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SU-E-J-39: Minimizing IGRT Imaging Exposures: KV Radiograph Vs. KV-CBCT Vs. MV Portal Images.

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Kilovoltage (kV) imaging significantly reduces radiation doses compared to megavoltage (MV) imaging during image-guided radiation therapy (IGRT). Optimizing kV beam angles and using bow-tie filters further minimize organ doses, especially for sensitive structures.

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Area of Science:

  • Medical Physics
  • Radiation Oncology
  • Radiological Imaging

Background:

  • Image-guided radiation therapy (IGRT) utilizes various imaging modalities for precise patient positioning.
  • Megavoltage (MV) and kilovoltage (kV) imaging, along with Cone-Beam Computed Tomography (CBCT), are common techniques in IGRT.
  • Understanding and comparing the radiation doses associated with these imaging techniques is crucial for minimizing patient exposure.

Purpose of the Study:

  • To quantitatively compare the radiation doses delivered by MV, kV, and CBCT imaging during IGRT procedures.
  • To evaluate the effectiveness of specific techniques, such as beam angle selection and bow-tie filters, in reducing organ doses during kV imaging.

Main Methods:

  • Monte Carlo simulations (BEAMnrc/DOSXYZnrc) were employed to model kV imaging systems and calculate doses to calibration phantoms.
  • Experimental measurements using calibrated ion chambers validated the Monte Carlo simulations for various kV beams.
  • Calculated kV beam doses were applied to patient CT images to assess organ doses using dose-volume histograms (DVHs).

Main Results:

  • kV imaging resulted in significantly lower organ doses (e.g., prostate, eye) compared to MV imaging.
  • CBCT doses were found to be comparable to or lower than MV imaging doses, with specific reductions noted for pelvis scans.
  • The use of bow-tie filters in kV radiography demonstrated a dose reduction of over 30% for specific organs.

Conclusions:

  • kV imaging offers a substantial dose reduction advantage over MV imaging in IGRT.
  • Strategic selection of kV beam angles and the implementation of bow-tie filters can further minimize radiation exposure to sensitive organs.
  • CBCT provides a viable imaging option with dose levels often lower than MV imaging, particularly when optimized for specific procedures.