Respiratory regularity gated 4D CT acquisition: concepts and proof of principle

Four-dimensional CT images are generally sorted through a post-acquisition procedure correlating images with a time-synchronized external respiration signal. The patient's ability to maintain reproducible respiration is the limiting factor during 4D CT, where artifacts occur in approximately 85% of scans with current technology. To reduce these artifacts and their subsequent effects during radiotherapy planning, a method for improved 4D CT image acquisition that relies on gating 4D CT acquisition based on the real time monitoring of the respiration signal has been proposed. The respiration signal and CT data acquisition are linked, such that data from irregular breathing cycles, which cause artifacts, are not acquired by gating CT acquisition by the respiratory signal. A proof-of-principle application of the respiratory regularity gated 4D CT method using patient respiratory signals demonstrates the potential of this method to reduce artifacts currently found in 4D CT scans. Numerical simulations indicate a potential reduction in motion within a respiratory phase bin by 20-40% depending on tolerances chosen. Additional advantages of the proposed method are dose reduction by eliminating unnecessary oversampling and obviating the need for post-processing to create the 4D CT data set.