MO-AB-BRA-09: Development and Evaluation of a Biomechanical Modeling-Assisted CBCT Reconstruction Technique (Bio-Recon)

Purpose: To develop a Bio-recon technique by incorporating the biomechanical properties of anatomical structures into the deformation-based CBCT reconstruction process. Methods: Bio-recon reconstructs the CBCT by deforming a prior high-quality CT/CBCT using a deformation-vector-field (DVF). The DVF is solved through two alternating steps: 2D–3D deformation and finite-element-analysis based biomechanical modeling. 2D–3D deformation optimizes the DVF through an 'intensity-driven' approach, which updates the DVF to minimize intensity mismatches between the acquired projections and the simulated projections from the deformed CBCT. In contrast, biomechanical modeling optimizes the DVF through a 'biomechanical-feature-driven' approach, which updates the DVF based on the biophysical properties of anatomical structures. In general, Biorecon extracts the 2D–3D deformation-optimized DVF at high-contrast structure boundaries, and uses it as the boundary condition to drive biomechanical modeling to optimize the overall DVF, especially at low-contrast regions. The optimized DVF is fed back into the 2D–3D deformation for further optimization, which forms an iterative loop. The efficacy of Bio-recon was evaluated on 11 lung patient cases, each with a prior CT and a new CT. Cone-beam projections were generated from the new CTs to reconstruct CBCTs, which were compared with the original new CTs for evaluation. 872 anatomical landmarks were also manually identified by a clinician on both the prior and new CTs to track the lung motion, which was used to evaluate the DVF accuracy. Results: Using 10 projections for reconstruction, the average (± s.d.) relative errors of reconstructed CBCTs by the clinical FDK technique, the 2D–3D deformation-only technique and Bio-recon were 46.5±5.9%, 12.0±2.3% and 10.4±1.3%, respectively. The average residual errors of DVF-tracked landmark motion by the 2D–3D deformation-only technique and Bio-recon were 5.6±4.3mm and 3.1±2.4mm, respectively. Conclusion: Bio-recon improved accuracy for both the reconstructed CBCT and the DVF. The accurate DVF can benefit multiple clinical practices, such as image-guided adaptive radiotherapy. We acknowledge funding support from the American Cancer Society (RSG-13-326-01-CCE), from the US National Institutes of Health (R01 EB020366), and from the Cancer Prevention and Research Institute of Texas (RP130109).