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Session: Radiography and Fluoroscopy [Return to Session]

Image Quality Preservation with Substantial Dose Reduction for Adults and Pediatric Patients Using New C-Arm CBCT Protocols

S Brady*, N Hilvert, J Racadio, Cincinnati Childrens Hospital Med Ctr, Mason, OH


TU-D1000-IePD-F9-4 (Tuesday, 7/12/2022) 10:00 AM - 10:30 AM [Eastern Time (GMT-4)]

Exhibit Hall | Forum 9

Purpose: C-arm cone beam CT (CBCT) acquisitions are performed for thoracoscopic resection in 3D. Image quality (IQ) and radiation dose differences were investigated for a recently released, lower-dose CBCT protocol specifically developed for the thorax.

Methods: 13 patients underwent an IRB-approved study using XperCT CBCT (Philips Healthcare) for thoracoscopic resection. 9 patients were imaged using the standard-of-care protocol: abdominal XperCT Roll 8 sec. 4 patients were imaged using a dedicated Lung XperCT Roll 8 sec 100% protocol. Dose reduction was measured using MOSFETs and a 5-year-old and adult anthropomorphic phantom (CIRS). Lung XperCT had 4 user options: 100% (i.e., no reduction), 25%, 50%, and 75% mA reduction; dose reduction was relative to the abdominal XperCT protocol.

Results: Maximum mA was 44% lower for Lung XperCT (51±6 mA) compared to abdomen XperCT (90±53 mA). The 5-year-old phantom’s abdomen XperCT protocol was 0.98 mSv, compared to Lung XperCT’s: 0.4, 0.31, 0.31, and 0.29 mSv for 100%, 25%, 50%, and 75% reduction, respectively. The adult phantom abdomen XperCT protocol was 1.01 mSv, compared to Lung XperCT’s: 0.71, 0.66, 0.65, and 0.62 mSv for 100%, 25%, 50%, and 75% reduction, respectively. Qualitative review of IQ, by an interventional radiologist indicated sufficient IQ for nodule visualization and localization. Mean nodule size was 3.4±1 mm for the Lung XperCT protocol and 3.0±0.8 mm for the Abdomen XperCT protocol. Quantitative IQ analysis demonstrated similar quantum noise between the abdominal XperCT protocol (37±7 HU) compared to the Lung XperCT (31±3 HU); IQ analysis was age-matched: (9±8 yrs) and (9±7 HU) for abdomen XperCT and Lung XperCT, respectively.

Conclusion: The Lung XperCT 100% protocol demonstrated an average 20% and 60% dose reduction for adult and 5-year-old phantoms, respectively. Image quality was quantitatively and qualitatively determined to be sufficient for nodule visualization and localization for throacoscopic resection.


Fluoroscopy, Radiation Dosimetry, Image Compression


IM- Radiation Dose and Risk: General (Most Aspects)

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