A novel phantom for characterization of dual energy imaging using an on-board imaging system

Dual-energy (DE) imaging using planar imaging with an on-board imager (OBI) is being considered in radiotherapy. We describe here a custom phantom designed to optimize DE imaging parameters using the OBI of a commercial linear accelerator. The phantom was constructed of lung-, tissue- and bone-equivalent material slabs. Five simulated tumors located at two different depths were encased in the lung-equivalent materials. Two slabs with bone-equivalent material inserts were constructed to simulate ribs, which overlap the simulated tumors. DE bone suppression was performed using a weighted logarithmic subtraction based on an iterative method that minimized the contrast between simulated bone- and lung-equivalent materials. The phantom was subsequently used to evaluate different combinations of high-low kV x-ray pairs of images based on the signal-difference-to-noise ratio (SDNR) metric. The results show a strong correlation between tumor visibility and selected energy pairs, where higher energy separation leads to larger SDNR values. To evaluate the effect of image post-processing methods on tumor visibility, an anti-correlated noise reduction (ACNR) technique and adaptive kernel scatter correction method were applied to subsequent DE images. Application of the ACNR technique approximately doubled the SDNR values, hence increasing tumor visibility, while scatter correction had little effect on SDNR values. This phantom allows for quick image acquisition and optimization of imaging parameters and weighting factors. Optimized DE imaging increases soft tissue visibility and may allow for markerless motion tracking of lung tumors.