Evaluation of using Gantry Tilt Scan to Head & Neck of Patients during Radiation Therapy for Reduction of Metal Artifact

Head & Neck 환자의 방사선 치료시 Metal Artifact의 감소를 위한 Gantry Tilt Scan의 유용성 평가

Purpose: The degradation of an image quality and error of the beam dose calculation can be caused because the metal artifact is generated during the CT simulation of head and neck patient. The usability of the gantry tilt scan for reducing the metal artifact tries to be appraised. Materials and Methods: The inferior $20^{\circ}$ gantry tilt scan was made in order to reduce the metal artifact and $0^{\circ}$ reconstruction image was acquired. The AAPM CT performance Phantom was used in order to compare the CT number of the reconstructed image and Original image. the difference of volume was compared by using the acrylic phantom. The homogeneity of the CT number was evaluated the Intensity volume Histogram (IVH) as in order to evaluate an influence by the metal artifact. A dose was evaluated as the Dose Volume Histogram (DVH). Results: in the comparison of the CT number and volume, the difference showed up less than 0.5%. As to the comparison of IVH, in the gantry tilt scan, influence by an artifact was reduced and the homogeneity of the CT number was improved. The comparison of DVH result reduced the mean dose error of the both sides parotid 0.2~6%. Conclusion: In the Head & Neck radiation therapy, It is difficult and to distinguish tumor and normal tissue and the error of dose is generated by the metal artifact. The delineation of the exact organization was possible if the Gantry tilt scan was used. The CT number homogeneity was improved and the error of dose could be reduced. The Gantry tilt scan confirmed in the Head & Neck radiation therapy to be very useful in the exact radiation therapy.

목 적: 두경부 환자의 CT simulation시 metal artifact가 발생하여 영상의 질 저하와 선량계산의 오차를 유발 할 수 있어 metal artifact를 줄이기 위한 gantry tilt scan의 유용성을 평가하고자 한다. 대상 및 방법: Metal artifact를 줄이기 위하여 $20^{\circ}$ gantry tilt scan하여 $0^{\circ}$로 재구성한 이미지를 획득하였다. AAPM CT performance Phantom을 이용하여 CT number를 비교 분석하고, 아크릴 팬텀을 이용하여 체적의 일치여부를 확인하였다. Metal artifact에 의한 영향을 평가하기 위해 Intensity volume Histogram (IVH)을 통한 CT number의 균질성 및 Dose Volume histogram (DVH)을 통한 선량평가를 시행하였다. 결 과: CT number와 체적의 비교에서는 차이가 0.5% 이하로 나타났다. IVH를 비교 분석결과 gantry tilt scan에서 artifact에 의한 영향이 감소되어 CT number의 균질도가 향상되고, DVH 비교결과는 양쪽 이하선의 0.2~6%의 평균선량 오차를 감소시켰다. 결 론: Head & Neck 방사선치료 시 metal artifact 때문에 체표윤곽의 구별이 어렵고 선량의 오차가 발생한다. Gantry tilt scan을 이용하면 정확한 조직의 묘사가 가능하고, CT number 균질도가 향상되어 선량의 오차를 줄일 수 있었다. Gantry tilt scan 은 Head & Neck 방사선치료 시 정확한 방사선치료에 매우 유용함을 확인하였다.