Experimental Study on Dual-Energy Cone-Beam CT for Proton Therapy Planning

Conference Paper (2026)
Author(s)

David Leibold (TU Delft - Applied Sciences)

Marlies C. Goorden (TU Delft - Applied Sciences)

Dennis R. Schaart (TU Delft - Applied Sciences, Holland Proton Therapy Centre)

Research Group
RST/Medical Physics & Technology
DOI related publication
https://doi.org/10.1117/12.3085612 Final published version
More Info
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Publication Year
2026
Language
English
Research Group
RST/Medical Physics & Technology
Article number
1392427
Publisher
SPIE
ISBN (electronic)
9781510697850
Event
Medical Imaging 2026: Physics of Medical Imaging (2025-02-15 - 2025-02-19), Vancouver, Canada
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Abstract

The objective of this study is to test the ability of dual-energy CBCT to extract proton stopping power ratio (SPR) values for proton radiotherapy planning and to compare its performance to single-energy CBCT, while optimising the operating parameters of both single- and dual-energy CBCT for SPR extraction. We scanned three phantoms with a clinical CBCT installed in the gantry of a proton therapy facility at different source voltage and current settings. Dual-energy CBCT was emulated by combining scans from different kVps. We employed the Hünemohr-Saito method to predict SPR values for dual-energy CBCT scans, whereas we used a Hounsfield look-up table for predicting SPR values based on single-energy CT scans. The optimum operating parameters for dual-energy CBCT scans were an 80/125 kVp combination with a low/high kVp dose ratio of 75/25. This resulted in a relative mean error (RME) and a relative root mean square error (RRMSE) of (0.1 ± 1.2) % and (2.53±0.73) %, respectively. For single-energy CBCT scans, 125 kVp was determined to be the optimum voltage, yielding a RME and RRMSE value of (1.5±3.3) % and (7.1±6.9) %, respectively. Although limited in scope and in need of further experiments, this study indicates that dual-energy CBCT performs better than single-energy CBCT.

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