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Algebraic reconstruction methods, such as the algebraic reconstruction technique (ART) and the related simultaneous ART (SART), reconstruct a two-dimensional (2-D) or three-dimensional (3-D) object from its X-ray projections. The algebraic methods have, in certain scenarios, many advantages over the more popular Filtered Backprojection approaches and have also recently been shown to perform well for 3-D cone-beam reconstruction. However, so far the slow speed of these iterative methods have prohibited their routine use in clinical applications. Here, the authors address this shortcoming and investigate the utility of widely available 2-D texture mapping graphics hardware for the purpose of accelerating the 3-D algebraic reconstruction. They find that this hardware allows 3-D cone-beam reconstructions to be obtained at almost interactive speeds, with speed-ups of over 50 with respect to implementations that only use general-purpose CPUs. However the authors also find that the reconstruction quality is rather sensitive to the resolution of the framebuffer, and to address this critical issue they propose a scheme that extends the precision of a given framebuffer by 4 bits, using the color channels. With this extension, a 12-bit framebuffer delivers useful reconstructions for 0.5% tissue contrast, while an 8-bit framebuffer requires 4%. Since graphics hardware generates an entire image for each volume projection, it is most appropriately used with an algebraic reconstruction method that performs volume correction at that granularity as well, such as SART or SIRT. The authors chose SART for its faster convergence properties.