Ultra-low-dose cone-beam CT compared to standard dose in the assessment for acute fractures

Murphy, Mark C.; Gibney, Brian; Walsh, John P.; Orpen, G.; Kenny, Emer; Bolster, Ferdia; MacMahon, Peter

doi:10.1007/s00256-021-03825-5

Cited by 2 publications

(1 citation statement)

References 22 publications

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“…A recently published study on phantoms and cadavers showed adequate value of tin-filtered ULD-CT compared to conventional CT regarding osseous anatomy and pathologies of the pelvis. 25 Other groups described the diagnostic performance of ULD-CT in the field of fracture detection with mixed results: Murphy et al 26 compared the diagnostic performance of ULD-CT with that of conventional radiography and that of conventional CT in the field of the peripheral extremities (wrist/hand and ankle/foot) at n = 64 patients with 34 fractures. Radiation exposure was reduced by the factor seven in ULD-CT compared to conventional CT, thereby it showed lower sensitivity and specificity compared to conventional CT and higher sensitivity and specificity compared to conventional radiography.…”

Section: Discussionmentioning

confidence: 99%

Ultra-low-dose CT is feasible for torsion measurement of the lower limb in patients with metal implants

Keller

Grünwald

Springer

2023

BJR

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Objectives: Patients that need torsion measurement of the lower limb often have metal implants hindering e.g. MRI. A new ultra-low dose (ULD-)CT protocol might be feasible for torsion measurement at cost of relatively low radiation exposure. Methods: We retrospectively included all patients with clinically indicated torsion measurement in the period July 2019 to June 2021 and metal implants in the scanning field. The ULD-CT protocol comprised automated tube current time product and automated tube voltage with reference settings of 100kV/20mAs (hip), 80kV/20mAs (knee) and 80kV/10mAs (ankle). Femoral neck anteversion, tibial, intraarticular knee and overall leg torsion measurements were performed by two radiologists independently. Diagnostic confidence regarding the delineation of the relevant cortical bone was rated on a 5-point Likert scale (1 = non-diagnostic, 5 = excellent). Results: 102 consecutive patients could be included (BMI 27.38 ± 5.85) with 154 metal implants. Median total dose length product of the ULD-CT-torsion measurement was 16.5mGycm [11-39]. Both readers showed high agreement with a maximum torsional difference of 4.1°. Diagnostic confidence was rated best (5/5) in 92.2% (reader 1) and 93.1% (reader 2) with a worst rating of 3/5. Conclusion: The new ULD-CT protocol is feasible for torsion measurement of the lower limb – even in patients with metal implants. Advances in knowledge: Metal implants are not an obstacle for ULD-CT torsion measurements of the lower limb.

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Section: Discussionmentioning

confidence: 99%

Ultra-low-dose CT is feasible for torsion measurement of the lower limb in patients with metal implants

Keller

Grünwald

Springer

2023

BJR

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Influence of exposure protocol, voxel size, and artifact removal algorithm on the trueness of segmentation utilizing an artificial‐intelligence‐based system

Alrashed,

Dutra,

Chu

et al. 2024

Journal of Prosthodontics

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PurposeTo evaluate the effects of exposure protocol, voxel sizes, and artifact removal algorithms on the trueness of segmentation in various mandible regions using an artificial intelligence (AI)‐based system.Materials and methodsEleven dry human mandibles were scanned using a cone beam computed tomography (CBCT) scanner under differing exposure protocols (standard and ultra‐low), voxel sizes (0.15 mm, 0.3 mm, and 0.45 mm), and with or without artifact removal algorithm. The resulting datasets were segmented using an AI‐based system, exported as 3D models, and compared to reference files derived from a white‐light laboratory scanner. Deviation measurement was performed using a computer‐aided design (CAD) program and recorded as root mean square (RMS). The RMS values were used as a representation of the trueness of the AI‐segmented 3D models. A 4‐way ANOVA was used to assess the impact of voxel size, exposure protocol, artifact removal algorithm, and location on RMS values (α = 0.05).ResultsSignificant effects were found with voxel size (p < 0.001) and location (p < 0.001), but not with exposure protocol (p = 0.259) or artifact removal algorithm (p = 0.752). Standard exposure groups had significantly lower RMS values than the ultra‐low exposure groups in the mandible body with 0.3 mm (p = 0.014) or 0.45 mm (p < 0.001) voxel sizes, the symphysis with a 0.45 mm voxel size (p = 0.011), and the whole mandible with a 0.45 mm voxel size (p = 0.001). Exposure protocol did not affect RMS values at teeth and alveolar bone (p = 0.544), mandible angles (p = 0.380), condyles (p = 0.114), and coronoids (p = 0.806) locations.ConclusionThis study informs optimal exposure protocol and voxel size choices in CBCT imaging for true AI‐based automatic segmentation with minimal radiation. The artifact removal algorithm did not influence the trueness of AI segmentation. When using an ultra‐low exposure protocol to minimize patient radiation exposure in AI segmentations, a voxel size of 0.15 mm is recommended, while a voxel size of 0.45 mm should be avoided.

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Ultra-low-dose cone-beam CT compared to standard dose in the assessment for acute fractures

Cited by 2 publications

References 22 publications

Ultra-low-dose CT is feasible for torsion measurement of the lower limb in patients with metal implants

Ultra-low-dose CT is feasible for torsion measurement of the lower limb in patients with metal implants

Influence of exposure protocol, voxel size, and artifact removal algorithm on the trueness of segmentation utilizing an artificial‐intelligence‐based system

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