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Ventilation measured on clinical 4D-CBCT: Increased ventilation accuracy through improved image quality
Kasper R Jensen1, Carsten Brink1, Olfred Hansen2
1Institute of Clinical Research, University of Southern Denmark, Odense, Denmark; Laboratory of Radiation Physics, Odense University Hospital, Denmark.
Improving image quality in four-dimensional cone-beam computed tomography (4D-CBCT) enhances ventilation measurement accuracy. This advancement in radiation therapy may help track patient breathing patterns dynamically.
Area of Science:
- Medical Imaging
- Radiation Oncology
- Image Processing
Background:
- Ventilation measured using 4D cone-beam computed tomography (CBCT) and deformable image registration (DIR) shows potential for predicting radiation sensitivity.
- Current 4D-CBCT image quality limits the accuracy of these ventilation measurements.
Purpose of the Study:
- To investigate if image quality improvements enhance the accuracy of 4D-CBCT measured ventilation.
- To compare 4D-CBCT ventilation measurements against four-dimensional computed tomography (4D-CT) as a gold standard.
Main Methods:
- Utilized 4D-CBCT and 4D-CT scans from 20 non-small-cell lung cancer patients.
- Applied standard or improved projection correction and FDK or SART reconstruction algorithms to CBCT data.
- Calculated ventilation using Jacobians from DIR and assessed accuracy via Spearman correlation with 4D-CT.
Main Results:
- Combining improved projection correction and SART reconstruction significantly increased the mean correlation (0.34) compared to the clinical standard (0.21).
- Averaging ventilation from three successive CBCT scans further improved the correlation to 0.38.
- These results indicate enhanced accuracy of CBCT-derived ventilation with image quality improvements.
Conclusions:
- Improved projection correction and SART reconstruction enhance the accuracy of 4D-CBCT ventilation measurements.
- This advancement could enable the extraction of dynamic respiratory pattern changes in patients during radiotherapy.
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