Assessment of TrueBeam kV Cone-Beam CT Image Quality and the Clinical Impact of Calibration Drift

In the TB system, advanced iterative reconstruction algorithms significantly enhance SNR and CNR by effectively reducing image noise. Halcyon provides improved image quality compared to TB with standard reconstruction; however, it remains inferior to TB-iCBCT. HU deviations were more pronounced in head CBCT than in pelvis mode, although HU variation in the pelvis CBCT mode exhibited greater sensitivity regarding clinical impact.