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Title: SU-D-BRA-07: Applications of Combined KV/MV CBCT Imaging with a High-DQE MV Detector

Abstract

Purpose: To investigate whether a high detection quantum efficiency (DQE) MV detector makes combined kV/MV CBCT clinically practical. Methods: Combined kV/MV CBCT was studied for scan time reduction (STR) and metal artifact reduction (MAR). 6MV CBCT data (dose rate = 0.017 MU/degree) were collected using 1) a novel focused pixelated cadmium tungstate (CWO) scintillator (15mm thickness, DQE(0) = 22%, 0.784mm pixel pitch) coupled to a flat panel imager, and 2) a commercial portal imager with a 133mg/cm{sup 2} gadolinium oxysulfide (GOS) screen (DQE(0) = 1.2%). The 100kVp data were acquired using a commercial imager employing a columnar cesium iodide scintillator (DQE(0) = 70%) with a dose rate of 0.0016 cGy/degree. For STR, MV and kV projections spanning 105° were combined to constitute a complete CBCT scan. Total dose was ∼2cGy and acquisition time was 18s. For MAR, only the metalcorrupted pixels in the kV projections were replaced with MV data resulting in a total dose of less than 1cGy for a 360° scan. Image quality was assessed using an 18-cm diameter electron density phantom with nine tissue inserts, some of which were replaced with steel rods for MAR studies. Results: The CWO contrast-to-noise ratio (CNR) was ∼4.0x higher than themore » GOS CNR and was ∼4.8x lower than the kV CNR when normalized for dose. When CWO MV data were combined with kV data for STR, all contrast inserts were visible, but only two were detectable in the composite kV/GOS image. Metal artifacts were greatly reduced using the kV/MV MAR technique with all contrast inserts clearly visible in the composite kV/CWO image but only two inserts visible in the composite kV/GOS image. Conclusion: We have demonstrated that a high DQE MV detector significantly improves kV/MV CBCT image quality thus enabling scan time reduction and metal artifact reduction without a severe dose penalty. AW and JS-L are employees of Varian, RF is an employee of Siemens.« less

Authors:
;  [1]; ;  [2]; ; ;  [3];  [4]
  1. University of Victoria, Victoria, BC (Australia)
  2. Varian Medical Systems, Palo Alto, CA (United States)
  3. Stanford University, Stanford, CA (United States)
  4. Vancouver Island Cancer Centre, Victoria, BC (Canada)
Publication Date:
OSTI Identifier:
22624387
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Physics; Journal Volume: 43; Journal Issue: 6; Other Information: (c) 2016 American Association of Physicists in Medicine; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
60 APPLIED LIFE SCIENCES; 61 RADIATION PROTECTION AND DOSIMETRY; ANIMAL TISSUES; BIOMEDICAL RADIOGRAPHY; CADMIUM; CESIUM; CESIUM IODIDES; COMPUTERIZED TOMOGRAPHY; DOSE RATES; ELECTRON DENSITY; GADOLINIUM; IMAGES; PHANTOMS; THICKNESS; TUNGSTATES

Citation Formats

Bazalova-Carter, M, Newson, M, Wang, A, Star-Lack, J, Wu, M, Xing, L, Fahrig, R, and Ansbacher, W. SU-D-BRA-07: Applications of Combined KV/MV CBCT Imaging with a High-DQE MV Detector. United States: N. p., 2016. Web. doi:10.1118/1.4955640.
Bazalova-Carter, M, Newson, M, Wang, A, Star-Lack, J, Wu, M, Xing, L, Fahrig, R, & Ansbacher, W. SU-D-BRA-07: Applications of Combined KV/MV CBCT Imaging with a High-DQE MV Detector. United States. doi:10.1118/1.4955640.
Bazalova-Carter, M, Newson, M, Wang, A, Star-Lack, J, Wu, M, Xing, L, Fahrig, R, and Ansbacher, W. Wed . "SU-D-BRA-07: Applications of Combined KV/MV CBCT Imaging with a High-DQE MV Detector". United States. doi:10.1118/1.4955640.
