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WE-G-BRF-03: A Quasi-Cine CBCT Reconstruction Technique for Real-Time On- Board Target Tracking of Lung Cancer Treatment.

PURPOSE
To develop a quasi-cine CBCT reconstruction technique that uses extremely-small angle (∼3°) projections to generate real-time high-quality lung CBCT images.


METHOD
4D-CBCT is obtained at the beginning and used as prior images. This study uses extremely-small angle (∼3°) on-board projections acquired at a single respiratory phase to reconstruct the CBCT image at this phase. An adaptive constrained free-form deformation (ACFD) method is developed to deform the prior 4D-CBCT volume at the same phase to reconstruct the new CBCT. Quasi-cine CBCT images are obtained by continuously reconstructing CBCT images at subsequent phases every 3° angle (∼0.5s). Note that the prior 4D-CBCT images are dynamically updated using the latest CBCT images. The 4D digital extended-cardiac-torso (XCAT) phantom was used to evaluate the efficacy of ACFD. A lung patient was simulated with a tumor baseline shift of 2mm along superior-inferior (SI) direction after every respiratory cycle for 5 cycles. Limited-angle projections were simulated for each cycle. The 4D-CBCT reconstructed by these projections were compared with the ground-truth generated in XCAT.Volume-percentage-difference (VPD) and center-of-mass-shift (COMS) were calculated between the reconstructed and the ground-truth tumors to evaluate their geometric differences. The ACFD was also compared to a principal-component-analysis based motion-modeling (MM) method.


RESULTS
Using orthogonal-view 3° projections, the VPD/COMS values for tumor baseline shifts of 2mm, 4mm, 6mm, 8mm, 10mm were 11.0%/0.3mm, 25.3%/2.7mm, 22.4%/2.9mm, 49.5%/5.4mm, 77.2%/8.1mm for the MM method, and 2.9%/0.7mm, 3.9%/0.8mm, 6.2%/1mm, 7.9%/1.2mm, 10.1%/1.1mm for the ACFD method. Using orthogonal-view 0° projections (1 projection only), the ACFD method yielded VPD/COMS results of 5.0%/0.9mm, 10.5%/1.2mm, 15.1%/1.4mm, 20.9%/1.6mm and 24.8%/1.6mm. Using single-view instead of orthogonal-view projections yielded less accurate results for ACFD.


CONCLUSION
The ACFD method accurately reconstructs snapshot CBCT images using orthogonal-view 3° projections. It has a great potential to provide real-time quasi-cine CBCT images for verification in lung radiation therapy. The research is supported by grant from Varian Medical Systems.