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DOI: 10.1055/s-0040-1709544
Multifunctional X-Ray System for Cone Beam CT Imaging of the Wrist: Evaluation of Image Quality and Radiation Dose
Publication History
Publication Date:
25 March 2020 (online)
Introduction We aimed to assess image quality and radiation dose of a twin robotic X-ray system with cone beam computed tomography (CBCT) function in cadaveric wrist imaging.
Material and Methods Sixteen wrists from body donors were scanned with a dedicated low-dose (RLD) and standard-dose (RFD) protocol using the CBCT mode of a multipurpose X-ray system. For comparison, we conducted multidetector computed tomography (MDCT) imaging with a clinical scan protocol. Three radiologists assessed overall image quality, noise, and artifacts in bone and soft tissue on 5-point Likert scales. Volume CT dose indices (CTDIvol) were compared for radiation dose analysis.
Results Overall image quality of most studies was very good or excellent in MDCT (reader 1/2/3; 100/100/87.5%), RFD (100/100/93.7%), and RLD scans (100/93.7/87.5%). One reader rated image quality of RFD (p ≤ 0.050) and RLD scans (p ≤ 0.050) superior to MDCT; the other observers found no significant difference. In soft tissue, RFD (R1/R2/R3 p ≤ 0.030) and RLD (all p ≤ 0.001) presented more image noise and artifacts than MDCT. In bone, one reader observed more noise (p ≤ 0.001) and artifacts (p ≤ 0.020) for RLD than MDCT, whereas no difference was found between RFD and MDCT. Mean CTDIvol was ~ 3 times lower for RFD (5.2 ± 0.6 mGy; p ≤ 0.001) and more than 7 times lower for RLD (1.8 ± 0.2 mGy; p ≤ 0.001) than for clinical MDCT scans without automatic dose modulation (15.0 ± 0.0 mGy).
Conclusion Significant dose reduction is feasible using the multifunctional X-ray system’s three-dimensional CBCT mode compared with conventional MDCT while maintaining suitable image quality for clinical wrist imaging.