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Objective. This study describes geometry-based and intensity-based tools for quality assurance (QA) of automatically generated structures for online adaptive radiotherapy, and designs an operator-independent traffic light system that identifies erroneous structure sets. Approach. A cohort of eight head and neck (HN) patients with daily CBCTs was selected for test development. Radiotherapy contours were propagated from planning computed tomography (CT) to daily cone beam CT (CBCT) using deformable image registration. These propagated structures were visually verified for acceptability. For each CBCT, several error scenarios were used to generate what were judged unacceptable structures. Ten additional HN patients with daily CBCTs and different error scenarios were selected for validation. A suite of tests based on image intensity, intensity gradient, and structure geometry was developed using acceptable and unacceptable HN planning structures. Combinations of one test applied to one structure, referred to as structure-test combinations, were selected for inclusion in the QA system based on their discriminatory power. A traffic light system was used to aggregate the structure-test combinations, and the system was evaluated on all fractions of the ten validation HN patients. Results. The QA system distinguished between acceptable and unacceptable fractions with high accuracy, labeling 294/324 acceptable fractions as green or yellow and 19/20 unacceptable fractions as yellow or red. Significance. This study demonstrates a system to supplement manual review of radiotherapy planning structures. Automated QA is performed by aggregating results from multiple intensity- and geometry-based tests. [ABSTRACT FROM AUTHOR]

Objective. The aim of this study was to reconstruct volumetric computed tomography (CT) images in real-time from ultra-sparse two-dimensional x-ray projections, facilitating easier navigation and positioning during image-guided radiation therapy. Approach. Our approach leverages a voxel-sapce-searching Transformer model to overcome the limitations of conventional CT reconstruction techniques, which require extensive x-ray projections and lead to high radiation doses and equipment constraints. Main results. The proposed XTransCT algorithm demonstrated superior performance in terms of image quality, structural accuracy, and generalizability across different datasets, including a hospital set of 50 patients, the large-scale public LIDC-IDRI dataset, and the LNDb dataset for cross-validation. Notably, the algorithm achieved an approximately 300% improvement in reconstruction speed, with a rate of 44 ms per 3D image reconstruction compared to former 3D convolution-based methods. Significance. The XTransCT architecture has the potential to impact clinical practice by providing high-quality CT images faster and with substantially reduced radiation exposure for patients. The model's generalizability suggests it has the potential applicable in various healthcare settings. [ABSTRACT FROM AUTHOR]

Objective. This study aims at investigating a novel super resolution CBCT imaging approach with a dual-layer flat panel detector (DL-FPD). Approach. With DL-FPD, the low-energy and high-energy projections acquired from the top and bottom detector layers contain over-sampled spatial information, from which super-resolution CT images can be reconstructed. A simple mathematical model is proposed to explain the signal formation procedure in DL-FPD, and a dedicated recurrent neural network, named suRi-Net, is developed based upon the above imaging model to nonlinearly retrieve the high-resolution dual-energy information. Physical benchtop experiments are conducted to validate the performance of this newly developed super-resolution CBCT imaging method. Main Results. The results demonstrate that the proposed suRi-Net can accurately retrieve high spatial resolution information from the low-energy and high-energy projections of low spatial resolution. Quantitatively, the spatial resolution of the reconstructed CBCT images from the top and bottom detector layers is increased by about 45% and 54%, respectively. Significance. In the future, suRi-Net will provide a new approach to perform high spatial resolution dual-energy imaging in DL-FPD-based CBCT systems. [ABSTRACT FROM AUTHOR]