Purpose
To evaluate the accuracy of relative stopping power and spatial resolution of images reconstructed with simulated helium CT (HeCT) in comparison to proton CT (pCT).Methods
A Monte Carlo (MC) study with the TOPAS tool was performed to compare the accuracy of relative stopping power (RSP) reconstruction and spatial resolution of low-fluence HeCT to pCT, both using 200 MeV/u particles. An ideal setup consisting of a flat beam source and a totally absorbing energy-range detector was implemented to estimate the theoretically best achievable RSP accuracy for the calibration and reconstruction methods currently used for pCT. The phantoms imaged included a cylindrical water phantom with inserts of different materials, sizes, and positions, a Catphan phantom with a module containing high-contrast line pairs (CTP528) and a module with cylindrical inserts of different RSP (CTP404), as well as a voxelized 10-year-old female phantom. Dose to the cylindrical water phantom was also calculated. The RSP accuracy was studied for all phantoms except the CTP528 module. The latter was used for the estimation of the spatial resolution, evaluated as the modulation transfer function (MTF) at 10%.Results
An overall error under 0.5% was achieved for HeCT for the water phantoms with the different inserts, in all cases better than that for pCT, in some cases by a factor 3. The inserts in the CTP404 module were reconstructed with an average RSP accuracy of 0.3% for HeCT and 0.2% for pCT. Anatomic structures (brain, bones, air cavities, etc.) in the digitized head phantom were well recognizable and no artifacts were visible with both HeCT and pCT. The three main tissue materials (soft tissue, brain, and cranium) were well identifiable in the reconstructed RSP-volume distribution with both imaging modalities. Using 360 projection angles, the spatial resolution was 4 lp/cm for HeCT and 3 lp/cm for pCT. Generally, spatial resolution increased with the number of projection angles and was always higher for HeCT than for pCT for the same number of projections. When HeCT and pCT scan were performed to deliver the same dose in the phantom, the resolution for HeCT was higher than pCT.Conclusion
MC simulations were used to compare HeCT and pCT image reconstruction. HeCT images had similar or better RSP accuracy and higher spatial resolution compared to pCT. Further investigation of the potential of helium ion imaging is warranted.