Time-resolved dynamic CBCT reconstruction using prior-model-free spatiotemporal Gaussian representation (PMF-STGR).

Time-resolved CBCT imaging, which reconstructs a dynamic sequence of CBCTs reflecting intra-scan motion (one CBCT per x-ray projection without phase sorting or binning), is highly desired for regular and irregular motion characterization, patient setup, and motion-adapted radiotherapy. Representing patient anatomy and associated motion fields as 3D Gaussians, we developed a Gaussian representation-based framework (PMF-STGR) for fast and accurate dynamic CBCT reconstruction. PMF-STGR comprises three major components: a dense set of 3D Gaussians to reconstruct a reference-frame CBCT for the dynamic sequence; another 3D Gaussian set to capture three-level, coarse-to-fine motion-basis-components (MBCs) to model the intra-scan motion; and a CNN-based motion encoder to solve projection-specific temporal coefficients for the MBCs. Scaled by the temporal coefficients, the learned MBCs will combine into deformation vector fields to deform the reference CBCT into projection-specific, time-resolved CBCTs to capture the dynamic motion. Due to the strong representation power of 3D Gaussians, PMF-STGR can reconstruct dynamic CBCTs in a 'one-shot' training fashion from a standard 3D CBCT scan, without using any prior anatomical or motion model. We evaluated PMF-STGR using XCAT phantom simulations and real patient scans. Metrics including the image relative error, structural-similarity-index-measure, tumor center-of-mass-error, and landmark localization error were used to evaluate the accuracy of solved dynamic CBCTs and motion. PMF-STGR shows clear advantages over a state-of-the-art, INR-based approach, PMF-STINR. Compared with PMF-STINR, PMF-STGR reduces reconstruction time by 50% while reconstructing less blurred images with better motion accuracy. With improved efficiency and accuracy, PMF-STGR enhances the applicability of dynamic CBCT imaging for potential clinical translation.