Purpose: Onboard cone-beam computed tomography (CBCT) connected to radiotherapy linear accelerators suffers CT number consistency and uniformity problems in addition to limited longitudinal coverage. Such problems have prevented CBCT from being fully utilized in many quantitative applications including tumor response evaluation and daily radiation dose computation. This paper presents a feasibility study on the helical CBCT scan with exact reconstruction that could be a potential solution.
Methods: A Varian TrueBeam treatment machine was programmed in the research mode to accomplish helical scans that required synchronized gantry circular rotation and couch table linear motion. Two physical phantoms were scanned in both 360° and 720° helical trajectories. A Katsevich exact reconstruction algorithm was implemented and tested with digital phantom simulations. It was further optimized to account for mechanical instabilities of both gantry rotation and couch table motion from the physical phantom measurements. Preprocessing was employed to correct photon scattering, beam hardening, and bowtie filtration. The reconstructed images were compared to those reconstructed from the FDK approximate reconstruction algorithm using the same phantom projections. Comparisons have also been made with the clinical circular CBCT images and the diagnostic helical CT images of the same physical phantoms.
Results: Satisfactory reconstruction results were obtained for the Katsevich algorithm in digital phantom study. Physical phantom results demonstrated that a 360° helical scan could provide up to 19 cm longitudinal coverage, which could be increased to 54 cm with a 720° helical scan. Image spatial resolution and soft tissue contrast were sufficient. The Q-value, which combined the spatial frequency response (modulation transfer function) and the image noise, was calculated, and suggested that the Katsevich algorithm was superior to the FDK algorithm.
Conclusions: A helical CBCT scan is useful to extend the longitudinal coverage. The Katsevich exact reconstruction algorithm could provide additional advantages in image qualities over the traditional FDK approximate algorithm. The combination of helical CBCT scan with exact reconstruction was proved feasible and would render CBCT more useful in image-guided radiation therapy.