Substantial Dose Reduction in Modern Multi-Slice Spiral Computed Tomography (MSCT)-Guided Craniofacial and Skull Base Surgery

Department of Radiology, Innsbruck Medical University, Austria.
RöFo - Fortschritte auf dem Gebiet der R (Impact Factor: 1.4). 02/2012; 184(2):136-42. DOI: 10.1055/s-0031-1281971
Source: PubMed


Reduction of the radiation exposure involved in image-guided craniofacial and skull base surgery is an important goal. The purpose was to evaluate the influence of low-dose protocols in modern multi-slice spiral computed tomography (MSCT) on target registration errors (TREs).
An anthropomorphic skull phantom with target markers at the craniofacial bone and the anterior skull base was scanned in Sensation Open (40-slice), LightSpeed VCT (64-slice) and Definition Flash (128-slice). Identical baseline protocols (BP) at 120  kV/100  mAs were compared to the following low-dose protocols (LD) in care dose/dose modulation: (LD-I) 100  kV/35ref. mAs, (LD-II) 80  kV/40 - 41ref. mAs, and (LD-III) 80  kV/15 - 17ref. mAs. CTDIvol and DLP were obtained. TREs using an optical navigation system were calculated for all scanners and protocols. Results were statistically analyzed in SPSS and compared for significant differences (p ≤ 0.05).
CTDIvol for the Sensation Open/LightSpeed VCT/Definition Flash showed: (BP) 22.24 /32.48 /14.32 mGy; (LD-I) 4.61 /3.52 /1.62 mGy; (LD-II) 3.15 /2.01 /0.87 mGy; and (LD-III) na/0.76 /0.76 mGy. Differences between the BfS (Bundesamt für Strahlenschutz) reference CTDIvol of 9 mGy and the lowest CTDIvol were approximately 3-fold for Sensation Open, and 12-fold for the LightSpeed VCT and Definition Flash. A total of 33 registrations and 297 TRE measurements were performed. In all MSCT scanners, the TREs did not significantly differ between the low-dose and the baseline protocols.
Low-dose protocols in modern MSCT provided substantial dose reductions without significant influence on TRE and should be strongly considered in image-guided surgery.

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