For various reasons, a projection dataset acquired on a computed tomography (CT) scanner can be truncated. That is, a portion of the scanned object is positioned outside the scan field-of-view (SFOV) and the line integrals corresponding to those regions are not measured. A projection truncation problem causes imaging artifacts that lead to suboptimal image quality. In this paper, we propose a reconstruction algorithm that enables an adequate estimation of the projection outside the SFOV. We make use of the fact that the total attenuation of each ideal projection in a parallel sampling geometry remains constant over views. We use the magnitudes and slopes of the projection samples at the location of truncation to estimate water cylinders that can best fit to the projection data outside the SFOV. To improve the robustness of the algorithm, continuity constraints are placed on the fitting parameters. Extensive phantom and patient experiments were conducted to test the robustness and accuracy of the proposed algorithm.

Real-time motion tracking and correction is technically feasible on a helical tomotherapy system. In one experiment, dose differences due to respiratory motion were greatly reduced. Dose differences due to nonrespiratory motion were also reduced, although not as much as in the respiratory case due to less frequent tracking updates. In both cases, beam-on time was not increased by motion correction, since the system tracks and corrects for motion simultaneously with treatment delivery.

Purpose: Anatomical motion, both cyclical and aperiodic, can impact the dose delivered during external beam radiation. In this work, we evaluate the use of a research version of the clinical TomoTherapy â dose calculator to calculate dose with intrafraction rigid motion. We also evaluate the feasibility of a method of motion compensation for helical tomotherapy using the jaws and MLC. Methods: Treatment plans were created using the TomoTherapy treatment planning system. Dose was recalculated for several simple rigid motion traces including a 4 mm step motion applied either longitudinally or transversely, and a sinusoidal motion. The calculated dose volumes were compared to dose measurements that were performed by translating the phantom with the same motion traces used in the calculations. Measurements were made using film and ion chambers. Finally, the delivery plans were modified to compensate for the motion by sweeping the jaws for longitudinal motion and shifting the MLC leaves for transverse motion, and the calculations and measurements were repeated. Results: A transverse step motion shifted the dose that was delivered after the step occurred, but otherwise did not impact the dose distribution. Film measurements agreed with dose calculations to within 2%/2 mm for 99% of dose points within the 50% isodose line. A shift in the MLC leaf delivery pattern successfully compensated for the step motion to within the 3 mm accuracy allowed by the finite leaf widths. A longitudinal step motion impacted the dose in the interior of the target volume to a degree that was dependent on the planning field width and step size. Film measurements agreed with dose calculations to within 2%/2 mm for 98% of dose points within the 50% isodose line. Shifts in the jaw position successfully compensated for the longitudinal step motion. Sinusoidal (breathinglike) motion was also studied, with similar results. Conclusions: A research version of the clinical TomoTherapy dose calculator has been shown to accurately calculate the dose from treatment plans delivered in the presence of arbitrary rigid motion. Modifications to the delivery plan using jaw and MLC leaf shifts that follow the motion can successfully compensate for the target motion.

High-dose imaging modes are made possible on a clinical tomotherapy machine by increasing the LINAC pulse rate. Increasing the imaging dose results in increased CNRs; making it easier to distinguish the boundaries of low contrast objects. The imaging dose levels observed in this work are considered acceptable at our institution for SBRT treatments delivered in 3-5 fractions.

Our study of the focal spot measurement using slit-collimators showed that accurate source profile measurements can be achieved through fitting of measurement results at different slit widths and source-to-slit distances (SSD). Quantitative measurements of the TomoTherapy linac focal spot showed that the source distribution could be better described with a model consisting of two Gaussian components rather than a single Gaussian model as assumed in previous studies.