Development and validation of a measurement-based source model for kilovoltage cone-beam CT Monte Carlo dosimetry...

The purpose of this study is to adapt an equivalent source model originally developed for conventional CT Monte Carlo dose quantification to the radiation oncology context and validate its application for evaluating concomitant dose incurred by a kilovoltage (kV) cone-beam CT (CBCT) system integrated into a linear accelerator.

In order to properly characterize beams from the integrated kV CBCT system, the authors have adapted a previously developed equivalent source model consisting of an equivalent spectrum module that takes into account intrinsic filtration and an equivalent filter module characterizing the added bowtie filtration. An equivalent spectrum was generated for an 80, 100, and 125 kVp beam with beam energy characterized by half-value layer measurements. An equivalent filter description was generated from bowtie profile measurements for both the full- and half-bowtie. Equivalent source models for each combination of equivalent spectrum and filter were incorporated into the Monte Carlo software package MCNPX. Monte Carlo simulations were then validated against in-phantom measurements for both the radiographic and CBCT mode of operation of the kV CBCT system. Radiographic and CBCT imaging dose was measured for a variety of protocols at various locations within a body (32 cm in diameter) and head (16 cm in diameter) CTDI phantom. The in-phantom radiographic and CBCT dose was simulated at all measurement locations and converted to absolute dose using normalization factors calculated from air scan measurements and corresponding simulations. The simulated results were compared with the physical measurements and their discrepancies were assessed quantitatively.

Strong agreement was observed between in-phantom simulations and measurements. For the radiographic protocols, simulations uniformly underestimated measurements by 0.54%-5.14% (mean difference = -3.07%, SD = 1.60%). For the CBCT protocols, simulations uniformly underestimated measurements by 1.35%-5.31% (mean difference = -3.42%, SD = 1.09%).

This work demonstrates the feasibility of using a measurement-based kV CBCT source model to facilitate dose calculations with Monte Carlo methods for both the radiographic and CBCT mode of operation. While this initial work validates simulations against measurements for simple geometries, future work will involve utilizing the source model to investigate kV CBCT dosimetry with more complex anthropomorphic phantoms and patient specific models.