Abstract

Purpose:To evaluate a moving‐blocker‐based approach in estimating and correcting megavoltage (MV) and kilovoltage (kV) scatter contamination in kV cone‐beam computed tomography (CBCT) acquired during volumetric modulated arc therapy (VMAT).Methods:XML code was generated to enable concurrent CBCT acquisition and VMAT delivery in Varian TrueBeam developer mode. A physical attenuator (i.e., “blocker”) consisting of equal spaced lead strips (3.2mm strip width and 3.2mm gap in between) was mounted between the x‐ray source and patient at a source to blocker distance of 232mm. The blocker was simulated to be moving back and forth along the gantry rotation axis during the CBCT acquisition. Both MV and kV scatter signal were estimated simultaneously from the blocked regions of the imaging panel, and interpolated into the un‐blocked regions. Scatter corrected CBCT was then reconstructed from un‐blocked projections after scatter subtraction using an iterative image reconstruction algorithm based on constraint optimization. Experimental studies were performed on a Catphan 600 phantom and an anthropomorphic pelvis phantom to demonstrate the feasibility of using moving blocker for MV‐kV scatter correction.Results:MV scatter greatly degrades the CBCT image quality by increasing the CT number inaccuracy and decreasing the image contrast, in addition to the shading artifacts caused by kV scatter. The artifacts were substantially reduced in the moving blocker corrected CBCT images in both Catphan and pelvis phantoms. Quantitatively, CT number error in selected regions of interest reduced from 377 in the kV‐MV contaminated CBCT image to 38 for the Catphan phantom.Conclusions:The moving‐blockerbased strategy can successfully correct MV and kV scatter simultaneously in CBCT projection data acquired with concurrent VMAT delivery.This work was supported in part by a grant from the Cancer Prevention and Research Institute of Texas (RP130109) and a grant from the American Cancer Society (RSG‐13‐326‐01‐CCE).

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