Evaluation of radiation treatment planning by computed tomography metal artifact reduction algorithm

Introduction: The objective of this study was to evaluate the usefulness of Computed Tomography(CT) images acquired through repeated subtraction reconstruction algorithms to reduce metal artifacts in CT Treatment Planning System(TPS).Materials and methods: Origin images of Gammex phantom and Rando phantom and non orthopedic metal artifact reduction(O-MAR) images were obtained after high density implantation. O-MAR applied images were also obtained. For evaluation of images, regions of interest(ROI) were set at five tissue rods and three points directly affected by artifacts in Gammex phantom. CT number and noise were compared and analyzed. To investigate dose change according to CT number change of the surrounding artifact, a three virtual cylindrical target volume was formed on Rando phantom CT images. The average dose was then compared and analyzed.Results: CT number difference according to the application of O-MAR showed significant difference among lung and bone rod and 3 ROI directly affected. Noise difference according to O-MAR application was significantly different in rod except for bone rod. In the treatment plan using Rando phantom, non-O-MAR and O-MAR images showed -4.3 ~ 1.9% and -0.4 ~ 2.3% dose differences, respectively.Conclusion: Applying a metal artifact reduction reconstruction algorithm can reduce image distortion due to high density implantation, improve image quality, and correct CT number.