Reducing radiation dose and enhancing imaging quality of 4DCT for radiation therapy using iterative reconstruction algorithms  George Noid, PhD, An Tai,

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Reducing radiation dose and enhancing imaging quality of 4DCT for radiation therapy using iterative reconstruction algorithms  George Noid, PhD, An Tai, PhD, Guang-Pei Chen, PhD, Jared Robbins, MD, X. Allen Li, PhD  Advances in Radiation Oncology  Volume 2, Issue 3, Pages 515-521 (July 2017) DOI: 10.1016/j.adro.2017.04.003 Copyright © 2017 The Authors on behalf of the American Society for Radiation Oncology Terms and Conditions

Figure 1 Noise and contrast-to-noise ratio (CNR) are plotted as a function to exposure and reconstruction type. The noise is measured from the substrate in the CTP515 low contrast module. The noise is quantified as the standard deviation of a selection of voxels in Hounsfield units. CNR is calculated using Equation 1. The contrasting regions of interest are in the 1% elements of CTP515 and the adjacent substrate. Advances in Radiation Oncology 2017 2, 515-521DOI: (10.1016/j.adro.2017.04.003) Copyright © 2017 The Authors on behalf of the American Society for Radiation Oncology Terms and Conditions

Figure 2 Detail of axial slices from 4 reconstructions of the same 4-dimensional computed tomography, time sorted to the 0% expiration phase. The kernel was 30f, CTDIvol was 29.2 mGy, and the tube voltage 120 kVp. The top left is the filtered back projection and the remaining 3 are the SAFIRE reconstructions from 3 to 5 in strength. Advances in Radiation Oncology 2017 2, 515-521DOI: (10.1016/j.adro.2017.04.003) Copyright © 2017 The Authors on behalf of the American Society for Radiation Oncology Terms and Conditions

Figure 3 The noise calculated from 4 regions of interest in 6 adjacent axial slices. The SAFIRE number of 0 indicates a filtered back projection. The scan parameters are the same as in Figure 2. Advances in Radiation Oncology 2017 2, 515-521DOI: (10.1016/j.adro.2017.04.003) Copyright © 2017 The Authors on behalf of the American Society for Radiation Oncology Terms and Conditions

Figure 4 The distribution of computed tomography (CT) numbers in detail from the two 4-dimensional CT axial slices on the right. The 2 reconstructions are from the same 4-dimensional CT data set, time sorted to the 0% expiration phase. The scan parameters are identical to those used to produce Figure 3. The image in the middle is the standard filtered back projection reconstruction (B30f), and the image on the right is the SAFIRE 5 reconstruction (I30f#5). Advances in Radiation Oncology 2017 2, 515-521DOI: (10.1016/j.adro.2017.04.003) Copyright © 2017 The Authors on behalf of the American Society for Radiation Oncology Terms and Conditions

Figure 5 Detail from axial slices of the single-phase computed tomography at the end of expiration. The top row is a low-dose scan (17.5 mGy CTDIvol), and the bottom row is a standard-dose scan (29.2 mGy CTDIvol). The images on the left are reconstructed with the standard filtered back projection algorithm (B30f), and the images on the right are reconstructed with SAFIRE (I30f#5). The maroon ring is a region of interest (ROI) inside the gross tumor volume (GTV), and the teal ring is an ROI adjacent to the GTV. Advances in Radiation Oncology 2017 2, 515-521DOI: (10.1016/j.adro.2017.04.003) Copyright © 2017 The Authors on behalf of the American Society for Radiation Oncology Terms and Conditions