Artikel
Intraoperative computed tomography (iCT) produces a multiple of the radiation exposure compared to a fluoroscopy-based 3D scan
Die intraoperative Computertomographie (iCT) verursacht ein Vielfaches der Strahlenbelastung im Vergleich zum Fluoroskopie-basierten 3D-Scan
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Autoren
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Jan-Helge Klingler
- Medical Center, University of Freiburg, Department of Neurosurgery, Freiburg, Deutschland
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Peter C. Reinacher
- Department of Stereotactic and Functional Neurosurgery, Department of Stereotactic and Functional Neurosurgery, Freiburg, Deutschland; Fraunhofer Institute for Laser Technology ILT, Aachen, Deutschland
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Herbert Hoedlmoser
- Helmholtz Zentrum München, German Research Center for Environmental Health, Individual Monitoring Service, München, Deutschland
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Yashar Naseri
- Medical Center, University of Freiburg, Department of Neurosurgery, Freiburg, Deutschland; Kantonsspital St. Gallen, Klinik für Neurochirurgie, St. Gallen, Schweiz
| Veröffentlicht: | 4. Juni 2021 |
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Gliederung
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Objective: Intraoperative 3D image data acquisition is being increasingly used, in particular for spinal 3D navigation. The personnel usually leave the operating room during 3D image data acquisition, but the patient is exposed to the associated radiation. This experimental dosemetric study compares the patient’s radiation exposure by intraoperative computed tomography (iCT) and 3D C-arms when generating spinal 3D image data sets.
Methods: This experimental study investigates the radiation exposure during spinal 3D imaging by an iCT (BodyTom®, NeuroLogica, Samsung) on an anthropomorphic Alderson phantom. Five 3D image data sets each of the cervical and lumbar spine were obtained. The average radiation dose was determined at defined locations using eye lens and film dosemeters (eye lens, thyroid gland, female and male gonads). In a second step, these data were descriptively compared with previously identically conducted and published examinations using a state-of-the-art 3D C-arm (Ziehm Vision RFD 3D, Ziehm Imaging).
Results: At all dosemeter locations, higher radiation exposures were measured using the iCT compared to our previously reported 3D C-arm data (Figure 1 [Fig. 1]). A cervical 3D scan caused a radiation dose of 12,155 vs. 287 µSv at the eye lens and 29,338 vs. 2173 µSv at the thyroid gland (iCT vs. 3D C-arm). A lumbar 3D scan caused a radiation dose of 30,677 vs. 6196 µSv at the female gonad and 396 vs. 67 µSv at the male gonad (iCT vs. 3D C-arm). Up to 13.5-fold higher radiation doses were measured using iCT compared to a fluoroscopy-based 3D scan using a 3D C-arm (at the thyroid gland during cervical 3D scans).
Conclusion: The radiation exposure of the patient during the acquisition of an intraoperative 3D image data set of the spine can be multiple times higher when using iCT compared to a fluoroscopy-based 3D scan. When using intraoperative imaging, this fact should be taken into account and weighed up together with other characteristics of the respective imaging device such as image quality, handling and costs.
