Noise properties of reconstructed images in a kilo-voltage on-board imaging system with iterative reconstruction techniques: A phantom study

X-ray computed tomography (CT) images obtained with a kilo-voltage (kV) on-board imaging (OBI) system improve the accuracy of patient setup and treatment planning. The use of iterative reconstruction techniques (IRTs) for CT imaging can also reduce radiation dose compared to analytic reconstruction techniques. Despite these improvements, the image quality varies with IRTs, and the noise structure of reconstructed images can be distorted by IRTs. In this study, the noise properties and spatial resolution of the images reconstructed by IRTs were evaluated in terms of conventional noise metrics, high-order statistics, noise spectral density (NSD) and modulation transfer function (MTF) at different radiation doses. A kV OBI system mounted on a Varian Trilogy machine and a CATPHAN600 phantom were used to obtain projections, and the projections were reconstructed by Feldkamp (FDK), algebraic reconstruction technique (ART), maximum-likelihood expectation-maximization (MLEM) and total variation (TV) minimization algorithms. The reconstructed images were compared according to mean, standard deviation, skewness, kurtosis, NSD and MTF at different radiation doses. The results demonstrated that the noise properties and spatial resolution of reconstructed images depend on the type of IRT and the radiation dose. The noise structures are altered by IRTs and can be characterized by high-order statistics and NSD, as well as conventional noise metrics. In conclusion, high-order statistics and NSD should be considered in order to provide detailed information for the images reconstructed by IRTs. Also, trade-off among noise properties, spatial resolution and contrast is important to optimize image quality obtained using IRTs.