No abstract

The use of cone-beam computed tomography (CBCT) has been proposed for guiding the delivery of radiation therapy, and investigators have examined the use of both kilovoltage (kV) and megavoltage (MV) x-ray beams in the development of such CBCT systems. In this paper, the inherent contrast and signal-to-noise ratio (SNR) performance for a variety of existing and hypothetical detectors for CBCT are investigated analytically as a function of imaging dose and object size. Theoretical predictions are compared to the results of experimental investigations employing largearea flat-panel imagers (FPIs) at kV and MV energies. Measurements were performed on two different FPI-based CBCT systems: a bench-top prototype incorporating an FPI and kV x-ray source (100 kVp x rays), and a system incorporating an FPI mounted on the gantry of a medical linear accelerator (6 MV x rays). The SNR in volume reconstructions was measured as a function of dose and found to agree reasonably with theoretical predictions. These results confirm the theoretically predicted advantages of employing kV energy x rays in imaging soft-tissue structures found in the human body. While MV CBCT may provide a valuable means of correcting 3D setup errors and may offer an advantage in terms of simplicity of mechanical integration with a linear accelerator (e.g., implementation in place of a portal imager), kV CBCT offers significant performance advantages in terms of image contrast and SNR per unit dose for visualization of soft-tissue structures. The relatively poor SNR performance at MV energies is primarily a result of the low x-ray quantum efficiencies (approximately a few percent or less) that are currently achieved with FPIs at high energies. Furthermore, kV CBCT with an FPI offers the potential of combined volumetric and radiographic/fluoroscopic imaging using the same device.

Computed tomography (CT) was used to evaluate mass effect on the greater curvature of the stomach in two children with histories of intermittent, recurrent vomiting. The paraduodenal herniae were identified on CT in both of these patients as small bowel interposed between the stomach and the body of the pancreas.

Purpose: To characterize the performance of a cone-beam computed tomography (CBCT) imaging system based upon an indirect-detection, amorphous silicon flat-panel imager (FPI). Tomographic images obtained using the FPI are presented, and the signal and noise characteristics of reconstructed images are quantified. Specifically, the spatial uniformity, CT linearity, contrast performance, noise characteristics, spatial resolution, and soft-tissue visualization are examined. Finally, the performance of the FPI-based CT system is discussed in relation to existing clinical technologies.Materials and Methods: A table-top measurements system was constructed to allow investigation of FP1 performance in CBCT within a precisely controlled and reproducible geometry. The FPI incorporates a 512x512 active matrix array of aSi:H thin-film transistors and photodiodes in combination with an overlying (133 mg/cm2 Gd2O2S:Tb) phosphor. The commercially available prototype FPI has a pixel pitch of400 tm, a fill factor of-8O%, can be read at a maximum frame rate of 5 fps, and provides 16 bit digitization. Mounted upon an optical bench are the x-ray tube (in a rigid support frame), the object to be imaged (upon a precision rotation/translation table), and the FPI (mounted upon a precision translation table). The entire setup is directed under computer control, and volumetric imaging is accomplished by rotating the object incrementally over 360 degrees, delivering a radiographic x-ray pulse (e.g., 100-130 kVp, -0.1-10mAs), and acquiring a projection image at each increment. Prior to reconstruction, dark and flood-field corrections are applied to account for stationary nonuniformities in detector response and dark current. Tomographic images are reconstructed from the projections using the Feldkamp filtered back-projection algorithm for CBCT. The linearity ofthe CBCT system was compared to that of a commercial scanner (Philips SR-7000) using materials ranging in CT number from -9OO to 1 100. The contrast sensitivity of the CBCT system and the conventional scanner was compared using these same materials. Images of a uniform water bath were acquired for characterization of the response uniformity and the dependence of noise on exposure. The spatial frequency response characteristics of the system were measured using a steel wire, from which the point spread function and modulation transfer function were determined. Finally, the soft-tissue contrast and spatial resolution of the CBCT system was demonstrated in volumetric images of a euthanized rat. The image quality was compared to images of the same subject acquired with an equivalent technique on the commercial scanner.Results and Conclusions: A table-top CBCT scanner based upon an a-Si:H FPI has been constructed, and a system for CBCT image acquisition, processing, and reconstruction has been implemented. This system is capable of producing highquality volumetric images. Reconstructions were generated from 300 radiographs (100 kVp; I mAs per projection) obtained at 1 .2°increments through 3...