Statistical limitations in ion imaging

In this study, we investigated the capacity of various ion beams available for radiotherapy to produce high quality relative stopping power map acquired from energy-loss measurements. The image quality metrics chosen to compare the different ions were signal-to-noise ratio (SNR) as a function of dose and spatial resolution. Geant4 Monte Carlo simulations were performed for: hydrogen, helium, lithium, boron and carbon ion beams crossing a 20 cm diameter water phantom to determine SNR and spatial resolution. It has been found that protons possess a significantly larger SNR when compared with other ions at a fixed range (up to 36$\%$ higher than helium) due to the proton nuclear stability and low dose per primary. However, it also yields the lowest spatial resolution against all other ions, with a resolution lowered by a factor 4 compared to that of Carbon imaging, for a beam with the same initial range. When comparing for a fixed spatial resolution of 10~lp/cm, carbon ions produce the highest image quality metrics with proton ions producing the lowest. In conclusion, it has been found that no ion can maximize all image quality metrics simultaneously and that a choice must be made between spatial resolution, SNR, and dose