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Title: Upright cone beam CT imaging using the onboard imager

Purpose: Many patients could benefit from being treated in an upright position. The objectives of this study were to determine whether cone beam computed tomography (CBCT) could be used to acquire upright images for treatment planning and to demonstrate whether reconstruction of upright images maintained accurate geometry and Hounsfield units (HUs). Methods: A TrueBeam linac was programmed in developer mode to take upright CBCT images. The gantry head was positioned at 0°, and the couch was rotated to 270°. The x-ray source and detector arms were extended to their lateral positions. The x-ray source and gantry remained stationary as fluoroscopic projections were taken and the couch was rotated from 270° to 90°. The x-ray tube current was normalized to deposit the same dose (measured using a calibrated Farmer ion chamber) as that received during a clinical helical CT scan to the center of a cylindrical, polyethylene phantom. To extend the field of view, two couch rotation scans were taken with the detector offset 15 cm superiorly and then 15 cm inferiorly. The images from these two scans were stitched together before reconstruction. Upright reconstructions were compared to reconstructions from simulation CT scans of the same phantoms. Two methods were investigatedmore » for correcting the HUs, including direct calibration and mapping the values from a simulation CT. Results: Overall geometry, spatial linearity, and high contrast resolution were maintained in upright reconstructions. Some artifacts were created and HU accuracy was compromised; however, these limitations could be removed by mapping the HUs from a simulation CT to the upright reconstruction for treatment planning. Conclusions: The feasibility of using the TrueBeam linac to take upright CBCT images was demonstrated. This technique is straightforward to implement and could be of enormous benefit to patients with thoracic tumors or those who find a supine position difficult to endure.« less
Authors:
;  [1] ; ; ;  [2] ;  [3] ;  [4]
  1. Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030 and The University of Texas Graduate School of Biomedical Sciences at Houston, Houston, Texas 77030 (United States)
  2. Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030 (United States)
  3. Varian Medical Systems, Zug 6303 (Switzerland)
  4. Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030 (United States)
Publication Date:
OSTI Identifier:
22250607
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Physics; Journal Volume: 41; Journal Issue: 6; Other Information: (c) 2014 American Association of Physicists in Medicine; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ACCURACY; COMPUTERIZED TOMOGRAPHY; FARMS; IMAGE PROCESSING; IMAGES; IONIZATION CHAMBERS; LINEAR ACCELERATORS; NEOPLASMS; PATIENTS; PHANTOMS; POLYETHYLENES; SIMULATION; X-RAY SOURCES; X-RAY TUBES