Variation of patient imaging doses with scanning parameters for linac-integrated kilovoltage cone beam CT

Abstract

To evaluate the Elekta kilovoltage CBCT doses and the associated technical protocols with patient dosimetry estimation. Image guidance technique with cone-beam CT (CBCT) in radiation oncology on a daily basis can deliver a significant dose to the patient. To evaluate the patient dose from LINAC-integrated kV cone beam CT imaging in image-guided radiotherapy. CT dose index (CTDI) were measured with PTW TM30009 CT ion chamber in air, in head phantom and body phantom, respectively; with different combinations of tube voltage, current, exposure time per frame, collimator and gantry rotation range. Dose length products (DLP) were subsequently calculated to account for volume integration effects. The CTDI and DLP were also compared to AcQSim™ simulator CT for routine clinical protocols. Both CTDI_air and CTDI_w depended quadratically on the voltage, while linearly on milliampere x seconds (mAs) settings. It was shown that CTDI_w and DLP had very close relationship with the collimator settings and the gantry rotation ranges. Normalized CTDI_w for Elekta XVI™ CBCT was lower than that of ACQSim simulator CT owing to its pulsed radiation output characteristics. CTDI_w can be used to assess the patient dose in CBCT due to its simplicity for measurement and reproducibility. Regular measurement should be performed in QA & QC program. Optimal image parameters should be chosen to reduce patient dose during CBCT.