title: Ultra-high resolution C-Arm CT arthrography of the wrist: Radiation dose and image quality compared to conventional multidetector computed tomography.
abstract: OBJECTIVE
  Objective of this phantom and cadaveric study was to compare the effective radiation dose (ED) and image quality (IQ) between C-arm computed tomography (CACT) using an ultra-high resolution 1×1 binning with a standard 16-slice CT (MDCT) arthrography of the wrist.
  
  
  METHODS
  ED was determined with thermoluminescence dosimetry using an anthropomorphic phantom and different patient positions. Imaging was conducted in 10 human cadaveric wrists after tri-compartmental injection of diluted iodinated contrast material and a wire phantom. IQ of MDCT was compared with CACT reconstructed with a soft (CACT1) and sharp (CACT2) kernel. High and low contrast resolution was determined. Three radiologists assessed IQ of wrist structures and occurrence of image artifacts using a 5-point Likert scale.
  
  
  RESULTS
  ED of MDCT was comparable to standard CACT (4.3μSv/3.7μSv). High contrast resolution was best for CACT2, decreased to CACT1 and MDCT. Low contrast resolution increased between CACT2 and MDCT (P<0.001). IQ was best for CACT2 (1.3±0.5), decreased to CACT1 (1.9±0.6) and MDCT (3.5±0.6). Non-compromising artifacts were only reported for CACT.
  
  
  CONCLUSIONS
  The results of this phantom and cadaveric study indicate that ultra-high resolution C-Arm CT arthrography of the wrist bears the potential to outperform MDCT arthrography in terms of image quality and workflow at the cost of mildly increasing image artifacts while radiation dose to the patient is comparably low for both, MDCT and C-Arm CT.
authors.affiliation: Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany. Electronic address: Werncke.Thomas@mh-hannover.de.
authors.forename: Thomas
authors.initials: T
authors.lastname: Werncke
authors.affiliation: Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
authors.forename: Lena
authors.initials: L
authors.lastname: Sonnow
authors.affiliation: Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
authors.forename: Bernhard C
authors.initials: BC
authors.lastname: Meyer
authors.affiliation: University of Veterinary Medicine Hannover, Institute for General Radiology and Medical Physics, Bischofsholer Damm 15, 30173 Hannover, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Lüpke
authors.affiliation: Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
authors.forename: Jan
authors.initials: J
authors.lastname: Hinrichs
authors.affiliation: Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
authors.forename: Frank K
authors.initials: FK
authors.lastname: Wacker
authors.affiliation: Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: von Falck
mesh_terms: D001132:Arm / Q000000981:diagnostic imaging; D001175:Arthrography / Q000379:methods*; D016477:Artifacts; D002102:Cadaver; D003287:Contrast Media; D005260:Female; D006801:Humans; D008297:Male; D061330:Multidetector Computed Tomography / Q000379:methods; D056888:Patient Positioning; D019047:Phantoms, Imaging; D011829:Radiation Dosage; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods; D014955:Wrist Joint / Q000000981:diagnostic imaging*
chemical_list: D003287:Contrast Media
keywords: Arthrography; C-Arm CT; Spiral computed tomography; Thermoluminescent dosimetry; Wrist