Abstract
Besides X-ray and fluoroscopy, a previously introduced X-ray scanner offers a 3D cone beam option (Multitom Rax, Siemens Healthcare). The aim of this study was to evaluate various scan parameters and post-processing steps to optimize image quality and radiation exposure for imaging of the parasinus region. Four human cadaver heads were examined with different tube voltages (90–121 kV), dose levels (DLs) (278–2180 nGy) and pre-filtration methods (none, Cu 0.2 mm, Cu 0.3 mm and Sn 0.4 mm). All images were reconstructed in 2 mm slice thickness with and without a metal artifact reduction algorithm in three different kernels. In total, 80 different scan protocols and 480 datasets were evaluated. Image quality was rated on a 5-point Likert scale. Radiation exposure (mean computed tomography volume index (CTDIvol) and effective dose) was calculated for each scan. The most dose-effective combination for the diagnosis of sinusitis was 121 kV/DL of 278/0.3 mm copper (CTDIvol 1.70 mGy, effective dose 77 µSv). Scan protocols with 121 kV/DL1090/0.3 mm copper were rated sufficient for preoperative sinus surgery planning (CTDIvol 4.66 mGy, effective dose 212 µSv). Therefore, sinusitis and preoperative sinus surgery planning can be performed in diagnostic image quality at low radiation dose levels with a multipurpose X-ray system.
Highlights
Sinusitis is a frequent disorder and one of the most common conditions treated by primary care physicians [1]
Sinusitis and preoperative sinus surgery planning can be performed in diagnostic image quality at low radiation dose levels with a multipurpose X-ray system
Reconstruction is based on a filtered back projection algorithm (Feldkamp, Davis, Kress) with additional correction methods to compensate for noncircular movement [19]
Summary
Sinusitis is a frequent disorder and one of the most common conditions treated by primary care physicians [1]. Each year in the United States, sinusitis affects one in seven adults, and is diagnosed in 31 million patients [2]. Multi-slice computed tomography (MSCT) is frequently used for imaging of the parasinus region [4,5]. It provides essential information for planning the surgical approach, image-guided navigation, and robotic surgery [6,7]. The computed tomography (CT) scan of the paranasal sinuses have superseded the conventional standard radiography as it offers more precise anatomic information to the surgeon on the complex anatomy of the sinus cavities and their drainage pathways, in
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