Characteristics of kilovoltage x-ray beams used for cone-beam computed tomography in radiation therapy.

The purpose of this investigation is to characterize the beams produced by a kilovoltage (kV) imager integrated into a linear accelerator (Varian on-board imager integrated into the Trilogy accelerator) for acquiring high resolution volumetric cone-beam computed tomography (CBCT) images of the patient on the treatment table. The x-ray tube is capable of generating photon spectra with kVp values between 40 and 125 kV. The Monte Carlo simulations were used to study the characteristics of kV beams and the properties of imaged target scatters. The Monte Carlo results were benchmarked against measurements, and excellent agreements were obtained. We also studied the effect of including the electron impact ionization (EII), and the simulation showed that the characteristic radiation is increased significantly in the energy spectra when EII is included. Although only slight beam hardening is observed in the spectra of all photons after passing through the phantom target, there is a significant difference in the spectra and angular distributions between scattered and primary photons. The results also show that the photon fluence distributions are significantly altered by adding bow tie filters. The results indicate that a combination of large cone-beam field size and large imaged target significantly increases scatter-to-primary ratios for photons that reach the detector panel. For phantoms 10 cm, 20 cm and 30 cm thick of water placed at the isocentre, the scatter-to-primary ratios are 0.94, 3.0 and 7.6 respectively for an open 125 kVp CBCT beam. The Monte Carlo simulations show that the increase of the scatter is proportional to the increase of the imaged volume, and this also applies to scatter-to-primary ratios. This study shows both the magnitude and the characteristics of scattered x-rays. The knowledge obtained from this investigation may be useful in the future design of the image detector to improve the image quality.