SU-E-J-06: A Time Dependence Analysis of CBCT Image Quality and Mechanical Stability

To quantify the change, if any, in flexmap correction factors and image quality with the XVI system over a course of several years and from these results, assess their clinical impact.

Flexmap, a calibration procedure which corrects for imperfect gantry rotation for cone-beam CT reconstruction, and image quality tests were performed on three Elekta Synergy linacs equipped with XVI. Data was collected per month over three years. U and V values, corresponding to lateral and longitudinal shifts respectively, were acquired through the XVI software. Image quality parameters were obtained through CT imaging of the Catphan 500®. For each reconstruction, pixel values for low density polyethylene (LDPE) and polystyrene materials were recorded.

For all three linacs, analysis of the flexmap showed a significant change in the U factor for both month-to-month comparisons and comparisons between machines. The V correction factor exhibited a small variation month to month, and showed a slight, gradual increase over time (0.2 +/-0.08 mm). Image quality analysis showed a near consistent decrease (5-10%) in LDPE and polystyrene. Despite this decrease in pixel values, the ratio of the two pixel values remained constant, thus a similar decreasing trend in contrast was not observed.

Analysis of monthly flexmap calibration showed the general monthly change in correction shifts and their general trend over several years. For image quality, our research exhibited roughly 0.5% per month decrease in pixel values of the Catphan®. Our results imply that CBCT images obtained from XVI are not appropriate for treatment planning and despite the decrease in panel response over time, image quality with respect to contrast will remain within acceptable clinical standards. Future studies may be carried out to assess any correlation between image quality and XVI source strength.