Evaluation of the effect of monochromatic images of Ti6Al4V implant material obtained with Dual Energy CT on radiotherapy plans using the Treatment Planning System and EGSnrc Monte Carlo simulation

Authors

DOI:

https://doi.org/10.22399/ijcesen.918

Keywords:

Radiotheraphy, Dual Energy CT, Single Energy CT, Metal Artefact Reduction (MAR), Monte Carlo Simulation, Ti6Al4V implant

Abstract

This study aimed to evaluate the effect of Dual Energy Computed Tomography (DECT) imaging on radiotherapy planning for Ti6Al4V (grade 23), a high-density implant material, using the Treatment Planning System (TPS) and Monte Carlo (MC) simulation. For this purpose, Ti6Al4V implants with diameters of 6.4 mm and 28 mm were produced with a 3D printer and placed in a Cheese phantom. Single Energy Computed Tomography (SECT) and DECT images were obtained for each implant. SECT and DECT plans were created using TPS on SECT and DECT images and DECT plans were simulated using the EGSnrc-based BEAM nrc MC code system. SECT images of the Cheese phantom consisting entirely of water were transferred to TPS and artefact-free reference plans were created by virtually creating implants in planning. The obtained planning and simulation results were compared with the reference plan and dose errors in planning were determined. As a result of the study, it was observed that DECT imaging significantly increased the dose accuracy for the 6.4 mm diameter TI6Al4V implant compared to conventional planning.  For the 28 mm diameter implant material, it was observed that DECT imaging decreased the success of artefact suppression, but significantly increased the dose accuracy in treatment planning. It was observed that DECT scanners could be used for simulation purposes in radiotherapy clinics for patients with Ti6Al4V implant material. The study needs to be extended to other high-density implant materials encountered in patients receiving radiotherapy.

References

Schwahofer A, Bär E, Kuchenbecker S, Grossmann JG, Kachelrieß M, Sterzing F. (2015) The application of metal artifact reduction (MAR) in CT scans for radiation oncology by monoenergetic extrapolation with a DECT scanner. Zeitschrift fur medizinische Physik. 25(4):314-325. doi:10.1016/j.zemedi.2015.05.004

Stradiotti P, Curti A, Castellazzi G, Zerbi A. (2009) Metal-related artifacts in instrumented spine. Techniques for reducing artifacts in CT and MRI: state of the art. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society. 18 Suppl 1(Suppl 1):102-8. doi:10.1007/s00586-009-0998-5

Bamberg F, Dierks A, Nikolaou K, Reiser MF, Becker CR, Johnson TR. (2011) Metal artifact reduction by dual energy computed tomography using monoenergetic extrapolation. European radiology. 21(7):1424-9. doi:10.1007/s00330-011-2062-1

Van Elmpt W, Landry G, Das M, Verhaegen F. (2016) Dual energy CT in radiotherapy: Current applications and future outlook. Radiother Oncol. 119(1):137-144. doi:10.1016/j.radonc.2016.02.026

Bongers MN, Schabel C, Thomas C, et al. (2015) Comparison and Combination of Dual-Energy- and Iterative-Based Metal Artefact Reduction on Hip Prosthesis and Dental Implants. PloS one. 10(11);e0143584. doi:10.1371/journal.pone.0143584

Bazalova M, Carrier JF, Beaulieu L, Verhaegen F. (2008) Dual-energy CT-based material extraction for tissue segmentation in Monte Carlo dose calculations. Physics in medicine and biology. 53(9);2439-56. doi:10.1088/0031-9155/53/9/015

Akyol O, Olgar T, Toklu T, Eren H, Dirican B. (2021). Dose distrubution evaluation of different dental implants on a real human dry-skull model for head and neck cancer radiotherapy. Radiation Physics and Chemistry.189;109751.

Beyzadeoglu M, Dirican B, Oysul K, Ozen J, Ucok O. (2006) Evaluation of scatter dose of dental titanium implants exposed to photon beams of different energies and irradiation angles in head and neck radiotherapy. Dento maxillo facial radiology. Jan 35(1):14-7. doi:10.1259/dmfr/28125805

Pawałowski B, Panek R, Szweda H, Piotrowski T. (2020). Combination of dual-energy computed tomography and iterative metal artefact reduction to increase general quality of imaging for radiotherapy patients with high dense materials. Phantom study. Physica medica : PM : an international journal devoted to the applications of physics to medicine and biology : official journal of the Italian Association of Biomedical Physics (AIFB). Sep 2020;77:92-99. doi:10.1016/j.ejmp.2020.08.009

Kawrakow I. (2000). Accurate condensed history Monte Carlo simulation of electron transport. I. EGSnrc, the new EGS4 version. Medical physics. 27(3);485-98. doi:10.1118/1.598917

Rogers DW, Faddegon BA, Ding GX, Ma CM, We J, Mackie TR. (1995). BEAM: a Monte Carlo code to simulate radiotherapy treatment units. Medical physics. 22(5);503-24. doi:10.1118/1.597552

