Technical Note: Long-term stability of Hounsfield unit calibration for cone beam computed tomography

Purpose The goal of this study was to investigate the stability of a phantom-based Hounsfield unit (HU) calibration for cone beam CT (CBCT). Methods Three consecutive scans of a large phantom configuration and a small phantom configuration were acquired and reconstructed with a uniform scatter correction method. The CBCT gray values of the phantom inserts were measured and the three values of each insert averaged. The linear calibration curve was determined and its slope and intercept were evaluated. This procedure was performed for three CBCT scanners (Elekta Synergy) over a period of 10 months with 1, 2, or 4 weeks between measurements. A dosimetric estimation of the HU fluctuations was carried out. Results The CBCT HUs were stable over time with only small variations in slope and intercept resulting in HU differences on the water level, that is, intercepts, of less than 7 HU (standard deviation). Therefore, the dosimetric influence of these HU differences was limited. The inter-scanner disparities (up to similar to 16 HU) were larger than the intra-scanner ones (up to similar to 7 HU). Conclusions Stable HUs were observed over a period of 10 months. Due to the differences between the CBCT scanners, scanner-specific calibration curves are necessary. (c) 2020 American Association of Physicists in Medicine