Effective dose and image quality for intraoperative imaging with a cone-beam CT and a mobile multi-slice CT in spinal surgery: A phantom study |
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| Institution: | 1. Medical Physics Division, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Ospedale Regionale di Bellinzona e Valli, 6500 Bellinzona, Switzerland;2. Service of Neurosurgery, Neurocenter of Southern Switzerland, 6900 Lugano, Switzerland;3. Department of Radiology, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Ospedale Regionale di Lugano, 6900 Lugano, Switzerland;1. Department of Neurosurgery, Juntendo University, Tokyo, Japan;2. Shin-Yurigaoka General Hospital, Kawasaki, Japan;1. Department of neurosurgery, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing, 102218, China;2. Peking Union Medical College Hospital, Beijing, 100730, China;1. Department of Medical Physics, Greater Poland Cancer Centre, Poznań, Poland;2. Department of Technical Physics, Poznan University of Technology, Poznań, Poland;3. Medical Physics & Clinical Engineering, Nottingham University Hospitals NHS Trust, Nottingham, UK;4. School of Medicine, University of Nottingham, Nottingham, UK;5. Department of Electroradiology, Poznań University of Medical Sciences, Poznań, Poland |
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| Abstract: | PurposeTo compare the effective dose (ED) and image quality (IQ) of O-arm cone-beam CT (Medtronic, Minneapolis, MN, USA) and Airo multi-slice CT (Brainlab AG, Munich, Germany) for intraoperative-CT (i-CT) in spinal surgery.MethodsThe manufacturer-defined protocols available in the O-arm and Airo systems for three-dimensional lumbar spine imaging were compared.Organ dose was measured both with thermo-luminescent dosimeters and GafChromic films in the Alderson Radiation Therapy anthropomorphic phantom.A subjective analysis was performed by neurosurgeons to compare the clinical IQ of the anthropomorphic phantom images acquired with the different i-CT systems and imaging protocols.Image uniformity, noise, contrast-to-noise-ratio (CNR), and spatial resolution were additionally assessed with the Catphan 504 phantom.ResultsO-arm i-CT caused 56% larger ED than Airo due to the high definition (HD) imaging protocol.The noise was larger for O-arm images leading to a lower CNR than that measured for Airo. Moreover, scattering and beam hardening effects were observed in the O-arm images. Better spatial resolution was measured for the O-arm system (9 lp/cm) than for Airo (4 lp/cm).For all the investigated protocols, O-arm was found to be better for identifying anatomical features important for accurate pedicle screw positioning.ConclusionsAccording to phantom measurements, the HD protocol of O-arm offered better clinical IQ than Airo but larger ED. The larger noise of O-arm images did not compromise the clinical IQ while the superior spatial resolution of this system allowed a better visibility of anatomical features important for pedicle screw positioning in the lumbar region. |
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| Keywords: | CT effective dose Intraoperative imaging Image quality O-arm CBCT Airo MSCT |
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