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Fast 4D cone-beam reconstruction using the McKinnon-Bates algorithm with truncation correction and nonlinear filtering

A challenge in using on-board cone beam computed tomography (CBCT) to image lung tumor motion prior to radiation therapy treatment is acquiring and reconstructing high quality 4D images in a sufficiently short time for practical use. For the 1 minute rotation times typical of Linacs, severe view aliasing artifacts, including streaks, are created if a conventional phase-correlated FDK reconstruction is performed. The McKinnon-Bates (MKB) algorithm provides an efficient means of reducing streaks from static tissue but can suffer from low SNR and other artifacts due to data truncation and noise. We have added truncation correction and bilateral nonlinear filtering to the MKB algorithm to reduce streaking and improve image quality. The modified MKB algorithm was implemented on a graphical processing unit (GPU) to maximize efficiency. Results show that a nearly 4x improvement in SNR is obtained compared to the conventional FDK phase-correlated reconstruction and that high quality 4D images with 0.4 second temporal resolution and 1 mm3 isotropic spatial resolution can be reconstructed in less than 20 seconds after data acquisition completes.