The impact of dual energy CT imaging on dose calculations for pre-clinical studies

BACKGROUND: To investigate the feasibility of using dual-energy CT (DECT) for tissue segmentation and kilovolt (kV) dose calculations in pre-clinical studies and assess potential dose calculation accuracy gain. METHODS: Two phantoms and an ex-vivo mouse were scanned in a small animal irradiator with two distinct energies. Tissue segmentation was performed with the single-energy CT (SECT) and DECT methods. A number of different material maps was used. Dose calculations were performed to verify the impact of segmentations on the dose accuracy. RESULTS: DECT showed better overall results in comparison to SECT. Higher number of DECT segmentation media resulted in smaller dose differences in comparison to the reference. Increasing the number of materials in the SECT method yielded more instability. Both modalities showed a limit to which adding more materials with similar characteristics ceased providing better segmentation results, and resulted in more noise in the material maps and the dose distributions. The effect was aggravated with a decrease in beam energy. For the ex-vivo specimen, the choice of only one high dense bone for the SECT method resulted in large volumes of tissue receiving high doses. For the DECT method, the choice of more than one kind of bone resulted in lower dose values for the different tissues occupying the same volume. For the organs at risk surrounded by bone, the doses were lower when using the SECT method in comparison to DECT, due to the high absorption of the bone. SECT material segmentation may lead to an underestimation of the dose to OAR in the proximity of bone. CONCLUSIONS: The DECT method enabled the selection of a higher number of materials thereby increasing the accuracy in dose calculations. In phantom studies, SECT performed best with three materials and DECT with seven for the phantom case. For irradiations in preclinical studies with kV photon energies, the use of DECT segmentation combined with the choice of a low-density bone is recommended.