton computed tomography (pCT).
  
  
  METHODS
  Relations exist between proton projections and multispectral megavoltage x-ray projections for human tissue. Based on these relations, these tissues can be categorized into: (a) adipose tissue; (b) nonadipose soft tissues; and (c) bone. These three tissue categories can be visibly identified on a regular megavoltage x-ray computed tomography (MVCT) image. With an MVCT image and its projection data available, the x-ray projections through heterogeneous anatomy can be converted to the corresponding proton projections using predetermined calibration curves for individual materials, aided by a coarse segmentation on the x-ray CT image. To show the feasibility of this approach, mathematical simulations were carried out. The converted proton projections, plotted on a proton sinogram, were compared to the simulated ground truth. Proton stopping power images were reconstructed using either the virtual proton projections only or a blend of physically available proton projections and virtual proton projections that make up for those missing due to the range limit. These images were compared to a reference image reconstructed from theoretically calculated proton projections.
  
  
  RESULTS
  The converted virtual projections had an uncertainty of ±0.8% compared to the calculated ground truth. Proton stopping power images reconstructed using a blend of converted virtual projections (48%) and physically available projections (52%) had an uncertainty of ±0.86% compared with that reconstructed from theoretically calculated projections. Reconstruction solely from converted virtual proton projections had an uncertainty of ±1.1% compared with that reconstructed from theoretical projections. If these images are used for treatment planning, the average proton range uncertainty is estimated to be less than 1.5% for an imaging dose in the milligray range.
  
  
  CONCLUSIONS
  The proposed method can be used to convert x-ray projections into virtual proton projections. The converted proton projections can be blended with existing proton projections or can be used solely for pCT reconstruction, addressing the range limit problem of pCT using current therapeutic proton machines.
authors: Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705, USA.
authors: Dongxu
authors: D
authors: Wang
authors: T Rockwell
authors: TR
authors: Mackie
authors: Wolfgang A
authors: WA
authors: Tomé
mesh_terms: D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008962:Models, Theoretical; D011522:Protons; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014584:User-Computer Interface
chemical_list: D011522:Protons