Kawrakow I, Rogers DW, Walters BR. (2004). Large efficiency improvements in BEAMnrc using directional bremsstrahlung splitting. Medical physics. 31(10):2883-98. doi:10.1118/1.1788912

Meyer E, Raupach R, Lell M, Schmidt B, Kachelriess M. (2010). Normalized metal artifact reduction (NMAR) in computed tomography. Medical physics. 37(10):5482-93. doi:10.1118/1.3484090

Lell MM, Meyer E, Schmid M, et al. (2013). Frequency split metal artefact reduction in pelvic computed tomography. European radiology. Aug 23(8);2137-45. doi:10.1007/s00330-013-2809-y

Abuş, F., Gürçalar , A., Günay, O., Tunçman , D., Kesmezacar, F. F., & Demir, M. (2024). Determination of Radiation Dose Levels Incurred by Lenses During Scopy Imaging. International Journal of Applied Sciences and Radiation Research , 1(1). https://doi.org/10.22399/ijasrar.11

gul, osman vefa, Demir, hikmettin, Kanyilmaz, G., & Cakır, T. (2024). Dosimetric comparison of 3D-Conformal and IMRT techniques used in radiotherapy of gastric cancer: A retrospective study. International Journal of Computational and Experimental Science and Engineering, 10(1). https://doi.org/10.22399/ijcesen.296

Serap ÇATLI DİNÇ, AKMANSU, M., BORA, H., ÜÇGÜL, A., ÇETİN, B. E., ERPOLAT, P., … ŞENTÜRK, E. (2024). Evaluation of a Clinical Acceptability of Deep Learning-Based Autocontouring: An Example of The Use of Artificial Intelligence in Prostate Radiotherapy. International Journal of Computational and Experimental Science and Engineering, 10(4). https://doi.org/10.22399/ijcesen.386

Özlen, M. S., Cuma, A. B., Yazıcı, S. D., Yeğin, N., Demir, Özge, Aksoy, H., … Günay, O. (2024). Determination of Radiation Dose Level Exposed to Thyroid in C-Arm Scopy. International Journal of Applied Sciences and Radiation Research , 1(1). https://doi.org/10.22399/ijasrar.13

MOHAMMED, H. A., Adem, Şevki, & SAHAB, K. S. (2023). Optimal Examination Ways to follow up patients effected by COVID-19: case study in Jalawla General Hospital in Iraq. International Journal of Applied Sciences and Radiation Research , 1(1). https://doi.org/10.22399/ijasrar.5

Çağlan, A., & Dirican, B. (2024). Evaluation of Dosimetric and Radiobiological Parameters for Different TPS Dose Calculation Algorithms and Plans for Lung Cancer Radiotherapy . International Journal of Computational and Experimental Science and Engineering, 10(2). https://doi.org/10.22399/ijcesen.335

Vural, M., Kabaca, A., Aksoy, S. H., Demir, M., Karaçam, S. Çavdar, Ulusoy, İdil, … Günay, O. (2025). Determination Of Radiation Dose Levels to Which Partois And Spinal Cord (C1-C2) Regions Are Exposed In Computed Tomography Brain Imaging. International Journal of Applied Sciences and Radiation Research , 2(1). https://doi.org/10.22399/ijasrar.17

Waheed, F., Mohamed Abdulhusein Mohsin Al-Sudani, & Iskender Akkurt. (2025). The Experimental Enhancing of the Radiation Shield Properties of Some Produced Compounds. International Journal of Applied Sciences and Radiation Research , 2(1). https://doi.org/10.22399/ijasrar.1

sengul, aycan, Toksoy, T., Kandemir, R., & Karaali, K. (2024). Feasibility of board tilt angle on critical organs during hippocampus-sparing whole-brain radiotherapy. International Journal of Computational and Experimental Science and Engineering, 10(1). https://doi.org/10.22399/ijcesen.292

Wang Y, Qian B, Li B, et al. (2013). Metal artifacts reduction using monochromatic images from spectral CT: evaluation of pedicle screws in patients with scoliosis. European journal of radiology. 82(8);e360-6. doi:10.1016/j.ejrad.2013.02.024

Yu L, Leng S, McCollough CH. (2012) Dual-energy CT-based monochromatic imaging. AJR American journal of roentgenology. 199(5 Suppl);S9-s15. doi:10.2214/ajr.12.9121

Sato E, Shigemitsu R, Mito T, Yoda N, Rasmussen J, Sasaki K. (2021). The effects of bone remodeling on biomechanical behavior in a patient with an implant-supported overdenture. Computers in biology and medicine. 129;104173. doi:10.1016/j.compbiomed.2020.104173

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Published

2025-03-06

How to Cite

Önal, E., Dirican, B., & Toklu, T. (2025). Evaluation of the effect of monochromatic images of Ti6Al4V implant material obtained with Dual Energy CT on radiotherapy plans using the Treatment Planning System and EGSnrc Monte Carlo simulation. International Journal of Computational and Experimental Science and Engineering, 11(1). https://doi.org/10.22399/ijcesen.918

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Research Article