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Cone-beam-CT guided radiation therapy: technical implementation.

Daniel Létourneau1, John W Wong, Mark Oldham

  • 1Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI, USA. daniel.letourneau@rmp.uhn.on.ca

Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology
|May 14, 2005
PubMed
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High-quality X-ray volumetric imaging (XVI) is achievable for image-guided treatments. Optimized irradiation parameters ensure excellent image quality and low patient dose, making XVI feasible for head and neck, torso, and pelvic areas.

Area of Science:

  • Medical Imaging
  • Radiotherapy Physics
  • Image Guidance Technology

Background:

  • X-ray volumetric imaging (XVI) systems integrated with linear accelerators offer potential for image-guided applications.
  • Clinical implementation requires optimization of irradiation parameters to balance image quality, patient dose, and scan time.

Purpose of the Study:

  • To determine optimal irradiation parameters for XVI systems to achieve a balance between image quality, patient dose, and scanning time.
  • To benchmark XVI performance against helical CT for phantom studies.
  • To identify favorable reconstruction parameters for clinical XVI scans through observer studies.

Main Methods:

  • Benchmarking XVI against helical CT using head and body phantoms, varying parameters like dose, projections, field of view, resolution, and scatter rejection.

Related Experiment Videos

  • Characterizing image quality using metrics such as relative contrast, noise, contrast-to-noise ratio (CNR), and point spread function (PSF).
  • Acquiring and evaluating clinical XVI scans of patients (pelvis, head/neck, lung) with varying reconstruction parameters.

    • Main Results:

    • A scatter rejection grid was found to reduce photon scatter and improve image uniformity.
    • For body phantoms, XVI and helical CT yielded similar image quality, with XVI surface doses of 0.044 Gy compared to 0.025 Gy for CT.
    • Local tomography technique improved image contrast and CNR while reducing skin dose by 40-50% compared to wide-field XVI.
    • Clinical scans demonstrated good soft tissue contrast and excellent bone definition.

    Conclusions:

    • High-quality XVI images are obtainable with optimized parameters and surface doses below 0.05 Gy, suitable for body-sized phantoms.
    • XVI is feasible for image-guided treatments in head and neck, torso, and pelvic regions, utilizing both soft tissue and bony structures.