{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T02:30:34Z","timestamp":1790389834933,"version":"4.1.0"},"reference-count":33,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,7,25]],"date-time":"2025-07-25T00:00:00Z","timestamp":1753401600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Applied Clin Med Phys"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Current cone\u2010beam computed tomography (CBCT) on\u2010board c\u2010arm linear accelerators (linacs) lack CT number precision sufficient for dose calculation due to increased scatter from the cone geometry. This investigation evaluated CT number and dose calculation accuracy in\u2010phantom on a novel on\u2010board CBCT unit with potential for improved dose calculation accuracy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Eight head and eight body configurations of an electron density phantom using 16 materials were acquired with a clinical CT\u2010simulator(CT\u2010sim) and novel on\u2010board CBCT imager. CBCT projection data was reconstructed using conventional Feldkamp\u2013Davis\u2013Kress(FDK) and patient scatter\u2010corrected iterative Acuros CTS with metal artifact reduction (Acuros\u2010CTS\u2010iCBCT\u2010MAR) to create a robust CT number to physical density curve. CT\u2010sim and CBCT images of anthropomorphic head and thorax phantoms were acquired, and three treatment plans were generated per phantom. All CBCT images were registered to the CT\u2010sim of the phantoms, and the dose was recalculated on the CBCT images. 3D gamma analysis was performed (10% dose threshold, local, 1% dose difference, 1 or 2\u00a0mm distance to agreement), and dose\u2013volume histogram (DVH) metrics were reported for target coverage and organ sparing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>CT numbers for materials\u00a0\u22641.08\u00a0g\/cc showed high agreement between CT\u2010sim and CBCT acquisitions. CT number precision improved with Acuros\u2010CTS\u2010iCBCT\u2010MAR compared to FDK in all materials. High agreement between CT\u2010sim and CBCT reconstructed with Acuros\u2010CTS\u2010iCBCT\u2010MAR was observed in 3D gamma analysis showing 93.8% voxels passing in the worst case for a spine stereotactic body radiotherapy (SBRT) plan at 1%\/1\u00a0mm. Maximum deviation in target coverage was \u22123.3% PTV\u2010D98% in the lung SBRT plan among the novel reconstructed CBCT images. Plan comparison using FDK reconstructions yielded similar or worse agreement in 3D gamma analysis, with 69.7% voxels passing in the worst case for a spine SBRT treatment plan. Maximum target coverage deviation was \u221211.7% PTV\u2010D98% among the FDK\u2010reconstructed CBCT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Novel CBCT solutions on c\u2010arm linacs show promise for enabling direct\u2010to\u2010unit or offline adaptive dose calculation, potentially increasing versatility and efficiency of patient\u2010centered care.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acm2.70145","type":"journal-article","created":{"date-parts":[[2025,7,26]],"date-time":"2025-07-26T03:45:14Z","timestamp":1753501514000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Hounsfield Unit characterization and dose calculation on a C\u2010arm linac with novel on\u2010board cone\u2010beam computed tomography feature and advanced reconstruction algorithms"],"prefix":"10.1002","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4831-3714","authenticated-orcid":false,"given":"Kenneth W.","family":"Gregg","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology University Hospitals Seidman Cancer Center  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2740-5934","authenticated-orcid":false,"given":"Theodore","family":"Arsenault","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University Hospitals Seidman Cancer Center  Cleveland Ohio USA"},{"name":"Department of Biomedical Engineering Case Western Reserve University  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atefeh","family":"Rezaei","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University Hospitals Seidman Cancer Center  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rojano","family":"Kashani","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University Hospitals Seidman Cancer Center  Cleveland Ohio USA"},{"name":"School of Medicine Case Western Reserve University  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Henke","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University Hospitals Seidman Cancer Center  Cleveland Ohio USA"},{"name":"School of Medicine Case Western Reserve University  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex T","family":"Price","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University Hospitals Seidman Cancer Center  Cleveland Ohio USA"},{"name":"School of Medicine Case Western Reserve University  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,25]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.1609271"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.3690466"},{"key":"e_1_2_9_4_1","doi-asserted-by":"crossref","unstructured":"PapanikolaouN BattistaJJ BoyerAL et\u00a0al.Tissue Inhomogeneity Corrections for Megavoltage Photon Beams(AAPM Report No. 85 2004). doi:10.37206\/86","DOI":"10.37206\/86"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/02841860802245155"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2022.6558"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2008.05.009"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/1748\u2010717X\u20106\u201014"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13566\u2010017\u20100336\u20101"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.778"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1088\/0031\u20109155\/54\/20\/013"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1120\/jacmp.v17i2.6040"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/acm2.14337"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.prro.2023.10.014"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1088\/1361\u20106560\/ad3cb0"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/acm2.70060"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.13396"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.1759828"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.15236"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.12849"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/acm2.13641"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.15069"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.4860195"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.phro.2024.100566"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.15943"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13014\u2010015\u20100549\u20107"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmir.2011.09.002"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1088\/2057\u20101976\/ac536b"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.meddos.2009.06.001"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejmp.2021.05.027"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2024.03.039"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2024.09.041"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2023.109538"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2024.02.016"}],"container-title":["Journal of Applied Clinical Medical Physics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acm2.70145","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,16]],"date-time":"2025-08-16T03:55:48Z","timestamp":1755316548000},"score":1,"resource":{"primary":{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/10.1002\/acm2.70145"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,25]]},"references-count":33,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1002\/acm2.70145"],"URL":"https:\/\/doi.org\/10.1002\/acm2.70145","archive":["Portico"],"relation":{},"ISSN":["1526-9914","1526-9914"],"issn-type":[{"value":"1526-9914","type":"print"},{"value":"1526-9914","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,25]]},"assertion":[{"value":"2024-10-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70145"}}