Image quality and localization accuracy in C‐arm tomosynthesis‐guided head and neck surgery

Bachar, Gideon; Siewerdsen, J. H.; Daly, Michael J.; Jaffray, David A.; Irish, Jonathan C.

doi:10.1118/1.2799492

Cited by 63 publications

(42 citation statements)

References 70 publications

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“…Current practices in oncologic imaging of the skull base rely on MDCT and MR imaging for combined osseous and soft-tissue definitions. 83 Several preclinical reports have begun to explore the potential uses of CBCT during surgeries at the skull base, 7,84,85 suggesting high 3D localization accuracy and low target-registration error with effective doses in the range of 0.1-0.35 mSv. The xCAT intraoperative CBCT scanner (Xoran Technologies), a cousin of the MiniCat, has been evaluated in clinical scenarios at the skull base as well, with favorable preliminary results.…”

Section: Skull Basementioning

confidence: 99%

Conebeam CT of the Head and Neck, Part 2: Clinical Applications

Miracle¹,

Mukherji²

2009

AJNR Am J Neuroradiol

301

207

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SUMMARY: Conebeam x-ray CT (CBCT) is being increasingly used for point-of-service head and neck and dentomaxillofacial imaging. This technique provides relatively high isotropic spatial resolution of osseous structures with a reduced radiation dose compared with conventional CT scans. In this second installment in a 2-part review, the clinical applications in the dentomaxillofacial and head and neck regions will be explored, with particular emphasis on diagnostic imaging of the sinuses, temporal bone, and craniofacial structures. Several controversies surrounding the emergence of CBCT technology will also be addressed. C onebeam CT (CBCT) is an advancement in CT imagingthat has begun to emerge as a potentially low-dose crosssectional technique for visualizing bony structures in the head and neck. The physical principles, image quality parameters, and technical limitations relevant to CBCT imaging were discussed in Part 1 of this 2-part series. The second part presented here will highlight the evidence related to CBCT applications in head and neck as well as dentomaxillofacial imaging. Controversial aspects of this technology will also be addressed, including limitations in image quality and its often officebased operational model.CBCT was first adapted for potential clinical use in 1982 at the Mayo Clinic Biodynamics Research Laboratory. 1 Initial interest focused primarily on applications in angiography in which soft-tissue resolution could be sacrificed in favor of high temporal and spatial-resolving capabilities. Since that time, several CBCT systems have been developed for use both in the interventional suite and for general applications in CT angiography. 2,3 Exploration of CBCT technologies for use in radiation therapy guidance began in 1992, 4,5 followed by integration of the first CBCT imaging system into the gantry of a linear accelerator in 1999. 6 The first CBCT system became commercially available for dentomaxillofacial imaging in 2001 (NewTom QR DVT 9000; Quantitative Radiology, Verona, Italy). Comparatively low dosing requirements and a relatively compact design have also led to intense interest in surgical planning and intraoperative CBCT applications, particularly in the head and neck but also in spinal, thoracic, abdominal, and orthopedic procedures. [7][8][9][10][11] Diagnostic applications in CT mammography and head and neck imaging are also under evaluation. 12-14 The technical and clinical considerations pertaining to CBCT imaging in many of these applications have been the subjects of several recent reviews. [15][16][17][18][19] The recent review by Dörfler et al 16 of the neurointerventional applications of CBCT is of particular interest to the field of neuroradiology.The discussion below will focus on the diagnostic and treatment-planning applications of CBCT in dentomaxillofacial and head and neck imaging. Commercially available CBCT systems for dentomaxillofacial imaging include the CB MercuRay and CB Throne (Hitachi Medical, Kashiwi-shi, Chiba-ken, Japan), 3D Accuitomo products (J. Mor...

