Bowtie filtration for dedicated cone beam CT of the head and neck: a simulation study.

Objective: To investigate the influence of bowtie filtration on dedicated cone beam CT (CBCT) of the head and neck. Methods: A validated hybrid simulation technique was used to model a commercial CBCT system with offset scanning geometry, 90kV tube potential and 145x75mm imaging field of view. Three bowtie filters were formulated to produce uniform flux intensity in the projection image of cylindrical objects of diameter 14, 16 and 18 cm. The influence of these simulated filters was compared with the original flat filtration in terms of the output radiation field, the dose delivered to the object, the scatter distribution in projections and the quality of the reconstructed image. Results: Compared against flat filtration, dose reduction for the bowtie case, examined as a function of radial distance within a 16-cm-diameter water cylinder, varied from 8.7% at the centre to 53.8% at the periphery. Scatter reduction, quantified using scatter-to-primary ratio in projection images, was up to 37.6% for a 14-cm-diameter cylindrical contrast phantom. Using the supplied routine image reconstruction, bowtie filtration resulted in comparable noise appearance, contrast resolution and artefact pattern for computational anatomical phantoms, with <5% difference in contrast-to-noise ratio. Conclusion: Bowtie filtration can effectively reduce the dose and scatter in CBCT of the head and neck. For better image quality, corresponding modification to the image pre-processing and reconstruction is needed. Advances in knowledge: The hybrid simulation approach can usefully explore the impact of proposed system component and design changes. [ABSTRACT FROM AUTHOR]