title: Application of Metal Implant 16-Bit Imaging: New Technique in Radiotherapy.
abstract: This study aimed to evaluate the computed tomography number and the variation of dose distribution based on 12-bit, 16-bit, and revised 16-bit images while the metal bars were inserted.
  
  
  
  The phantoms containing stainless steel, titanium alloy, and aluminum bar were scanned with computed tomography. These images were reconstructed with 12-bit and 16-bit imaging technologies. The "cupping artifacts" computed tomography value of the metal object revised by Matlab software was called the revised 16-bit image. The computed tomography values of these metal materials were analyzed. Two radiotherapy treatment plans were designed using the treatment plan system: (1) gantry was of 0° irradiation field and (2) gantry was of 90° and 270° for 2 opposed irradiation fields. The dose profile and dose-volume histogram of a structure of interest were analyzed in various images. The analysis was based on the radiotherapy plan differences between 3 different imaging techniques (12-bit imaging, 16-bit imaging, and revised 16-bit imaging technologies).
  
  
  
  For low-density metal object (computed tomography value <3071 Hounsfield unit, HU), the radiotherapy plan results were consistent based on 3 different imaging techniques. For high-density metal object (computed tomography value >3071 HU), the difference in radiotherapy plan results was obvious. The dose of 12-bit was 15.9% higher than revised 16-bit on average for the downstream of titanium rod. For stainless steel, this number reached up to 42.7%.
  
  
  
  A 16-bit imaging technology of metal implants can distinguish the computed tomography value of different metal materials. Furthermore, the revised 16-bit imaging technology can improve the dose computational accuracy of radiotherapy plan with high-density metal implants.
authors.affiliation: 1 Second People's Hospital of Changzhou, Nanjing Medical University, Changzhou, China.
authors.forename: Ni
authors.initials: N
authors.lastname: Xin-Ye
authors.affiliation: 1 Second People's Hospital of Changzhou, Nanjing Medical University, Changzhou, China.
authors.forename: Gao
authors.initials: G
authors.lastname: Liugang
authors.affiliation: 2 Changzhou Cancer Hospital of Soochow University, Changzhou, China.
authors.forename: Fang
authors.initials: F
authors.lastname: Mingming
authors.affiliation: 1 Second People's Hospital of Changzhou, Nanjing Medical University, Changzhou, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Tao
mesh_terms: D019583:Dose Fractionation, Radiation; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008670:Metals; D019047:Phantoms, Imaging; D019736:Prostheses and Implants; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted; D061089:Radiotherapy, Image-Guided; D014057:Tomography, X-Ray Computed
chemical_list: D008670:Metals
keywords: CT value; metal implant; radiotherapy