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Research ArticleHead and Neck Imaging
Open Access

CT Radiation Dose for Computer-Assisted Endoscopic Sinus Surgery: Dose Survey and Determination of Dose-Reduction Limits

C.B. Nauer, A. Eichenberger, P. Dubach, J. Gralla and M. Caversaccio
American Journal of Neuroradiology March 2009, 30 (3) 617-622; DOI: https://doi.org/10.3174/ajnr.A1378
C.B. Nauer
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A. Eichenberger
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P. Dubach
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J. Gralla
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M. Caversaccio
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    Fig 1.

    A and B, A surface-rendered image reconstructed on an Advantage Windows workstation (GE Healthcare) from a CT dataset performed with a CTDIvol of 65 mGy (A) shows no discernible noise, whereas with a CTDIvol of 9.5 mGy (B), delineation of facial contours is impaired due to image noise which might, according to our initial hypothesis, render surface registration impossible.

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    Fig 2.

    Screenshot from the navigation system display shows the information the ENT surgeon has available during the intervention. A low-dose dataset (CTDIvol of 3.1 mGy) was used.

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    Fig 3.

    This screenshot from the planning software iPlan shows a CT dataset with coronal and sagittal reformations. The central screw head pit of the screw in the zygomatic bone is heavily magnified for positioning the marker circle used for the accuracy measurements.

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    Fig 4.

    Results of the dose survey. Doses used for CAS-CT (gray) and diagnostic sinus CT (black) in 15 CT scanners. O is our institution before the CAS-CT protocol was adapted.

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    Fig 5.

    Scatterplot of accuracy measurements in millimeters for screw-marked points depicted on the y-axis. CAS-CT dose used in mGy depicted on the logarithmic x-axis. Each column represents the accuracy in mm for 7 screw-marked points on 4 cadaveric heads for registration with CAS-CT at a given dose. The regression line shows no clinically significant slope for accuracy with exponential growth of the radiation dose in the dose interval tested. Note that slight irregularities of the regression line due to the limited resolution of the software used for statistical analysis were straightened by using Photoshop (Adobe Systems, San Jose, Calif), without altering the content of the graphic.

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    Fig 6.

    Sinus CT in an edge-enhanced (bone) algorithm performed with a CTDIvol of 65 mGy (A) and with a CTDIvol of 9.5 mGy (B). The sevenfold dose difference is not appreciated well, though image B is obviously noisier than A.

Tables

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  • Scanning parameters used in the experiments with phantom and cadaver heads

    CTDIvol (mGy)kVmAs
    65120210
    9.512030
    6.312020
    410020
    3.112010
    210010
    1.18010
    • Note:—CTDIvol indicates volumetric CT-dose index.

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American Journal of Neuroradiology: 30 (3)
American Journal of Neuroradiology
Vol. 30, Issue 3
March 2009
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Cite this article
C.B. Nauer, A. Eichenberger, P. Dubach, J. Gralla, M. Caversaccio
CT Radiation Dose for Computer-Assisted Endoscopic Sinus Surgery: Dose Survey and Determination of Dose-Reduction Limits
American Journal of Neuroradiology Mar 2009, 30 (3) 617-622; DOI: 10.3174/ajnr.A1378

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CT Radiation Dose for Computer-Assisted Endoscopic Sinus Surgery: Dose Survey and Determination of Dose-Reduction Limits
C.B. Nauer, A. Eichenberger, P. Dubach, J. Gralla, M. Caversaccio
American Journal of Neuroradiology Mar 2009, 30 (3) 617-622; DOI: 10.3174/ajnr.A1378
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