Impact of reduction of flux overlap region on kilovoltage cone-beam computed tomography image quality and patients’ exposure dose

AimIn high-precision radiation therapy, kilovoltage cone-beam computed tomography plays an important role in verifying the position of patient and localization of the target. However, the exposure dose is a problem with kilovoltage cone-beam computed tomography. Flux overlap region increases the patient dose around the center when the scan is performed in a full-scan mode. We assessed the influence of flux overlap region in a full-scan mode to understand the relationship between dose and image quality and investigated methods to achieve a dose reduction.MethodA Catphan phantom was scanned using various flux overlap region patterns in the pelvis on a full-scan mode. We used an intensity-modulated radiation therapy phantom for measuring the central dose. DoseLab was used to perform image analysis and to evaluate the linearity of the computed tomography values, uniformity, high-contrast resolution, and contrast-to-noise ratio.ResultsThe Hounsfield unit value varied by ±40 Hounsfield unit of the acceptance value for the X1 field size of 3.5 cm. However, there were no differences in high-contrast resolution and contrast-to-noise ratio among different scan patterns. The absorbed dose decreased by 7% at maximum for the case within the tolerance value.ConclusionDose reduction is possible by reducing the overlap region after calibration and by performing computed tomography in the appropriate overlap region.