Image quality robustness of HyperSight-enabled versus conventional iterative cone-beam CT across patient size and imaging geometry.
- 1Department of Radiation Oncology, University of Utah, Salt Lake City, Utah, USA.
Abstract
Background
Recent advances in cone-beam computed tomography (CBCT) have led to the development of next-generation CBCT systems with enhanced image quality and quantitative imaging capabilities. These advances are particularly relevant in the context adaptive radiation therapy, where improved soft tissue visualization and Hounsfield unit (HU) stability are increasingly important for target localization and CBCT-based dose calculation.Purpose
To determine how image quality and HU stability change with increasing phantom size, non-cylindrical geometries, and exposure level, and compare the robustness of Acuros-based HyperSight-enabled iterative CBCT (HS-iCBCT) and conventional iterative CBCT on a TrueBeam (TB-iCBCT) under these conditions.Methods
The CatPhan® 604 phantom, combined with custom annular extensions, was used to simulate increasing patient size and non-cylindrical imaging geometries. Three configurations (no annulus, small annulus, and large annulus) were imaged across a range of exposure levels (mAs) using HS-iCBCT and TB-iCBCT. Image evaluation metrics included noise, contrast-to-noise ratio (CNR), low-contrast visibility (LCV), image uniformity, spatial resolution, and Hounsfield unit (HU) constancy.Results
For the no-annulus configuration, image quality was comparable between systems, with slightly lower noise observed for TB-iCBCT. With increasing phantom size through the added annuli, TB-iCBCT exhibited substantial degradation in noise, contrast, and uniformity, whereas HS-iCBCT maintained more consistent performance. Spatial resolution was primarily dependent on field of view and was similar between systems, with smaller fields of view provided improved spatial resolution. HU constancy degraded with increasing phantom size and material density for both systems but remained substantially more stable for HS-iCBCT.Conclusions
HS-iCBCT demonstrated improved robustness to patient size and imaging geometry, providing superior image quality and HU stability compared to TB-iCBCT. These improvements may support potential lower-dose imaging and more reliable performance in larger patients and non-cylindrical imaging geometries commonly encountered in clinical radiotherapy.
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BibTeX
@article{nelson2026image,
title = {{Image quality robustness of HyperSight-enabled versus conventional iterative cone-beam CT across patient size and imaging geometry.}},
author = {Nicholas Nelson and Sorour Hosseini and Geoff Nelson and Thomas Martin and Bradley Nordin and Jessica Huang and Hui Zhao},
journal = {Journal of applied clinical medical physics},
year = {2026},
month = oct,
doi = {10.1002/acm2.70874},
url = {https://europepmc.org/article/MED/42900568},
note = {CC BY},
}
RIS
TY - JOUR
TI - Image quality robustness of HyperSight-enabled versus conventional iterative cone-beam CT across patient size and imaging geometry.
AU - Nicholas Nelson
AU - Sorour Hosseini
AU - Geoff Nelson
AU - Thomas Martin
AU - Bradley Nordin
AU - Jessica Huang
AU - Hui Zhao
PY - 2026
DA - 2026/10/30
JO - Journal of applied clinical medical physics
DO - 10.1002/acm2.70874
UR - https://europepmc.org/article/MED/42900568
AB - Background Recent advances in cone-beam computed tomography (CBCT) have led to the development of next-generation CBCT systems with enhanced image quality and quantitative imaging capabilities. These advances are particularly relevant in the context adaptive radiation therapy, where improved soft tissue visualization and Hounsfield unit (HU) stability are increasingly important for target localization and CBCT-based dose calculation.Purpose To determine how image quality and HU stability change with increasing phantom size, non-cylindrical geometries, and exposure level, and compare the robustness of Acuros-based HyperSight-enabled iterative CBCT (HS-iCBCT) and conventional iterative CBCT on a TrueBeam (TB-iCBCT) under these conditions.Methods The CatPhan® 604 phantom, combined with custom annular extensions, was used to simulate increasing patient size and non-cylindrical imaging geometries. Three configurations (no annulus, small annulus, and large annulus) were imaged across a range of exposure levels (mAs) using HS-iCBCT and TB-iCBCT. Image evaluation metrics included noise, contrast-to-noise ratio (CNR), low-contrast visibility (LCV), image uniformity, spatial resolution, and Hounsfield unit (HU) constancy.Results For the no-annulus configuration, image quality was comparable between systems, with slightly lower noise observed for TB-iCBCT. With increasing phantom size through the added annuli, TB-iCBCT exhibited substantial degradation in noise, contrast, and uniformity, whereas HS-iCBCT maintained more consistent performance. Spatial resolution was primarily dependent on field of view and was similar between systems, with smaller fields of view provided improved spatial resolution. HU constancy degraded with increasing phantom size and material density for both systems but remained substantially more stable for HS-iCBCT.Conclusions HS-iCBCT demonstrated improved robustness to patient size and imaging geometry, providing superior image quality and HU stability compared to TB-iCBCT. These improvements may support potential lower-dose imaging and more reliable performance in larger patients and non-cylindrical imaging geometries commonly encountered in clinical radiotherapy.
SN - 1526-9914
ER -