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A comparison of kilovoltage and megavoltage cone beam CT in radiotherapy

Published online by Cambridge University Press:  01 September 2007

M. Broderick*
Affiliation:
Division of Radiation Therapy, School of Medicine, Trinity College Dublin, Ireland, Sheffield, UK
G. Menezes
Affiliation:
Division of Radiation Therapy, School of Medicine, Trinity College Dublin, Ireland, Sheffield, UK
M. Leech
Affiliation:
Division of Radiation Therapy, School of Medicine, Trinity College Dublin, Ireland, Sheffield, UK
M. Coffey
Affiliation:
Division of Radiation Therapy, School of Medicine, Trinity College Dublin, Ireland, Sheffield, UK
R. Appleyard
Affiliation:
Faculty of Health & Wellbeing, Sheffield Hallam University, Sheffield, UK
*
Correspondence to: Maria Broderick, Division of Radiation Therapy, Trinity Centre for Health Sciences, St James’s Hospital, Dublin 8, Ireland. E-mail: osheam2@@tcd.ie

Abstract

As more and more patients are planned in 3D, the need to verify their position and treatment in 3D also becomes apparent. Megavoltage (MV) and kilovoltage (KV) cone beam computed tomography (CBCT) provide 3D verification of patient position. However, the soft tissue contrast and thus the accuracy of delineation is superior with KV CT imaging. CBCT in conjunction with energy fluence maps from electronic portal imaging devices (EPIDs) could theoretically be used to verify the dose delivered. In this instance, a cross calibration between the KV CBCT and the EPID would be required which would not be necessary with MV CBCT. Adaptive planning with CBCT poses similar challenges for both KV and MV CBCT. Although KV CBCT can produce images with Hounsfield units (HUs) comparable with conventional CT in homogenous phantoms there are large discrepancies in inhomogeneous mediums. If the cupping artefact is corrected for in MV CBCT, the HU values can compare well with KV CBCT for homogenous media. However, advances need to be made to achieve a lower patient dose with MV CBCT. At present, the lower dose required for KV CBCT allows for more frequent imaging and better image quality.

Type
Original Article
Copyright
Copyright © Cambridge University Press 2007

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