WE-DE-BRA-01: SCIENCE COUNCIL JUNIOR INVESTIGATOR COMPETITION WINNER: Acceleration of a Limited-Angle Intrafraction Verification (LIVE) System Using Adaptive Prior Knowledge Based Image Estimation.

PURPOSE: To develop an adaptive prior knowledge based image estimation method to reduce the scan angle needed in the LIVE system to reconstruct 4D-CBCT for intrafraction verification.

METHODS: The LIVE system has been previously proposed to reconstructs 4D volumetric images on-the-fly during arc treatment for intrafraction target verification and dose calculation. This system uses limited-angle beam's eye view (BEV) MV cine images acquired from the treatment beam together with the orthogonally acquired limited-angle kV projections to reconstruct 4D-CBCT images for target verification during treatment. In this study, we developed an adaptive constrained free-form deformation reconstruction technique in LIVE to further reduce the scanning angle needed to reconstruct the CBCT images. This technique uses free form deformation with energy minimization to deform prior images to estimate 4D-CBCT based on projections acquired in limited angle (orthogonal 6°) during the treatment. Note that the prior images are adaptively updated using the latest CBCT images reconstructed by LIVE during treatment to utilize the continuity of patient motion.The 4D digital extended-cardiac-torso (XCAT) phantom was used to evaluate the efficacy of this technique with LIVE system. A lung patient was simulated with different scenario, including baseline drifts, amplitude change and phase shift. Limited-angle orthogonal kV and beam's eye view (BEV) MV projections were generated for each scenario. The 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 the reconstruction accuracy.

RESULTS: Using orthogonal-view of 6° kV and BEV- MV projections, the VPD/COMS values were 12.7±4.0%/0.7±0.5 mm, 13.0±5.1%/0.8±0.5 mm, and 11.4±5.4%/0.5±0.3 mm for the three scenarios, respectively.

CONCLUSION: The technique enables LIVE to accurately reconstruct 4D-CBCT images using only orthogonal 6° angle, which greatly improves the efficiency and reduces dose of LIVE for intrafraction verification.