Towards automated prompt-gamma treatment verification: Feasibility of PGI simulations on cone-beam CTs

Cone-beam CTs are a promising solution for fast imaging required by Online Adaptive Proton Therapy. Verifying adapted treatment plans with prompt-gamma-imaging (PGI) requires a reference simulation on the respective planning image. Cone-beam CTs and conventional fan-beam CTs were acquired for a homogeneous PMMA cylinder and an antropomorphic head phantom. Two RayStation algorithms were used to create a corrected cone-beam CT and a virtual CT for each phantom. PGI simulations were performed on all datasets and compared to a corresponding dose evaluation. CBCT data was shown to be suitable for PGI reference simulations if range prediction is correct, which is a requirement for plan adaptation. Uncertainty in material assignment due to noise in CBCT does not worsen PGI emission signal.