@article{osti_22624387,
title = {SU-D-BRA-07: Applications of Combined KV/MV CBCT Imaging with a High-DQE MV Detector},
author = {Bazalova-Carter, M and Newson, M and Wang, A and Star-Lack, J and Wu, M and Xing, L and Fahrig, R and Ansbacher, W},
abstractNote = {Purpose: To investigate whether a high detection quantum efficiency (DQE) MV detector makes combined kV/MV CBCT clinically practical. Methods: Combined kV/MV CBCT was studied for scan time reduction (STR) and metal artifact reduction (MAR). 6MV CBCT data (dose rate = 0.017 MU/degree) were collected using 1) a novel focused pixelated cadmium tungstate (CWO) scintillator (15mm thickness, DQE(0) = 22%, 0.784mm pixel pitch) coupled to a flat panel imager, and 2) a commercial portal imager with a 133mg/cm{sup 2} gadolinium oxysulfide (GOS) screen (DQE(0) = 1.2%). The 100kVp data were acquired using a commercial imager employing a columnar cesium iodide scintillator (DQE(0) = 70%) with a dose rate of 0.0016 cGy/degree. For STR, MV and kV projections spanning 105° were combined to constitute a complete CBCT scan. Total dose was ∼2cGy and acquisition time was 18s. For MAR, only the metalcorrupted pixels in the kV projections were replaced with MV data resulting in a total dose of less than 1cGy for a 360° scan. Image quality was assessed using an 18-cm diameter electron density phantom with nine tissue inserts, some of which were replaced with steel rods for MAR studies. Results: The CWO contrast-to-noise ratio (CNR) was ∼4.0x higher than the GOS CNR and was ∼4.8x lower than the kV CNR when normalized for dose. When CWO MV data were combined with kV data for STR, all contrast inserts were visible, but only two were detectable in the composite kV/GOS image. Metal artifacts were greatly reduced using the kV/MV MAR technique with all contrast inserts clearly visible in the composite kV/CWO image but only two inserts visible in the composite kV/GOS image. Conclusion: We have demonstrated that a high DQE MV detector significantly improves kV/MV CBCT image quality thus enabling scan time reduction and metal artifact reduction without a severe dose penalty. AW and JS-L are employees of Varian, RF is an employee of Siemens.},
doi = {10.1118/1.4955640},
journal = {Medical Physics},
number = 6,
volume = 43,
place = {United States},
year = {Wed Jun 15 00:00:00 EDT 2016},
month = {Wed Jun 15 00:00:00 EDT 2016}
}
  • Purpose: The purposes of this work are to develop 4D-CBCT imaging system with orthogonal dual source kV X-ray tubes, and to determine the imaging doses from 4D-CBCT scans. Methods: Dual source kV X-ray tubes were used for the 4D-CBCT imaging. The maximum CBCT field of view was 200 mm in diameter and 150 mm in length, and the imaging parameters were 110 kV, 160 mA and 5 ms. The rotational angle was 105°, the rotational speed of the gantry was 1.5°/s, the gantry rotation time was 70 s, and the image acquisition interval was 0.3°. The observed amplitude of infraredmore » marker motion during respiration was used to sort each image into eight respiratory phase bins. The EGSnrc/BEAMnrc and EGSnrc/DOSXYZnrc packages were used to simulate kV X-ray dose distributions of 4D-CBCT imaging. The kV X-ray dose distributions were calculated for 9 lung cancer patients based on the planning CT images with dose calculation grid size of 2.5 x 2.5 x 2.5 mm. The dose covering a 2-cc volume of skin (D2cc), defined as the inner 5 mm of the skin surface with the exception of bone structure, was assessed. Results: A moving object was well identified on 4D-CBCT images in a phantom study. Given a gantry rotational angle of 105° and the configuration of kV X-ray imaging subsystems, both kV X-ray fields overlapped at a part of skin surface. The D2cc for the 4D-CBCT scans was in the range 73.8–105.4 mGy. Linear correlation coefficient between the 1000 minus averaged SSD during CBCT scanning and D2cc was −0.65 (with a slope of −0.17) for the 4D-CBCT scans. Conclusion: We have developed 4D-CBCT imaging system with dual source kV X-ray tubes. The total imaging dose with 4D-CBCT scans was up to 105.4 mGy.« less
