Effective radiation dose of a MSCT, two CBCT and one conventional radiography device in the ankle region

Koivisto, Juha; Kiljunen, Timo; Kadesjö, Nils; Shi, Xie‐Qi; Wolff, Jan

doi:10.1186/s13047-015-0067-8

Cited by 60 publications

(47 citation statements)

References 41 publications

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“…Wrist dose of 2.4 μSv and foot‐ankle dose of 6.0 μSv have also been reported for the Verity unit. These compare with 0.5 μSv hand‐wrist and 1.8 μSv single foot‐ankle doses found for the LineUP unit . These studies also acquired dosimetry of the same phantoms using MSCT protocols.…”

Section: Discussionsupporting

confidence: 59%

“…These studies also acquired dosimetry of the same phantoms using MSCT protocols. A 3.6‐fold reduction in comparable hand‐wrist and foot‐ankle effective dose for the CBCT unit was found in comparison with MDCT scanning . Foot‐ankle dose of 3.8 μSv has also been reported for a dedicated weight‐bearing foot‐ankle CBCT device …”

Section: Discussionmentioning

confidence: 77%

“…Based on the number of studies supporting this observation, the active marrow fractions used Koivisto and co‐authors appear to be high. The range of marrow fractions calculated for different age groups in this study encompass those used by Koivisto and co‐authors but occur in the 10–15 yr age range rather than at the adult end of the age spectrum …”

Section: Discussionmentioning

confidence: 99%

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Hand‐wrist, knee, and foot‐ankle dosimetry and image quality measurements of a novel extremity imaging unit providing CBCT and 2D imaging options

Ludlow

2018

Medical Physics

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CBCT effective doses calculated from anthropomorphic phantom exposures following manufacturer suggested protocols appear to be substantially less than previously reported doses for similar MDCT extremity examinations. In this study, effective dose from 2D radiographic imaging was approximately two orders of magnitude less than CBCT imaging. Doses were on the order of a few minutes to hours of ubiquitous per-capita background dose for 2D imaging and a few hours to days for 3D imaging. Dose significantly increased for children younger than age 10. Lite protocols resulted in substantial dose reductions and can be recommended for children and those examinations where reduced CNR will not affect diagnosis. Flexibility of 2D and 3D imaging options with low-dose protocols make this technology a promising option for radiographic evaluation of the extremities. Efficacy studies are needed to determine when MDCT, CBCT or Digital Radiography are best used for particular diagnostic tasks.

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Section: Discussionsupporting

confidence: 59%

Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 99%

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Hand‐wrist, knee, and foot‐ankle dosimetry and image quality measurements of a novel extremity imaging unit providing CBCT and 2D imaging options

Ludlow

2018

Medical Physics

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“…The CBCT device NewTom 5G offers several acquisition protocols as described in an earlier study . In the latter work, an effective dose of 14.3 μSv was measured using a high‐resolution scanning protocol with 12 cm × 8 cm field of view (FOV), whereas Mys and colleagues reported an effective dose of 1.6 μSv without bringing evidence for this value.…”

Section: Technical Specifications For a Customized Scan Of 6 CM On Hrmentioning

confidence: 99%

Clinical in Vivo Assessment of Bone Microarchitecture With CT Scanners: An Enduring Challenge

Tran

Vilayphiou

Koller

2019

Journal of Bone and Mineral Research

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The assessment of bone microarchitecture in vivo is of high interest in the understanding of bone metabolism. Many fields of bone research are interested in such characterization: diagnosis, treatment, and monitoring of osteoporosis, secondary osteoporosis, drug development, pediatrics, athletes, and more.The current gold standard to quantify trabecular and cortical bone microarchitecture in vivo is the high-resolution peripheral quantitative computed tomography (HR-pQCT). This technology only allows bone extremities scanning. Therefore, developing novel technologies to assess bone microarchitecture at other bone sites seems interesting. In a recent issue of JBMR, Mys and colleagues were comparing the accuracy of cone-beam computed tomography (CBCT) and HR-pQCT in regard to micro-CT for bone microarchitecture parameters. (1) They also determined the correlation of these parameters between CBCT and HR-pQCT.The original article described the technical specifications of HR-pQCT (namely XtremeCT, referred to incorrectly in the article as XtremeCT I, and Xtreme CT II) scanners, manufactured by SCANCO Medical AG (Bruttisellen, Switzerland) and CBCT (NewTom 5G, Cefla, Verona, Italy). They presented the protocol of image acquisition, reconstruction, segmentation, and analysis for all in vivo scanners in order to compare the ex vivo assessment of trabecular bone microarchitecture of 19 trapezia. The authors concluded that CBCT and its associated image processing and analysis method is able to quantify trabecular bone microstructure of trapezia.Considering the very high interest in the community in such technologies (~850 publications in the last 15 years for HR-pQCT), we propose a corrected comparison of the scanners' performances as described below. That would allow to better understand these different imaging systems and to properly evaluate the advances in this field.In the recent article by Mys and colleagues, the comparison between the specifications of the imaging modalities was unclear, as those systems allow various acquisition modes and acquisition protocols. Moreover, several figures in the article were simply inaccurate.The CBCT device NewTom 5G offers several acquisition protocols as described in an earlier study. (2) In the latter work, an effective dose of 14.3 μSv was measured using a high-resolution scanning protocol with 12 cm × 8 cm field of view (FOV), whereas Mys and colleagues reported an effective dose of 1.6 μSv without bringing evidence for this value. Also, this recent investigation was done on a smaller FOV of 6 cm × 6 cm, for which an extrapolation of the effective dose can be calculated: Assuming the distance between X-ray source and detector is constant and considering the scan length ratio, the extrapolated effective dose would be 10.7 μSv. Another group reported an effective dose of 10 μSv for a similar acquisition protocol with the same CBCT device. (3) HR-pQCT devices, namely XtremeCT and XtremeCT II, offer a standard single stack scan with a FOV of 12.6 cm × 0.9 cm and 14 cm × 1.0 cm, res...

