Target-specific optimization of four-dimensional cone beam computed tomography

Purpose: Under-sampling artifacts are a major problem in four-dimensional cone-beam computed tomography (4D-CBCT) and may compromise evaluation of target motion. Several studies have addressed scan parameter selection for minimizing under-sampling artifacts; however, the role of the target characteristics in scan parameter selection has not been investigated. In this work, the authors evaluated 4D-CBCT performance by assessing the accuracy of target motion measurements for various target sizes and motions. The results may serve as patient-specific guidelines for scan parameters selection in 4D-CBCT. Methods: The authors acquired 4D-CBCT scans of a moving phantom consisting of six water-filled sphere targets of sizes 10-37 mm, using various scan times ranging from 30 s to 3 min., setting the motion to 3-s and 6-s periods. The authors used automatic image registration to extract the target motion trajectories and evaluated these measurements for various target sizes and motions over various combinations of scan parameters including scan time, detector configuration, number of respiration phases, and reconstruction filters. Results: The most important object parameter to 4D-CBCT performance was the period of motion. Measurements for the 6-s motion were always systematically less accurate than measurements for the 3-s motion for 34 of 36 objects of various sizes and periods of motion. The 6-s motion required a greater scan time than the 3-s motion for equivalent measurement accuracy. The second most influential parameter was the target size. For the 3-s period of motion, objects larger than 13 mm were tracked with sub-millimeter accuracy with a 1-min scan time. For the 6-s period of motion, objects larger than 22-mm were tracked with sub-millimeter accuracy with a 1.5-min scan time. For all sizes and motions, temporal blurring was observed when the number of phases was fewer than 8. Offset detector configuration provided the same performance as centered detector except for small targets (20 mm.) at short scan times (1 min). Finally, reconstruction filtering and number of respiratory phases did not affect performance. Conclusions: Scan time should be set according to target size and motion. The authors have provided figures that provide the minimum scan time needed to achieve the particular motion measurement accuracy for a particular size and motion period.