On-beam computed tomography reconstruction for radiotherapy verification from projection image differences caused by...

The purpose of this study is to propose a reconstruction method of a target and its neighborhood, representative of the moment of radiotherapy delivery, based on differences in its transit images between the time of planning computed tomography (pCT) and the time of treatment beam delivery. To validate the method, a lung phantom with a target object was constructed, and CT-scanned before and after making a shift of the target. The latter scan was intended to simulate a potential organ movement at the time of treatment, and to serve as ground-truth images. Treatment planning using arc-beam delivery was done on the first pCT images. The planned beams were irradiated to the phantom after the shift, while cine transit images were acquired. Cine transit images were also calculated through the pCT images before the shift. From the ratio of the measured and calculated transit images, the amount of image changes due to the organ movement between the time of pCT and that of treatment was three-dimensionally reconstructed. By adding the reconstructed images to the pCT images before the shift, the CT images of the phantom at the time of the beam delivery were generated and compared with the ground truth images. The phantom after the shift was also scanned by on-board cone-beam computer tomography (CBCT) and reconstructed from the measured transit images (MVCT) for comparison. The proposed method reconstructed images that are very close to the ground-truth images in the volume and HU values of the target and the dose-volume coverage of the target and lung. Similar agreement was not found in the CBCT and MVCT images. The method may be used for 4D target image reconstruction, and, combined with the reconstructed image of un-irradiated areas, may offer clinically useful images of the entire region of interest.