Technical assessment of a prototype cone‐beam CT system for imaging of acute intracranial hemorrhage

Xu, Jennifer; Sisniega, Alejandro; Zbijewski, Wojciech; Dang, Hao; Stayman, J. Webster; Mow, Michael; Wang, Xiaohui; Foos, David H.; Koliatsos, V. E.; Aygün, Nafi; Siewerdsen, Jeffrey H.

doi:10.1118/1.4963220

Cited by 22 publications

(21 citation statements)

References 87 publications

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“…For the head protocols, a range of higher dose protocols was investigated that may be suitable to imaging of low‐contrast soft‐tissue or intracranial hemorrhage — denoted Custom Head 1, 2, and 3. The hypothesis for such higher‐dose protocols is that they would provide soft‐tissue visualization while maintaining a clinically acceptable dose level (~10–50 mGy, recognizing ~50 mGy as a typical dose level for diagnostic CT of the head), whereas the manufacturer‐specified head protocols (all < 5 mGy) may only be suitable to bone visualization. To accomplish this, the internal system settings were modified to increase the dose per frame by 10×, resulting in ~57–272 mAs range for scans of a 16 cm diameter acrylic cylinder.…”

Section: Methodsmentioning

confidence: 99%

“…In spine surgery, CBCT integrated with real‐time tracking is the basis for minimally invasive approaches with surgical navigation . In vascular surgery, CBCT can better depict soft‐tissue anatomy, abnormalities, and hemorrhage . In each of these areas, CBCT provides a basis for surgical planning, quality assurance (QA), and improved patient safety .…”

Section: Introductionmentioning

confidence: 99%

“…4,5 In vascular surgery, CBCT can better depict soft-tissue anatomy, abnormalities, and hemorrhage. 6 In each of these areas, CBCT provides a basis for surgical planning, quality assurance (QA), and improved patient safety. [7][8][9] Integration with three-dimensional (3D)-3D image registration (CBCT to preoperative CT or MRI), 10 3D-2D image registration (CBCT to radiographs), 11 and surgical robotics are active areas of translational development.…”

Section: Introductionmentioning

confidence: 99%

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A mobile isocentric C‐arm for intraoperative cone‐beam CT: Technical assessment of dose and 3D imaging performance

et al. 2020

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Purpose To characterize the radiation dose and three‐dimensional (3D) imaging performance of a recently developed mobile, isocentric C‐arm equipped with a flat‐panel detector (FPD) for intraoperative cone‐beam computed tomography (CBCT) (Cios Spin 3D, Siemens Healthineers) and to identify potential improvements in 3D imaging protocols for pertinent imaging tasks. Methods The C‐arm features a 30 × 30 cm2 FPD and isocentric gantry with computer‐controlled motorization of rotation (0–195°), angulation (±220°), and height (0–45 cm). Geometric calibration was assessed in terms of 9 degrees of freedom of the x‐ray source and detector in CBCT scans, and the reproducibility of geometric calibration was evaluated. Standard and custom scan protocols were evaluated, with variation in the number of projections (100–400) and mAs per view (0.05–1.65 mAs). Image reconstruction was based on 3D filtered backprojection using “smooth,” “normal,” and “sharp” reconstruction filters as well as a custom, two‐dimensional 2D isotropic filter. Imaging performance was evaluated in terms of uniformity, gray value correspondence with Hounsfield units (HU), contrast, noise (noise‐power spectrum, NPS), spatial resolution (modulation transfer function, MTF), and noise‐equivalent quanta (NEQ). Performance tradeoffs among protocols were visualized in anthropomorphic phantoms for various anatomical sites and imaging tasks. Results Geometric calibration showed a high degree of reproducibility despite ~19 mm gantry flex over a nominal semicircular orbit. The dose for a CBCT scan varied from ~0.8–4.7 mGy for head protocols to ~6–38 mGy for body protocols. The MTF was consistent with sub‐mm spatial resolution, with f10 (frequency at which MTF = 10%) equal to 0.64 mm−1, 1.0 mm−1, and 1.5 mm−1 for smooth, standard, and sharp filters respectively. Implementation of a custom 2D isotropic filter improved CNR ~ 50–60% for both head and body protocols and provided more isotropic resolution and noise characteristics. The NPS and NEQ quantified the 3D noise performance and provided a guide to protocol selection, confirmed in images of anthropomorphic phantoms. Alternative scan protocols were identified according to body site and task — for example, lower‐dose body protocols (<3 mGy) sufficient for visualization of bone structures. Conclusion The studies provided objective assessment of the dose and 3D imaging performance of a new C‐arm, offering an important basis for clinical deployment and a benchmark for quality assurance. Modifications to standard 3D imaging protocols were identified that may improve performance or reduce radiation dose for pertinent imaging tasks.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A mobile isocentric C‐arm for intraoperative cone‐beam CT: Technical assessment of dose and 3D imaging performance

