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However, conventional CBCT can be easily compromised by scatter and beam hardening artifacts, and the entanglement of scatter and spectral effects introduces additional\u00a0complexity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>The intertwined scatter and spectral effects within CBCT pose significant challenges to the quantitative performance of spectral imaging. In this work, we present the first attempt to develop a stationary spectral modulator with flying focal spot (SMFFS) technology as a promising, low\u2010cost approach to accurately solving the x\u2010ray scattering problem and physically enabling spectral imaging in a unified framework, and with no significant misalignment in data sampling of spectral projections.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>To deal with the intertwined scatter\u2010spectral challenge, we propose a novel scatter\u2010decoupled material decomposition (SDMD) method for SMFFS, which consists of four steps in total, including (1) spatial resolution\u2010preserved and noise\u2010suppressed multi\u2010energy \u201cresidual\u201d projection generation free from scatter, based on a hypothesis of scatter similarity; (2) first\u2010pass material decomposition from the generated multi\u2010energy residual projections in non\u2010penumbra regions, with a structure similarity constraint to overcome the increased noise and penumbra effect; (3) scatter estimation for complete data; and (4) second\u2010pass material decomposition for complete data by using a multi\u2010material spectral correction method. Monte Carlo simulations of a pure\u2010water cylinder phantom with different focal spot deflections are conducted to validate the scatter similarity hypothesis. Both numerical simulations using a clinical abdominal CT dataset, and physics experiments on a tabletop CBCT system using a Gammex multi\u2010energy CT phantom and an anthropomorphic chest phantom, are carried out to demonstrate the feasibility of CBCT spectral imaging with SMFFS and our proposed SDMD method.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Monte Carlo simulations show that focal spot deflections within a range of\u00a02 mm share quite similar scatter distributions overall. Numerical simulations demonstrate that SMFFS with SDMD method can achieve better material decomposition and CT number accuracy with fewer artifacts. In physics experiments, for the Gammex phantom, the average error of the mean values () in selected regions of interest (ROIs) of virtual monochromatic image (VMI) at 70 keV is 8 HU in SMFFS cone\u2010beam (CB) scan, and 19 and 210 HU in sequential 80\/120 kVp (dual kVp, DKV) CB scan with and without scatter correction, respectively. For the chest phantom, the in selected ROIs of VMIs is 12 HU for SMFFS CB scan, and 15 and 438 HU for sequential 80\/140 kVp CB scan with and without scatter correction, respectively. Also, the non\u2010uniformity among selected regions of the chest phantom is 14 HU for SMFFS CB scan, and 59 and 184 HU for the DKV CB scan with and without a traditional scatter correction method, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We propose a SDMD method for CBCT with SMFFS. Our preliminary results show that SMFFS can enable spectral imaging with simultaneous scatter correction for CBCT and effectively improve its quantitative imaging\u00a0performance.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mp.17022","type":"journal-article","created":{"date-parts":[[2024,3,13]],"date-time":"2024-03-13T14:25:30Z","timestamp":1710339930000},"page":"2398-2412","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Multi\u2010energy blended CBCT spectral imaging and scatter\u2010decoupled material decomposition using a spectral modulator with flying focal spot (SMFFS)"],"prefix":"10.1002","volume":"51","author":[{"given":"Yifan","family":"Deng","sequence":"first","affiliation":[{"name":"Department of Engineering Physics Tsinghua University Beijing China"},{"name":"Ministry of Education Key Laboratory of Particle &amp; Radiation Imaging, Tsinghua University Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Engineering Physics Tsinghua University Beijing China"},{"name":"Ministry of Education Key Laboratory of Particle &amp; Radiation Imaging, Tsinghua University Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhilei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Engineering Physics Tsinghua University Beijing China"},{"name":"Ministry of Education Key Laboratory of Particle &amp; Radiation Imaging, Tsinghua University Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam S.","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Radiology Stanford University Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hewei","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Engineering Physics Tsinghua University Beijing China"},{"name":"Ministry of Education Key Laboratory of Particle &amp; Radiation Imaging, Tsinghua University Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,3,13]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejmp.2019.02.014"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejmp.2021.07.007"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10215135"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.14157"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.212579"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.4962929"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1088\/1361-6560\/ab5c35"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.14211"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.15240"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1109\/TMI.2021.3095419"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.adro.2019.07.013"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/RLI.0000000000000257"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1109\/TMI.2018.2796858"},{"key":"e_1_2_8_15_1","article-title":"Physical modeling and performance of spatial\u2010spectral filters for CT material decomposition","volume":"10948","author":"Tivnan M","year":"2019","journal-title":"Proc SPIE Int Soc Opt Eng"},{"key":"e_1_2_8_16_1","doi-asserted-by":"crossref","unstructured":"GaoH WuC WangS.Spectral modulator with flying focal spot: a new concept of full\u2010scale multi\u2010energy cone\u2010beam CT and simultaneous scatter correction. 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