title: Limited Evaluation of Image Quality Produced by a Portable Head CT Scanner (CereTom) in a Neurosurgery Centre.
abstract: BACKGROUND
  Computed tomography (CT) is the preferred diagnostic toolkit for head and brain imaging of head injury. A recent development is the invention of a portable CT scanner that can be beneficial from a clinical point of view.
  
  
  OBJECTIVE
  To compare the quality of CT brain images produced by a fixed CT scanner and a portable CT scanner (CereTom).
  
  
  METHODS
  This work was a single-centre retrospective study of CT brain images from 112 neurosurgical patients. Hounsfield units (HUs) of the images from CereTom were measured for air, water and bone. Three assessors independently evaluated the images from the fixed CT scanner and CereTom. Streak artefacts, visualisation of lesions and grey-white matter differentiation were evaluated at three different levels (centrum semiovale, basal ganglia and middle cerebellar peduncles). Each evaluation was scored 1 (poor), 2 (average) or 3 (good) and summed up to form an ordinal reading of 3 to 9.
  
  
  RESULTS
  HUs for air, water and bone from CereTom were within the recommended value by the American College of Radiology (ACR). Streak artefact evaluation scores for the fixed CT scanner was 8.54 versus 7.46 (Z =-5.67) for CereTom at the centrum semiovale, 8.38 (SD = 1.12) versus 7.32 (SD = 1.63) at the basal ganglia and 8.21 (SD = 1.30) versus 6.97 (SD = 2.77) at the middle cerebellar peduncles. Grey-white matter differentiation showed scores of 8.27 (SD = 1.04) versus 7.21 (SD = 1.41) at the centrum semiovale, 8.26 (SD = 1.07) versus 7.00 (SD = 1.47) at the basal ganglia and 8.38 (SD = 1.11) versus 6.74 (SD = 1.55) at the middle cerebellar peduncles. Visualisation of lesions showed scores of 8.86 versus 8.21 (Z =-4.24) at the centrum semiovale, 8.93 versus 8.18 (Z =-5.32) at the basal ganglia and 8.79 versus 8.06 (Z =-4.93) at the middle cerebellar peduncles. All results were significant withP-value < 0.01.
  
  
  CONCLUSIONS
  Results of the study showed a significant difference in image quality produced by the fixed CT scanner and CereTom, with the latter being more inferior than the former. However, HUs of the images produced by CereTom do fulfil the recommendation of the ACR.
authors.affiliation: Department of Neurosurgery, Hospital Sultanah Aminah, Jalan Persiaran Sultan Abu Bakar, 80100 Johor Bahru, Johor, Malaysia; Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Jalan Sultanah Zainab 2, 16150 Kubang Kerian, Kelantan, Malaysia; Center for Neuroscience Services and Research, Universiti Sains Malaysia, Jalan Hospital USM, 16150 Kubang Kerian, Kelantan, Malaysia.
authors.forename: Ariz Chong
authors.initials: AC
authors.lastname: Abdullah
authors.affiliation: Department of Neurosurgery, Hospital Sultanah Aminah, Jalan Persiaran Sultan Abu Bakar, 80100 Johor Bahru, Johor, Malaysia.
authors.forename: Johari Siregar
authors.initials: JS
authors.lastname: Adnan
authors.affiliation: Department of Neurosurgery, Hospital Sultanah Aminah, Jalan Persiaran Sultan Abu Bakar, 80100 Johor Bahru, Johor, Malaysia.
authors.forename: Noor Azman A
authors.initials: NA
authors.lastname: Rahman
authors.affiliation: Department of Neurosurgery, Hospital Sultanah Aminah, Jalan Persiaran Sultan Abu Bakar, 80100 Johor Bahru, Johor, Malaysia.
authors.forename: Ravikant
authors.initials: R
authors.lastname: Palur
keywords: CT; CereTom; Hounsfield unit; image quality; portable