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Upright cone beam CT imaging using the onboard imager.

Xenia Fave1, Jinzhong Yang2, Luis Carvalho3

  • 1Department 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.

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Summary

Cone beam computed tomography (CBCT) can acquire upright images for treatment planning. This method maintains geometry and spatial linearity, offering benefits for patients unable to lie flat.

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Area of Science:

  • Medical Imaging
  • Radiation Oncology
  • Radiotherapy Physics

Background:

  • Many patients benefit from upright treatment positioning.
  • Accurate imaging is crucial for effective radiotherapy planning.

Purpose of the Study:

  • To determine if cone beam computed tomography (CBCT) can acquire upright images for treatment planning.
  • To assess if upright image reconstruction maintains accurate geometry and Hounsfield units (HUs).

Main Methods:

  • A TrueBeam linac was programmed to acquire upright CBCT images.
  • Phantoms underwent upright and helical CT scans for comparison.
  • Hounsfield units were corrected using direct calibration or simulation CT mapping.

Main Results:

  • Upright CBCT reconstructions maintained overall geometry, spatial linearity, and high contrast resolution.
  • Some artifacts were present, and HU accuracy was initially compromised.
  • Mapping HUs from simulation CT to upright reconstructions mitigated limitations.

Conclusions:

  • The TrueBeam linac can feasibly acquire upright CBCT images.
  • This straightforward technique benefits patients with thoracic tumors or supine intolerance.