A feasibility study for megavoltage cone beam CT using a commercial EPID

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Abstract
This study used a standard commercial electronic portal imaging device (EPID) area detector attached to an isocentric linear accelerator and the Feldkamp algorithm to produce cone beam tomographic reconstructions. The EPID has a active area of 32.5 x 32.5 cm2, and can record 12-bit images using two monitor units (MU), with a resolution of 2.1 x 2.0 mm2 FWHM. Since the EPID was not large enough to record the full patient projection at about 1.5 geometric magnification, it was necessary to offset the detector to collect half-cone projections. Corrections are required to convert pixel values into units of exit dose and to realign the projections to overcome the +/- 4 mm support arm sag. With a geometric magnification of 1.5 the sensitive volume is a cylinder of radius 21 cm and length 17 cm. Unfortunately, the patient couch contains metal bed support rails that lie just outside this cylinder, and produce streak artefacts in the reconstruction. Using 90 views the system delivers a central dose of 90 cGy, and has a density resolution of 4%.