ArticleJournal of applied clinical medical physics2025
Hounsfield Unit characterization and dose calculation on a C-arm linac with novel on-board cone-beam computed tomography feature and advanced reconstruction algorithms.
Article in Journal of applied clinical medical physics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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8 citing papers in PubMed.
- Patient-reported distress and anxiety during cone-beam CT imaging sessions with increased gantry rotation speeds.Technical innovations & patient support in radiation oncology · 2026Article
- Quantitative assessment of CBCT image quality metrics and their translation to clinical Art workflow performance in breast cancer patients.Journal of applied clinical medical physics · 2026Article
- First evaluation of in-patient dose calculation accuracy on a C-arm Linear Accelerator with advanced Cone-Beam computed tomography (CBCT) imaging.Physics and imaging in radiation oncology · 2026Article
- Low-dose CBCT image reconstruction: a review.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2026Review
- Quantifying gantry rotation speed and gating effects on CBCT isocenter accuracy for radiotherapy image acquisition.Physics and imaging in radiation oncology · 2026Article
- Automated target misalignment correction for cone beam computed tomography-based online adaptive radiotherapy of locally advanced lung cancer patients.Physics and imaging in radiation oncology · 2025Article
- Hounsfield Unit characterization and dose calculation on a C-arm linac with novel on-board cone-beam computed tomography feature and advanced reconstruction algorithms.Journal of applied clinical medical physics · 2025Article
- Characterization of a prototype rapid kilovoltage x-ray image guidance system designed for a linear accelerator radiation therapy unit.Journal of applied clinical medical physics · 2025Article
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6 authors.
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Abstract
purposeCurrent cone-beam computed tomography (CBCT) on-board c-arm linear accelerators (linacs) lack CT number precision sufficient for dose calculation due to increased scatter from the cone geometry. This investigation evaluated CT number and dose calculation accuracy in-phantom on a novel on-board CBCT unit with potential for improved dose calculation accuracy.
methodsEight head and eight body configurations of an electron density phantom using 16 materials were acquired with a clinical CT-simulator(CT-sim) and novel on-board CBCT imager. CBCT projection data was reconstructed using conventional Feldkamp-Davis-Kress(FDK) and patient scatter-corrected iterative Acuros CTS with metal artifact reduction (Acuros-CTS-iCBCT-MAR) to create a robust CT number to physical density curve. CT-sim and CBCT images of anthropomorphic head and thorax phantoms were acquired, and three treatment plans were generated per phantom. All CBCT images were registered to the CT-sim of the phantoms, and the dose was recalculated on the CBCT images. 3D gamma analysis was performed (10% dose threshold, local, 1% dose difference, 1 or 2 mm distance to agreement), and dose-volume histogram (DVH) metrics were reported for target coverage and organ sparing.
resultsCT numbers for materials ≤1.08 g/cc showed high agreement between CT-sim and CBCT acquisitions. CT number precision improved with Acuros-CTS-iCBCT-MAR compared to FDK in all materials. High agreement between CT-sim and CBCT reconstructed with Acuros-CTS-iCBCT-MAR was observed in 3D gamma analysis showing 93.8% voxels passing in the worst case for a spine stereotactic body radiotherapy (SBRT) plan at 1%/1 mm. Maximum deviation in target coverage was -3.3% PTV-D98% in the lung SBRT plan among the novel reconstructed CBCT images. Plan comparison using FDK reconstructions yielded similar or worse agreement in 3D gamma analysis, with 69.7% voxels passing in the worst case for a spine SBRT treatment plan. Maximum target coverage deviation was -11.7% PTV-D98% among the FDK-reconstructed CBCT.
conclusionsNovel CBCT solutions on c-arm linacs show promise for enabling direct-to-unit or offline adaptive dose calculation, potentially increasing versatility and efficiency of patient-centered care.
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