Crescent artifacts in cone‐beam CT

Purpose: In image‐guided radiation therapy, cone‐beam CT has been adopted for three‐dimensional target localization in the treatment room. In many of these cone‐beam CT images, dark and light crescent artifacts can be seen. This study investigates potential causes of this artifact and a technique for mitigating the crescents.Methods: Three deviations from an ideal geometry were simulated to assess their ability to cause crescent artifacts: Bowtie filter sag, x‐ray tube sag, and x‐ray tube rotation. The magnitudes of these deviations were estimated by matching shifts in simulated projections to those observed with clinical systems. To correct the artifacts, angle‐dependent blank projections were acquired and incorporated into image reconstruction. The degree of artifact reduction was evaluated with varying numbers (1–380) of blank projections. Scanner‐acquired phantom and patient studies were conducted to demonstrate the effectiveness of the proposed correction method.Results: All three investigated causes of the crescent artifact introduced similar mismodeling of the acquired projections and similar crescent artifacts. The deviations required for these artifacts were in the range of 0.5–5 mm or 0.1°. RMS error is reduced from 8.91 × 10 − 4to 5.25 × 10 − 7for 1–380 blank projections over a 200° scan angle. In the patient and phantom studies, reconstructions that utilized 380 blank projections largely mitigated the crescent artifacts.Conclusions: Small deviations from an ideal geometry can result in crescent artifacts due to steep gradients in the bowtie filter. Angle‐dependent blank projections can largely alleviate the artifacts.