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Advanced reliability of radiomic features in ex vivo hypersightTM-CBCT imaging by iCBCT-Acuros reconstruction

Background/Aim: High-quality cone-beam CT (CBCT) imaging, such as HyperSight™-CBCT on the ETHOS® O-ring linear accelerator, has significantly improved adaptive radiotherapy by providing high imaging precision. Advanced reconstruction techniques like the iCBCT-Acuros reconstruction mode have the pote...

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Main Authors: Siefert, Victor (Author) , Haag, Florian (Author) , Bicu, Alicia Simone (Author) , Schmidt, Ralf (Author) , Willam, Marvin (Author) , Eckl, Miriam (Author) , Stieler, Florian (Author) , Ehmann, Michael (Author) , Bürgy, Daniel (Author) , Fleckenstein, Jens (Author) , Schönberg, Stefan (Author) , Giordano, Frank Anton (Author) , Boda-Heggemann, Judit (Author) , Froelich, Matthias F. (Author) , Dreher, Constantin (Author)
Format: Article (Journal)
Language:English
Published: April 2026
In: Anticancer research
Year: 2026, Volume: 46, Issue: 4, Pages: 1785-1798
ISSN:1791-7530
DOI:10.21873/anticanres.18074
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.21873/anticanres.18074
Verlag, kostenfrei, Volltext: https://ar.iiarjournals.org/content/46/4/1785
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Author Notes:Victor Siefert, Florian Haag, Alicia S. Bicu, Ralf Schmidt, Marvin Willam, Miriam Eckl, Florian Stieler, Michael Ehmann, Daniel Buergy, Jens Fleckenstein, Stefan O. Schoenberg, Frank A. Giordano, Judit Boda-Heggemann, Matthias F. Froelich and Constantin Dreher
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Summary:Background/Aim: High-quality cone-beam CT (CBCT) imaging, such as HyperSight™-CBCT on the ETHOS® O-ring linear accelerator, has significantly improved adaptive radiotherapy by providing high imaging precision. Advanced reconstruction techniques like the iCBCT-Acuros reconstruction mode have the potential to enhance reliability of quantitative image evaluations, especially regarding interpretation of radiomic features. This study evaluated how the iCBCT-Acuros reconstruction mode improves reliability of radiomic features compared to standard iCBCT in HyperSight™-CBCT imaging. - Materials and Methods: An ex vivo phantom analysis of 16 fruits and vegetables was conducted with HyperSight™-CBCT using iCBCT and iCBCT-Acuros reconstruction modes. Test-retest reliability was assessed at 0° and 90° rotations, along with inter- and intrareader reliability, inter-reconstruction reproducibility, and interphantom discrimination. A total of 110 radiomic features were extracted with LIFEx software, and reliability was analyzed using concordance and intraclass correlation coefficients. Boruta Random Forest analysis evaluated interphantom discrimination. - Results: Mean test-retest reliability (CCC) was higher for iCBCT-Acuros (0.936±0.137) than iCBCT (0.816±0.199, p<0.0001). “Morphological” features showed the highest reliability for both modes. Interreader and intrareader reliability were significantly higher for iCBCT-Acuros (p<0.0001). Reproducibility was moderate overall (mean 0.832±0.224), with “Morphological” features being most reproducible. Interphantom separability was increased with iCBCT-Acuros. - Conclusion: The iCBCT-Acuros reconstruction mode of HyperSight™-CBCT significantly improves radiomic feature reliability compared to iCBCT. These advancements likely extend to other quantitative parameters, enhancing their potential as radiological biomarkers. The iCBCT-Acuros reconstruction enables a significantly more robust imaging analysis, facilitating the integration of advanced quantitative imaging techniques into high-precision radiotherapy.
Item Description:Gesehen am 20.04.2026
Physical Description:Online Resource
ISSN:1791-7530
DOI:10.21873/anticanres.18074

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