et al. 2020

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“…We found that a computationally lightweight water‐precorrection (ECC) results in sufficiently accurate CT‐values for scatter correction in the subjects we analyzed and perform the beam hardening correction at a later stage as described above. The subsequent application of the correction algorithms results in a stepwise enhancement of the image quality and a volume with a significantly improved CT‐value accuracy can be reconstructed . We recognize that the water‐precorrection plays a significant role in our setup, so we describe it in more detail in Section 2.C and analyze its influence on the resulting scatter correction in Section 3.B.…”

Section: Methodsmentioning

confidence: 99%

“…The subsequent application of the correction algorithms results in a stepwise enhancement of the image quality and a volume with a significantly improved CT-value accuracy can be reconstructed. 1,19,20 We recognize that the water-precorrection plays a significant role in our setup, so we describe it in more detail in Section 2.C and analyze its influence on the resulting scatter correction in Section 3.B.…”

Section: A Artifact Correction Pipelinementioning

confidence: 99%

Effect of detruncation on the accuracy of Monte Carlo‐based scatter estimation in truncated CBCT

et al. 2018

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Our contribution is twofold: first we give a comprehensive comparison of various detruncation methods for the purpose of scatter estimation. We find that the choice of the detruncation method has a significant influence on the quality of MC-based scatter correction. Simple or no detruncation is often insufficient for artifact removal and results in inaccurate CT-values. On the contrary, prior-based detruncation can achieve a high CT-value accuracy and nearly artifact-free volumes from truncated CBCT data when combined with other state-of-the-art artifact corrections. Secondly, we show that prior-based detruncation is effective even with data from a different patient or phantom. The fact that data completion does not require data from the same patient dramatically increases the applicability and usability of this scatter estimation.

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Image quality and dose characteristics for an O‐arm intraoperative imaging system with model‐based image reconstruction

Uneri

Zhang

et al. 2018

Medical Physics

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A variety of improvements in FBP implementation (geometric calibration, truncation and saturation effects, and isotropic apodization) offer the potential for improved image quality and reduced radiation dose on the O-arm system. Further gains are possible with MBIR, including improved soft-tissue visualization, low-dose imaging protocols, and extension to methods that naturally incorporate prior information of patient anatomy and/or surgical instrumentation.

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Technical assessment of a prototype cone‐beam CT system for imaging of acute intracranial hemorrhage

Abstract: Technical assessment of the prototype demonstrates dose characteristics and imaging performance consistent with point-of-care detection and monitoring of head injury-most notably, conspicuous detection of ICH-and supports translation of the system to clinical studies.

Cited by 22 publications

References 87 publications

A mobile isocentric C‐arm for intraoperative cone‐beam CT: Technical assessment of dose and 3D imaging performance

A mobile isocentric C‐arm for intraoperative cone‐beam CT: Technical assessment of dose and 3D imaging performance

Effect of detruncation on the accuracy of Monte Carlo‐based scatter estimation in truncated CBCT

Image quality and dose characteristics for an O‐arm intraoperative imaging system with model‐based image reconstruction

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