title: Image quality and effective dose of a robotic flat panel 3D C-arm vs computed tomography.
abstract: BACKGROUND
  The aim of this study was to determine the effective dose and corresponding image quality of different imaging protocols of a robotic 3D flat panel C-arm in comparison to computed tomography (CT).
  
  
  METHODS
  Dose measurements were performed using a Rando-Alderson Phantom. The phantom was exposed to different scanning protocols of the 3D C-arm and the CT. Pedicle screws were inserted in a fresh swine cadaver. Images were obtained using the same scanning protocols.
  
  
  RESULTS
  At the thoracolumbar junction, the effective dose was comparable for 3D high-dose protocols, with (4.4 mSv) and without (4.3 mSv) collimation and routine CT (5 mSv), as well as a dose-reduction CT (4.0 mSv). A relevant reduction was achieved with the 3D low-dose protocol (1.0 mSv). Focusing on Th6, a similar reduction with the 3D low-dose protocol was achieved. The image quality of the 3D protocols using titanium screws was rated as 'good' by all viewers, with excellent correlation.
  
  
  CONCLUSIONS
  Modern intra-operative 3D-C-arms produce images of CT-like quality with low-dose radiation. Copyright © 2015 John Wiley & Sons, Ltd.
authors.affiliation: Centre for Orthopaedic, Trauma and Spine Surgery, Donau-Ries Hospital, Donauwoerth, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Kraus
authors.affiliation: Hessing Foundation, Augsburg, Germany.
authors.forename: Eric
authors.initials: E
authors.lastname: Fischer
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, Ulm University, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Gebhard
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, Ulm University, Germany.
authors.forename: Peter H
authors.initials: PH
authors.lastname: Richter
mesh_terms: D000818:Animals; D002102:Cadaver; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D015588:Observer Variation; D065289:Pedicle Screws; D019047:Phantoms, Imaging; D011829:Radiation Dosage; D012371:Robotics; D013552:Swine; D013819:Thermoluminescent Dosimetry; D014025:Titanium / Q000737:chemistry; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D014025:Titanium
keywords: 3D C-arm; Rando-Alderson phantom; computed tomography; fluoroscopy; pedicle screw; radiation