{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T09:44:22Z","timestamp":1784367862194,"version":"3.55.0"},"reference-count":36,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,11,28]],"date-time":"2024-11-28T00:00:00Z","timestamp":1732752000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["525659135"],"award-info":[{"award-number":["525659135"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010687","name":"H2020 Euratom","doi-asserted-by":"publisher","award":["847707"],"award-info":[{"award-number":["847707"]}],"id":[{"id":"10.13039\/100010687","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Medical Physics"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Treatment planning in radiation therapy (RT) is performed on image sets acquired with commercial x\u2010ray computed tomography (CT) scanners. Considering an increased frequency of verification scans for adaptive RT and the advent of alternatives to x\u2010ray CTs, there is a need to review the requirements for image sets used in RT planning.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>This study aims to derive the required image quality (IQ) for the computation of the dose distribution in proton therapy (PT) regarding spatial resolution and the combination of spatial resolution and noise. The knowledge gained is used to explore the potential for dose reduction in tomography\u2010guided\u00a0PT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Mathematical considerations indicate that the required spatial resolution for dose computation is on the scale of the set\u2010up margins fed into the robust optimization. This hypothesis was tested by processing retrospectively 12 clinical PT cases, which reflect a variety of tumor localizations. Image sets were low\u2010pass filtered and were made noisy in a generic manner. Dose distributions on the modified CT scans were computed with a Monte\u2010Carlo dose engine. The similarity of these dose distributions with clinical ones was quantified with the gamma\u2010index (1\u00a0mm\/1%). The potential reduction of the x\u2010ray exposure compared to the planning CT scan was estimated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Dose distributions within the irradiated volume were robust against low\u2010pass filtering of the CTs with kernels up to a full\u2010width\u2010at\u2010half\u2010maximum of 4\u00a0mm, that is, the gamma pass rate (1\u00a0mm\/1%) was 98%. The limit of the filter width was 6\u00a0mm for brain tumors and 8\u00a0mm for targets in the abdomen. These pass rates remained approximately unchanged if a limited amount of noise was added to the CT image sets. The estimated potential reductions of the x\u2010ray exposure were at least a factor of\u00a020.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The requirements on IQ in terms of spatial resolution in combination with noise for computing the dose in PT are clearly lower than the IQ of current clinical planning. The results apply, for example, to ultra\u2010low dose x\u2010ray CTs, proton CTs with coarse spatial detection, and attenuation images from the joint reconstruction of time\u2010of\u2010flight PET scans.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mp.17530","type":"journal-article","created":{"date-parts":[[2024,11,28]],"date-time":"2024-11-28T13:15:20Z","timestamp":1732799720000},"page":"1293-1304","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Dose distributions of proton therapy plans are robust against lowering the resolution of CTs combined\u00a0with increasing noise"],"prefix":"10.1002","volume":"52","author":[{"given":"Carla","family":"Frensch","sequence":"first","affiliation":[{"name":"West German Proton Therapy Centre Essen Essen Germany"},{"name":"West German Cancer Center (WTZ) University Hospital Essen Essen Germany"},{"name":"Department of Physics TU Dortmund University Dortmund Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claus Maximilian","family":"B\u00e4cker","sequence":"additional","affiliation":[{"name":"West German Proton Therapy Centre Essen Essen Germany"},{"name":"West German Cancer Center (WTZ) University Hospital Essen Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter","family":"Jentzen","sequence":"additional","affiliation":[{"name":"Clinic for Nuclear Medicine University Hospital Essen Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann\u2010Kristin","family":"L\u00fcvelsmeyer","sequence":"additional","affiliation":[{"name":"West German Proton Therapy Centre Essen Essen Germany"},{"name":"West German Cancer Center (WTZ) University Hospital Essen Essen Germany"},{"name":"Department of Physics TU Dortmund University Dortmund Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammadreza","family":"Teimoorisichani","sequence":"additional","affiliation":[{"name":"Siemens Medical Solutions USA Inc. Knoxville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f6rg","family":"Wulff","sequence":"additional","affiliation":[{"name":"West German Proton Therapy Centre Essen Essen Germany"},{"name":"West German Cancer Center (WTZ) University Hospital Essen Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beate","family":"Timmermann","sequence":"additional","affiliation":[{"name":"West German Proton Therapy Centre Essen Essen Germany"},{"name":"West German Cancer Center (WTZ) University Hospital Essen Essen Germany"},{"name":"German Cancer Consortium (DKTK) Essen Germany"},{"name":"Department of Particle Therapy University Hospital Essen Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"B\u00e4umer","sequence":"additional","affiliation":[{"name":"West German Proton Therapy Centre Essen Essen Germany"},{"name":"West German Cancer Center (WTZ) University Hospital Essen Essen Germany"},{"name":"Department of Physics TU Dortmund University Dortmund Germany"},{"name":"German Cancer Consortium (DKTK) Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,11,28]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.12256"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1063\/1.1729798"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.160.3825.303"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.1884906"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nima.2016.02.001"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1088\/1361-6560\/ab2b72"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2019.06.2535"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1088\/1361-6560\/ac27b5"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1088\/0031-9155\/55\/6\/N01"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1088\/1361-6560\/ac8dde"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1088\/1361-6560\/ab8953"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1088\/0031-9155\/61\/12\/4646"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semradonc.2017.11.005"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.3556559"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1120\/jacmp.v14i4.3905"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.2478\/pjmpe-2019-0024"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1088\/1361-6560\/aa86e9"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejmp.2017.09.136"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.13898"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.14546"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2019.08.005"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.32628\/IJSRST218333"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejmp.2017.11.017"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1088\/1361-6560\/aaa035"},{"issue":"2","key":"e_1_2_10_26_1","first-page":"153","article-title":"On the correlation of pixel noise, spatial resolution and dose in computed tomography: theoretical prediction and verification by simulation and measurement","author":"Kalender WA","year":"2003","journal-title":"Phys Med"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejmp.2015.08.007"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.16862"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/RLI.0000000000000614"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1088\/1361-6560\/abc5ca"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2023.1222800"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2021.07.027"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.4884039"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1088\/0031-9155\/58\/5\/1433"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-023-10499-1"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1088\/0031-9155\/50\/22\/007"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2024.1369603"}],"container-title":["Medical Physics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mp.17530","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T03:39:43Z","timestamp":1738553983000},"score":1,"resource":{"primary":{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/10.1002\/mp.17530"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,28]]},"references-count":36,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,2]]}},"alternative-id":["10.1002\/mp.17530"],"URL":"https:\/\/doi.org\/10.1002\/mp.17530","archive":["Portico"],"relation":{},"ISSN":["0094-2405","2473-4209"],"issn-type":[{"value":"0094-2405","type":"print"},{"value":"2473-4209","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,28]]},"assertion":[{"value":"2024-05-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-11-11","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-11-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}