{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T03:23:20Z","timestamp":1789269800969,"version":"build-2803163510"},"reference-count":52,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,12,3]],"date-time":"2023-12-03T00:00:00Z","timestamp":1701561600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Medical Physics"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Online dose calculations before the delivery of radiation treatments have applications in dose delivery verification, online adaptation of treatment plans, and simulation\u2010free treatment planning. While dose calculations by directly utilizing CBCT images are desired, dosimetric accuracy can be compromised due to relatively lower HU accuracy in CBCT images.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>In this work, we propose a novel CBCT imaging pipeline to enhance the accuracy of CBCT\u2010based dose calculations in the pelvis region. Our approach aims to improve the HU accuracy in CBCT images, thereby improving the overall accuracy of CBCT\u2010based dose calculations prior to radiation treatment delivery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>An in\u2010house developed quantitative CBCT pipeline was implemented to address the CBCT raw data contamination problem. The pipeline combines algorithmic data correction strategies and 2D antiscatter grid\u2010based scatter rejection to achieve high CT number accuracy. To evaluate the effect of the quantitative CBCT pipeline on CBCT\u2010based dose calculations, phantoms mimicking pelvis anatomy were scanned using a linac\u2010mounted CBCT system, and a gold standard multidetector CT used for treatment planning (pCT). A total of 20 intensity\u2010modulated treatment plans were generated for five targets, using 6 and 10 MV flattening filter\u2010free beams, and utilizing small and large pelvis phantom images. For each treatment plan, four different dose calculations were performed using pCT images and three CBCT imaging configurations: quantitative CBCT, clinical CBCT protocol, and a high\u2010performance 1D antiscatter grid (1D ASG). Subsequently, dosimetric accuracy was evaluated for both targets and organs at risk as a function of patient size, target location, beam energy, and CBCT imaging configuration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>When compared to the gold\u2010standard pCT, dosimetric errors in quantitative CBCT\u2010based dose calculations were not significant across all phantom sizes, beam energies, and treatment sites. The largest error observed was 0.6% among all dose volume histogram metrics and evaluated dose calculations. In contrast, dosimetric errors reached up to 7% and 97% in clinical CBCT and high\u2010performance ASG CBCT\u2010based treatment plans, respectively. The largest dosimetric errors were observed in bony targets in the large phantom treated with 6 MV beams. The trends of dosimetric errors in organs at risk were similar to those observed in the targets.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The proposed quantitative CBCT pipeline has the potential to provide comparable dose calculation accuracy to the gold\u2010standard planning CT in photon radiation therapy for the abdomen and pelvis. These robust dose calculations could eliminate the need for density overrides in CBCT images and enable direct utilization of CBCT images for dose delivery monitoring or online treatment plan adaptations before the delivery of radiation treatments.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mp.16867","type":"journal-article","created":{"date-parts":[[2023,12,3]],"date-time":"2023-12-03T18:37:45Z","timestamp":1701628665000},"page":"3053-3066","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["2D antiscatter grid and scatter sampling based CBCT method for online dose calculations during CBCT guided radiation therapy of pelvis"],"prefix":"10.1002","volume":"51","author":[{"given":"Farhang","family":"Bayat","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology University of Colorado School of Medicine  Aurora Colorado 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