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

Abstract

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.

Virtual fracture clinic reduces patient X-ray volume for common wrist and ankle fractures

“…The average dose of an ankle or wrist X-ray is estimated to be 0.001–0.06 μSv [ 17 ]. Though low compared to other imaging modalities, this avoidable radiation dosage theoretically leads to an increased risk of cancer [ 18 ] and is often a source of concern for patients [ 19 ].…”

Weight-bearing CT Technology in Musculoskeletal Pathologies of the Lower Limbs: Techniques, Initial Applications, and Preliminary Combinations with Gait-Analysis Measurements at the Istituto Ortopedico Rizzoli

“…For these reasons, radiographic angles were shown to be not repeatable, resulting in unreliable clinical studies 53 known as "intrinsic imprecision." 54 Some modern medical imaging devices now allow CT scans in weight-bearing, 6,7 finally giving access to thorough 3D geometric measurements of the foot and ankle bones under load. Because this condition was accessible for decades only for planar radiograph images, 11,55 novel 3D measures of the overall foot bone architecture now need to be defined carefully and established in the biomechanical and clinical communities.…”

“…These devices can now provide 3D images in loading conditions (weight-bearing computed tomography [WBCT]). This fundamental new feature offers relatively low radiation, high spatial resolution, and convenient ergonomy, [5][6][7][8][9][10] and as such it may have a promising role in making more precise diagnoses and assessments in various applications in orthopaedics and musculoskeletal disorders. In particular, the foot, ankle, and knee, but also the hand, wrist, and elbow, can finally benefit from this equipment because weight-bearing situations are fundamental to comprehend the functional mechanisms of these anatomical structures.…”

Angular and linear measurements of adult flexible flatfoot via weight-bearing CT scans and 3D bone reconstruction tools

“…These modern CBCT devices can provide 3D scans in weight-bearing, which is particularly valuable for foot and ankle studies 20 – 24 . This new feature adds to the demonstrated relatively low radiation, high spatial resolution, and convenient ergonomy and post-processing 13 , 25 – 29 , making this technology fundamental nowadays in many clinical studies 6 , 7 , 10 , 12 – 16 , 20 – 23 , 26 – 28 , 30 . The load can be modulated from case to case, ranging from standard single- or double-leg up-right postures to other postural conditions with the leg under determined and controlled positions 13 .…”