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“…This value had been reported by Koivisto and colleagues in their dose measurements at the wrist. (3) The 14.3 μSv mentioned by Tran and colleagues is taken from another article by Koivisto and colleagues (4) and refers to the effective radiation dose at the ankle. In our draft manuscript, we referred to the 2015 Koivisto article.…”

Section: To the Editormentioning

confidence: 99%

Reply Letter to the Editor: Clinical in Vivo Assessment of Bone Microarchitecture With CT Scanners: An Enduring Challenge

Mys

Варга

Gueorguiev

et al. 2019

Journal of Bone and Mineral Research

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We thank Drs Tran, Vilayphiou, and Koller for their Letter to the Editor (1) commenting on our recent publication (2) in this journal. In their letter, they highlight the need for in vivo imaging of bone microarchitecture. We cannot agree more. As a matter of fact, this notion was at the basis of our work as there is a strong demand in clinical practice for bone microstructural imaging and subsequent quantitative analyses. We also fully agree with their conclusion that "…both HR-pQCT and CBCT are useful devices for bone microarchitectural research." Indeed, the devices possess different components affecting the field of view (FOV), the effective dose, and the ability to measure fine microarchitectural parameters.In our article, we made a comparative analysis on some of the technical specifications of the HR-pQCT (XtremeCT and Xtreme CT II) scanners, manufactured by Scanco Medical AG (Bruttisellen, Switzerland) and CBCT (NewTom 5G), manufactured by Cefla (Verona, Italy). According to Tran and colleagues, this comparison was at places unclear and "…several figures were simply inaccurate." First, we inform you that Tran and colleagues confirmed to us in separate writing that the latter statement does not relate to any of the figures in our article but to some of the numbers we used when comparing HR-pQCT and CBCT scanners; these issues will be discussed below.Tran and colleagues are right that the CBCT device allows for several acquisition protocols. In our article, we used a cubic 6 x 6 x 6 cm 3 field of view (FOV) when scanning trapezia. This protocol would have allowed us to scan an object of 6 cm in height and would have required 6 to 7 stacks when using the XtremeCT or XtremeCT II; this would have resulted in long scanning times of 20 and 12 minutes for the XtremeCT and XtremeCT II, respectively, as nicely illustrated in Table 1 of Tran and colleagues. (1) We mentioned an effective radiation dose at the wrist of 1.6 μSv when using CBCT. This value had been reported by Koivisto and colleagues in their dose measurements at the wrist. (3) The 14.3 μSv mentioned by Tran and colleagues is taken from another article by Koivisto and colleagues (4) and refers to the effective radiation dose at the ankle. In our draft manuscript, we referred to the 2015 Koivisto article. The 2018 Koivisto article had been suggested to us during the review process as a replacement for the 2015 Koivisto article; we apologize for not having adapted the reference accordingly. The difference in effective dose can be explained by the current modulation that has been built into the scanner to reduce the radiation dose. Note that the current (16 mA) mentioned by Tran and colleagues is an upper limit; in general, the actual current will be lower, though we did not do any dosage measurements to confirm the reported findings. We believe that the optimization of the dosage and the effects on image quality and morphometric analyses are interesting topics for future studies.In their letter, Tran and colleagues mentioned that we reported 60 μSv when u...

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Effective radiation dose of a MSCT, two CBCT and one conventional radiography device in the ankle region

Cited by 60 publications

References 41 publications

Hand‐wrist, knee, and foot‐ankle dosimetry and image quality measurements of a novel extremity imaging unit providing CBCT and 2D imaging options

Hand‐wrist, knee, and foot‐ankle dosimetry and image quality measurements of a novel extremity imaging unit providing CBCT and 2D imaging options

Clinical in Vivo Assessment of Bone Microarchitecture With CT Scanners: An Enduring Challenge

Reply Letter to the Editor: Clinical in Vivo Assessment of Bone Microarchitecture With CT Scanners: An Enduring Challenge

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