The results demonstrated a substantial reduction in beam hardening artifacts when iBHC was applied. As shown in Figure 2, the artifact profile across the phantom significantly improved, especially in configurations with thicker clay wrapping. For instance, in the 2 cm thick clay-wrapped configuration, the mean HU error for cortical bone decreased from 185.2 HU (without iBHC) to 17.2 HU (with iBHC) (Figure 3). Even in thinner wrapping conditions (e.g., 0.5 cm clay), the mean HU error was reduced from 69.2 HU (without iBHC) to 49.6 HU (with iBHC), demonstrating that iBHC is effective across various tissue densities.

Interestingly, dense tissues, such as cortical bone, benefited the most from iBHC, whereas water-equivalent tissues, such as liver, exhibited minimal change (10.6 HU (with iBHC) vs. 36.9 HU (without iBHC) in 2 cm clay wrapping condition). These findings indicate that iBHC is particularly beneficial in imaging dense body regions like the pelvis and abdomen so to acquire accurate HU values for radiotherapy treatment planning and eventually reduce radiation dose uncertainty.

Additionally, the standard deviation of HU measurements remained consistently low (<4 HU difference after applying iBHC), confirming that it did not introduce additional noise variability while reducing beam hardening artifacts (Figure 4).