Impact of breathing signal-guided dose modulation on step-and-shoot 4D CT image reconstruction.

Background: Breathing signal-guided 4D CT sequence scanning such as the intelligent 4D CT (i4DCT) approach reduces imaging artifacts compared to conventional 4D CT. By design, i4DCT captures entire breathing cycles during beam-on periods, leading to redundant projection data and increased radiation exposure to patients exhibiting prolonged exhalation phases. A recently proposed breathing-guided dose modulation (DM) algorithm promises to lower the imaging dose by temporarily reducing the CT tube current, but the impact on image reconstruction and the resulting images have not been investigated.

Benchmarking machine learning-based real-time respiratory signal predictors in 4D SBRT.

Background: Stereotactic body radiotherapy of thoracic and abdominal tumors has to account for respiratory intrafractional tumor motion. Commonly, an external breathing signal is continuously acquired that serves as a surrogate of the tumor motion and forms the basis of strategies like breathing-guided imaging and gated dose delivery. However, due to inherent system latencies, there exists a temporal lag between the acquired respiratory signal and the system response.

Dose reduction in sequence scanning 4D CT imaging through respiratory signal-guided tube current modulation: A feasibility study.

Background: Respiratory signal-guided 4D CT sequence scanning such as the recently introduced Intelligent 4D CT (i4DCT) approach reduces image artifacts compared to conventional 4D CT, especially for irregular breathing. i4DCT selects beam-on periods during scanning such that data sufficiency conditions are fulfilled for each couch position. However, covering entire breathing cycles during beam-on periods leads to redundant projection data and unnecessary dose to the patient during long exhalation phases.

Clinical application of breathing-adapted 4D CT: image quality comparison to conventional 4D CT.

Purpose: 4D CT imaging is an integral part of 4D radiotherapy workflows. However, 4D CT data often contain motion artifacts that mitigate treatment planning. Recently, breathing-adapted 4D CT (i4DCT) was introduced into clinical practice, promising artifact reduction in in-silico and phantom studies.