An inhomogeneous most likely path formalism for proton computed tomography.

Purpose: Multiple Coulomb scattering (MCS) poses a challenge in proton CT (pCT) image reconstruction. The assumption of straight paths is replaced with Bayesian models of the most likely path (MLP). Current MLP-based pCT reconstruction approaches assume a water scattering environment. We propose an MLP formalism based on accurate determination of scattering moments in inhomogeneous media.

Methods: Scattering power relative to water (RScP) was calculated for a range of human tissues and investigated against relative stopping power (RStP). Monte Carlo simulation was used to compare the new inhomogeneous MLP formalism to the water approach in a slab geometry and a human head phantom. An MLP-Spline-Hybrid method was investigated for improved computational efficiency.

Results: A piecewise-linear correlation between RStP and RScP was shown, which may assist in iterative pCT reconstruction. The inhomogeneous formalism predicted Monte Carlo proton paths through a water cube with thick bone inserts to within 1.0 mm for beams ranging from 210 to 230 MeV incident energy. Improvement in accuracy over the conventional MLP ranged from 5% for a 230 MeV beam to 17% for 210 MeV. There was no noticeable gain in accuracy when predicting 200 MeV proton paths through a clinically relevant human head phantom. The MLP-Spline-Hybrid method reduced computation time by half while suffering negligible loss of accuracy.

Conclusions: We have presented an MLP formalism that accounts for material composition. In most clinical cases a water scattering environment can be assumed, however in certain cases of significant heterogeneity the proposed algorithm may improve proton path estimation.