Using a DirectDensity calibration curve in emergency workflows with image data acquired without DirectDensity leads to clinically acceptable treatment plans. Dose deviations can be reduced by carefully evaluating the entire treatment chain. A self-generated hybrid CT density curve shows the best results, although deviations remain larger (< 1.5%) than when planning directly on a calibrated planning CT. The combined phantom- and patient-based analysis demonstrates that calibration curve selection can influence dose distributions under clinically realistic conditions, supporting the superior performance of the hybrid curve and highlighting clinical relevance beyond technical feasibility.
Krause et al. (Sun,) studied this question.