  • Purpose: To develop a novel strategy to extract the respiratory motion of the thoracic diaphragm from kilovoltage cone beam computed tomography (CBCT) projections by a constrained linear regression optimization technique. Methods: A parabolic function was identified as the geometric model and was employed to fit the shape of the diaphragm on the CBCT projections. The search was initialized by five manually placed seeds on a pre-selected projection image. Temporal redundancies, the enabling phenomenology in video compression and encoding techniques, inherent in the dynamic properties of the diaphragm motion together with the geometrical shape of the diaphragm boundary and the associatedmore » algebraic constraint that significantly reduced the searching space of viable parabolic parameters was integrated, which can be effectively optimized by a constrained linear regression approach on the subsequent projections. The innovative algebraic constraints stipulating the kinetic range of the motion and the spatial constraint preventing any unphysical deviations was able to obtain the optimal contour of the diaphragm with minimal initialization. The algorithm was assessed by a fluoroscopic movie acquired at anteriorposterior fixed direction and kilovoltage CBCT projection image sets from four lung and two liver patients. The automatic tracing by the proposed algorithm and manual tracking by a human operator were compared in both space and frequency domains. Results: The error between the estimated and manual detections for the fluoroscopic movie was 0.54mm with standard deviation (SD) of 0.45mm, while the average error for the CBCT projections was 0.79mm with SD of 0.64mm for all enrolled patients. The submillimeter accuracy outcome exhibits the promise of the proposed constrained linear regression approach to track the diaphragm motion on rotational projection images. Conclusion: The new algorithm will provide a potential solution to rendering diaphragm motion and ultimately improving tumor motion management for radiation therapy of cancer patients.« less
  • Purpose: To combine orthogonal kilo-voltage (kV) and Mega-voltage (MV) projection data for short scan cone-beam CT to reduce imaging time on current radiation treatment systems, using a calibration-free gain correction method. Methods: Combining two orthogonal projection data sets for kV and MV imaging hardware can reduce the scan angle to as small as 110° (90°+fan) such that the total scan time is ∼18 seconds, or within a breath hold. To obtain an accurate reconstruction, the MV projection data is first linearly corrected using linear regression using the redundant data from the start and end of the sinogram, and then themore » combined data is reconstructed using the FDK method. To correct for the different changes of attenuation coefficients in kV/MV between soft tissue and bone, the forward projection of the segmented bone and soft tissue from the first reconstruction in the redundant region are added to the linear regression model. The MV data is corrected again using the additional information from the segmented image, and combined with kV for a second FDK reconstruction. We simulated polychromatic 120 kVp (conventional a-Si EPID with CsI) and 2.5 MVp (prototype high-DQE MV detector) projection data with Poisson noise using the XCAT phantom. The gain correction and combined kV/MV short scan reconstructions were tested with head and thorax cases, and simple contrast-to-noise ratio measurements were made in a low-contrast pattern in the head. Results: The FDK reconstruction using the proposed gain correction method can effectively reduce artifacts caused by the differences of attenuation coefficients in the kV/MV data. The CNRs of the short scans for kV, MV, and kV/MV are 5.0, 2.6 and 3.4 respectively. The proposed gain correction method also works with truncated projections. Conclusion: A novel gain correction and reconstruction method was developed to generate short scan CBCT from orthogonal kV/MV projections. This work is supported by NIH Grant 5R01CA138426-05.« less