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Section: Skull Basementioning

confidence: 99%

Conebeam CT of the Head and Neck, Part 2: Clinical Applications

Miracle¹,

Mukherji²

2009

AJNR Am J Neuroradiol

301

207

View full text Add to dashboard Cite

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“…Tomosynthesis presents an approach similar to CBCT but reconstructs a 3-D volume from multiple projections acquired over a limited scanning angle or arc (e.g., 20 -90 ). The shorter arc reduces both the scan and reconstruction times (e.g., a factor of 9 times faster for a 20 tomosynthesis orbit compared to a 180 CBCT orbit 8 ). Similarly, radiation dose is reduced in proportion to the shorter arc length with a 9 times reduction in dose for a 20 tomosynthesis orbit compared to a 180…”

Section: Introductionmentioning

confidence: 99%

“…We recently described our preclinical experience with tomosynthesis, reporting both image quality and localization accuracy 8 and evaluating the trade-off in image quality associated with the extent of the acquisition arc, the number of projection views, and the total radiation dose in phantom and cadaver studies. Surgical localization performance was evaluated using cadaver heads.…”

Section: Introductionmentioning

confidence: 99%

Three‐dimensional tomosynthesis and cone‐beam computed tomography: An experimental study for fast, low‐dose intraoperative imaging technology for guidance of sinus and skull base surgery

et al. 2009

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“…Tomosynthesis is also being evaluated for use intraoperatively 72 or in emergency settings where standard CT imaging would be impractical or too time consuming.…”

Section: Ive Other Clinical Applicationsmentioning

confidence: 99%

Tomosynthesis imaging: At a translational crossroads

2009

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Tomosynthesis is a decades-old technique for section imaging that has seen a recent upsurge in interest due to its promise to provide three-dimensional information at lower dose and potentially lower cost than CT in certain clinical imaging situations. This renewed interest in tomosynthesis began in the late 1990s as a new generation of flat-panel detectors became available; these detectors were the one missing piece of the picture that had kept tomosynthesis from enjoying significant utilization earlier. In the past decade, tomosynthesis imaging has been investigated in a variety of clinical imaging situations, but the two most prominent have been in breast and chest imaging. Tomosynthesis has the potential to substantially change the way in which breast cancer and pulmonary nodules are detected and managed. Commercial tomosynthesis devices are now available or on the horizon. Many of the remaining research activities with tomosynthesis will be translational in nature and will involve physicist and clinician alike. This overview article provides a forwardlooking assessment of the translational questions facing tomosynthesis imaging and anticipates some of the likely research and clinical activities in the next five years. © 2009 American Association of Physicists in Medicine. ͓DOI: 10.1118/1.3120285͔ Key words: tomosynthesis, breast imaging, chest imaging, tomography I. OVERVIEWDigital tomosynthesis is a simple and relatively inexpensive method of producing section images using conventional digital x-ray equipment. It is a form of limited angle tomography that produces section, or "slice," images from a series of projection images acquired as the x-ray tube moves over a prescribed path. The total angular range of movement is often less than 40°. Because the projection images are not acquired over a full 360°rotation about the patient, the resolution in the z direction ͑i.e., in the depth direction perpendicular to the x-y plane of the projection images͒ is limited, and thus tomosynthesis does not produce the isotropic spatial resolution achievable with computed tomography ͑CT͒. However, the resolution of images in the x-y plane of the reconstructed slices is often superior to CT, and the ease of use in conjunction with conventional radiography makes tomosynthesis a potentially quite useful imaging modality.There has been a high degree of research interest in tomosynthesis imaging in the past decade, and at least two commercial products have recently been approved by the Food and Drug Administration ͑FDA͒ and released on the market. It is expected that other approved devices will soon follow. As such, tomosynthesis imaging is in a period of a high rate of change, with an increasing number of investigators and manufacturers nearing completion of projects involving both the physics and clinical aspects of the technique. If one were to compare the current state of tomosynthesis imaging to a metaphorical calendar year, the field is firmly in the middle of spring. It has moved beyond the "winter" of initial research ...

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Image quality and localization accuracy in C‐arm tomosynthesis‐guided head and neck surgery

Cited by 63 publications

References 70 publications

Conebeam CT of the Head and Neck, Part 2: Clinical Applications

Conebeam CT of the Head and Neck, Part 2: Clinical Applications

Three‐dimensional tomosynthesis and cone‐beam computed tomography: An experimental study for fast, low‐dose intraoperative imaging technology for guidance of sinus and skull base surgery

Tomosynthesis imaging: At a translational crossroads

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