# A Novel Approach for Position Verification and Dose Calculation through Local MVCT Reconstruction

## TL;DR

A new method for verifying patient positioning in radiotherapy using MVCT reconstruction and EPID images improves accuracy and dose calculation.

## Contribution

Introduces a novel positioning verification method using local MVCT reconstruction and EPID images for precise radiotherapy setup.

## Key findings

- Reconstructed MVCT images meet registration requirements for positioning verification.
- Registration algorithm accurately detects positioning errors for treatment adjustments.
- Dose from the process is included in total dose calculations, improving accuracy.

## Abstract

Traditional positioning verification using cone-beam computed tomography (CBCT) may incur errors due to potential misalignments between the isocenter of CBCT and the treatment beams in radiotherapy. This study introduces an innovative method for verifying patient positioning in radiotherapy. Initially, the transmission images from an electronic portal imaging device (EPID) are acquired from 10 distinct angles. Utilizing the ART-TV algorithm, a sparse reconstruction of local megavoltage computed tomography (MVCT) is performed. Subsequently, this MVCT is aligned with the planning CT via a three-dimensional mutual information registration technique, pinpointing any patient-positioning discrepancies and facilitating corrective adjustments to the treatment setup. Notably, this approach employs the same radiation source as used in treatment to obtain three-dimensional images, thereby circumventing errors stemming from misalignment between the isocenter of CBCT and the accelerator. The registration process requires only 10 EPID images, and the dose absorbed during this process is included in the total dose calculation. The results show that our method’s reconstructed MVCT images fulfill the requirements for registration, and the registration algorithm accurately detects positioning errors, thus allowing for adjustments in the patient’s treatment position and precise calculation of the absorbed dose.