Image quality evaluation of a new high-performance ring-gantry cone-beam computed tomography imager

Objective. Newer cone-beam computed tomography (CBCT) imaging systems offer reconstruction algorithms including metal artifact reduction (MAR) and extended field-of-view (eFoV) techniques to improve image quality. In this study a new CBCT imager, the new Varian HyperSight CBCT, is compared to fan-beam CT and two CBCT imagers installed in a ring-gantry and C-arm linear accelerator, respectively. Approach. The image quality was assessed for HyperSight CBCT which uses new hardware, including a large-size flat panel detector, and improved image reconstruction algorithms. The decrease of metal artifacts was quantified (structural similarity index measure (SSIM) and root-mean-squared error (RMSE)) when applying MAR reconstruction and iterative reconstruction for a dental and spine region using a head-and-neck phantom. The geometry and CT number accuracy of the eFoV reconstruction was evaluated outside the standard field-of-view (sFoV) on a large 3D-printed chest phantom. Phantom size dependency of CT numbers was evaluated on three cylindrical phantoms of increasing diameter. Signal-to-noise and contrast-to-noise were quantified on an abdominal phantom. Main results. In phantoms with streak artifacts, MAR showed comparable results for HyperSight CBCT and CT, with MAR increasing the SSIM (0.97-0.99) and decreasing the RMSE (62-55 HU) compared to iterative reconstruction without MAR. In addition, HyperSight CBCT showed better geometrical accuracy in the eFoV than CT (Jaccard Conformity Index increase of 0.02-0.03). However, the CT number accuracy outside the sFoV was lower than for CT. The maximum CT number variation between different phantom sizes was lower for the HyperSight CBCT imager (∼100 HU) compared to the two other CBCT imagers (∼200 HU), but not fully comparable to CT (∼50 HU). Significance. This study demonstrated the imaging performance of the new HyperSight CBCT imager and the potential of applying this CBCT system in more advanced scenarios by comparing the quality against fan-beam CT.