  • Purpose: To assess the robustness of immobilization using open-face mask technology for linac-based stereotactic radiosurgery (SRS) with multiple non-coplanar arcs via repeated CBCT acquisition, with comparison to contemporaneous optical surface tracking data. Methods: 25 patients were treated in open faced masks with cranial SRS using 3–4 non-coplanar arcs. Repeated CBCT imaging was performed to verify the maintenance of proper patient positioning during treatment. Initial patient positioning was performed based on prescribed shifts and optical surface tracking. Positioning refinements employed rigid 3D-matching of the planning CT and CBCT images and were implemented via automated 6DOF couch control. CBCT imaging was repeatedmore » following the treatment of all non-transverse beams with associated couch kicks. Detected patient translations and rotations were recorded and automatically corrected. Optical surface tracking was applied throughout the treatments to monitor motion, and this contemporaneous patient positioning data was recorded to compare against CBCT data and 6DOF couch adjustments. Results: Initial patient positions were refined on average by translations of 3±1mm and rotations of ±0.9-degrees. Optical surface tracking corroborated couch corrections to within 1±1mm and ±0.4-degrees. Following treatment of the transverse and subsequent superior-oblique beam, average translations of 0.6±0.4mm and rotations of ±0.4-degrees were reported via CBCT, with optical surface tracking in agreement to within 1.1±0.6mm and ±0.6-degrees. Following treatment of the third beam, CBCT indicated additional translations of 0.4±0.2mm and rotations of ±0.3-degrees. Cumulative couch corrections resulted in 0.7 ± 0.4mm average magnitude translations and rotations of ±0.4-degrees. Conclusion: Based on CBCT measurements of patients during SRS, the open face mask maintained patient positioning to within 1.5mm and 1-degree with >95% confidence. Patient positioning determined by optical surface tracking agreed with CBCT assessment to within 1±1mm and ±0.6-degree rotations. These data support the use of 1–2mm PTV margins and repeated CBCT to maintain stereotactic positioning tolerances.« less
  • Purpose: Scatter correction in cone-beam computed tomography (CBCT) has obvious effect on the removal of image noise, the cup artifact and the increase of image contrast. Several methods using a beam blocker for the estimation and subtraction of scatter have been proposed. However, the inconvenience of mechanics and propensity to residual artifacts limited the further evolution of basic and clinical research. Here, we propose a rotating collimator-based approach, in conjunction with reconstruction based on a discrete Radon transform and Tchebichef moments algorithm, to correct scatter-induced artifacts. Methods: A rotating-collimator, comprising round tungsten alloy strips, was mounted on a linear actuator.more » The rotating-collimator is divided into 6 portions equally. The round strips space is evenly spaced on each portion but staggered between different portions. A step motor connected to the rotating collimator drove the blocker to around x-ray source during the CBCT acquisition. The CBCT reconstruction based on a discrete Radon transform and Tchebichef moments algorithm is performed. Experimental studies using water phantom and Catphan504 were carried out to evaluate the performance of the proposed scheme. Results: The proposed algorithm was tested on both the Monte Carlo simulation and actual experiments with the Catphan504 phantom. From the simulation result, the mean square error of the reconstruction error decreases from 16% to 1.18%, the cupping (τcup) from 14.005% to 0.66%, and the peak signal-to-noise ratio increase from 16.9594 to 31.45. From the actual experiments, the induced visual artifacts are significantly reduced. Conclusion: We conducted an experiment on CBCT imaging system with a rotating collimator to develop and optimize x-ray scatter control and reduction technique. The proposed method is attractive in applications where a high CBCT image quality is critical, for example, dose calculation in adaptive radiation therapy. We want to thank Dr. Lei Xing and Dr. Yong Yang in the Stanford University School of Medicine for this work. This work was jointly supported by NSFC (61471226), Natural Science Foundation for Distinguished Young Scholars of Shandong Province (JQ201516), and China Postdoctoral Science Foundation (2015T80739, 2014M551949).« less