Fast kilovoltage/megavoltage (kVMV) breathhold cone-beam CT for image-guided radiotherapy of lung cancer

核医学 图像质量 医学 成像体模 锥束ct 影像引导放射治疗 直线粒子加速器 平板探测器 锥束ct 放射治疗 放射科 探测器 梁(结构) 计算机断层摄影术 物理 计算机科学 光学 图像(数学) 人工智能
作者
H. Wertz,Dzmitry Stsepankou,Manuel Blessing,Michael Rossi,C Knox,Kevin Brown,Uwe Gros,Judit Boda-Heggemann,Cornelia Walter,Juergen Hesser,Frank Lohr,Frederik Wenz
出处
期刊:Physics in Medicine and Biology [IOP Publishing]
卷期号:55 (15): 4203-4217 被引量:35
标识
DOI:10.1088/0031-9155/55/15/001
摘要

Long image acquisition times of 60-120 s for cone-beam CT (CBCT) limit the number of patients with lung cancer who can undergo volume image guidance under breathhold. We developed a low-dose dual-energy kilovoltage-megavoltage-cone-beam CT (kVMV-CBCT) based on a clinical treatment unit reducing imaging time to < or =15 s. Simultaneous kVMV-imaging was achieved by dedicated synchronization hardware controlling the output of the linear accelerator (linac) based on detector panel readout signals, preventing imaging artifacts from interference of the linac's MV-irradiation and panel readouts. Optimization was performed to minimize the imaging dose. Single MV-projections, reconstructed MV-CBCT images and images of simultaneous 90 degrees kV- and 90 degrees MV-CBCT (180 degrees kVMV-CBCT) were acquired with different parameters. Image quality and imaging dose were evaluated and compared to kV-imaging. Hardware-based kVMV synchronization resulted in artifact-free projections. A combined 180 degrees kVMV-CBCT scan with a total MV-dose of 5 monitor units was acquired in 15 s and with sufficient image quality. The resolution was 5-6 line pairs cm(-1) (Catphan phantom). The combined kVMV-scan dose was equivalent to a kV-radiation scan dose of approximately 33 mGy. kVMV-CBCT based on a standard linac is promising and can provide ultra-fast online volume image guidance with low imaging dose and sufficient image quality for fast and accurate patient positioning for patients with lung cancer under breathhold.

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