Abstract
To evaluate the impact on free-breathing CBCT (FBCBCT) image quality to properly visualize the motion range of moving tumors as a function of imaging dose. A multi-purpose body phantom (QUASAR) with a cylindrical cedar wood (density = 0.330g/cc), and an embedded 3-cm diameter Polystyrene sphere (density = 0.855g/cc) were used to simulate lung tumor motion. Varian Trilogy with OBI system was used to acquire CBCT images (high-dose mode: 125kVp, 80mA, 25ms/frame & low-dose mode: 110kVp, 20mA, 20ms/frame). As the FBCBCT projections were acquired, the sphere moved in accordance to 30 simulated sinusoidal patient breathing patterns using a programmable motion platform, which were given the parameters: inhalation-to-exhalation (I/E) ratio ranging from 1-0.2131, amplitudes of 1 and 3 cm, and periods 2, 4, and 6 seconds. Following the acquisition of FBCBCT images, the ITV contrast, defined as = (target pixel values inside the sphere - avg. pixel values in background)/(avg. pixel values in background), were calculated per image slice. All parameters, I/E ratio, period, and amplitude did not seem to have much impact on the percentage change of the ITV contrast as a function of imaging dose. The percentage-change for all coronal images with a reduced ITV contrast when going from high-dose to low-dose was - 4.61 ± 3.04%, while the percentage-change for all coronal images with an ncreased ITV contrast when going from high-dose to low-dose, was 8.19 ± 3.61%. The overall percentage-change of all 30 coronal images was 5.21 ± 6.49%. We found that imaging dose did not have much impact on the visibility of the ITV volume, irrespective of the amplitude, I/E ratio, or period. Thus, it seems that low-dose FBCBCT may be just as suitable for clinical use while sparing a significant imaging dose to the patients.
Published Version
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