Cone-Beam CT Area Detector CT CBCT JNET journal of Neuroendovascular Therapy

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1 Cone-Beam CT Area Detector CT shimada.takashi@nihon-u.ac.jp CBCT JNET journal of Neuroendovascular Therapy

2 Cone-Beam CT Area Detector CT Cone-Beam CT(CBCT) CT CBCT CT Area Detector CT(ADCT) CBCT 16 CT dose index (CTDI) 5 5 CBCT 15 MIDDLE ADCT CT 200 CBCT 2011 (ICRP)

3 150m Sv 5 20m Sv 50m Sv ) ICRP Publication118 ) 0.5 Gy CT X (Flat panel detector FPD) Cone-Beam CT(CBCT) CT ) ) CT CBCT CT ) CBCT ) CT CBCT Interventional Radiology(IVR) CT CT dose index (CTDI) IVR CT CBCT

4 CT CBCT CBCT CBCT Flat panel detector(fpd) Infinix-8000V/N5, CT 320 Area Detector CT(ADCT) Aquilion one/vision edition, CT dose index(ctdi) Pro-CT dose M model (, ) Piranha(RTI Electronics, Molndal, Sweden) CT DOSE PROFILER(RTI Electronics, Molndal, Sweden) ) CBCT 3 FAST MIDDLE HIGH bit Table Field of view(fov)

5 12 Source Image receptor Distance(SID) 110cm mm CT ( 120 kv 250 ma AIDR3D weak) CTDI 16cm 15cm M ADCT CBCT CT CBCT ADCT CBCT MIDDLE 110 kv Automatic exposure control dose(aec DOSE) 77.4nC/ (Figure 1) +X X Y Y Y CBCT

6 CBCT 20 HIGH 15 MIDDLE 10 FAST 110 kv AEC DOSE 77.4nC/ 5 (Table 2) CBCT CBCT 15 MIDDLE 80 kv 110 kv 10 kv AEC DOSE 77.4nC/ (Table 3) CT CBCT (Table 4) MIDDLE CBCT 320 ADCT CTDI ADCT Y 72.85m Gy Y 56.41m Gy m Gy [ ]6.09 CBCT Y 94.41m Gy Gy Y

7 25.62 X X m Gy X 63.16m Gy m Gy R wilcoxon 2 CBCT (Table 5) CBCT MIDDLE CBCT Gy Gy Gy Gy Gy Gy CBCT (Table ) CBCT MIDDLE AEC DOSE 110 kv Gy Gy 80kv 10kv 100 kv 61.26m Gy 25.28m Gy 90kv 70.14m Gy 28.07m Gy 80kv 85.43m Gy

8 34.67m Gy ADCT CBCT ADCT CBCT ) ADCT X CBCT X FPD FPD (Figure 2) 360 CT (Table ) Y Y Y 6.09 Y X ) CBCT X X X 僅 Y Y Y Y MIDDLE CBCT ADCT

9 CBCT58.89 Gy ADCT64.60 Gy 1.1 CBCT24.33 Gy ADCT72.85 Gy 3.0 X CBCT CBCT (Table ) ) CT FAST CBCT 13.99m Gy ADCT 80.8 CBCT (Table ) 80 kv 110 kv 30 (Table ) )

10 X 0.91 Gy ) CT CBCT CBCT ADCT X CT CBCT CBCT1 32 (2016 ICRP, ICRP Statement on tissue reactions/ early and late effects of radiation in normal tissues and organs-threshold doses for tissue reactions in a radiation protection context,

11 ICRP Publication 118, Ann. ICRP, 41(1/2) (2012) 2) IAEA; Radiation protection and safety of radiation sources: International Basic Safety Standards Interim Edition. General Safety Requirements Part 3, No. GSR Part 3[online] 3) Kuriyama T, Sakai N, Niida N, et al Dose reduction in conebeam CT scanning for intracranial stent deployment before coil embolization of intracranial wide-neck aneurysms. Interv Neuroradiol 2016; 22: ) Patel NV, Gounis MJ, Wakhloo AK, et al. Contrast enhanced angiographic cone-beam CT of cerebrovascular stents: experimental optimization and clinical application. AJNR Am J neuroradiol 5) Sakamoto K, Miura K, Ueda T, Evaluation of Low Contrast Resolution in Cone Beam CT Using FPD Jap J Radiolog Technol 2006; 62: Shinohara Y, Sakamoto M, Takeuchi H, et al. Subarachnoid hyperattenuation on flat panel detector-based conebeam CT immediately after uneventful coil embolization of unruptured intracranial aneurysms. AJNR Am J Neuroradiol 2013; 34: Edith C C, Ix-Berenice G F, Jesús G H, el at. Verification of CTDI and DLP values for a head tomography reported by the manufacturers of the CT scanners, using a CT dose profiler probe, a head phantom and a piranha electrometer.

12 International Symposium on Solid State Dosimetry Leon, Guanajuato (Mexico); Sep 2015 Hosokawa S, Kawai N, Sato M, et al. Comparison of air kerma between C-arm CT and 64-multidetector-row CT using a phantom. Jpn J Radiol 2014; 32: ) Nakae Y, Oda M, Minamoto T, Patient Dose Simulation in X ray CT Using a Radiation Treatment planning System Jap J Radiolog Technol 2003; 59: Takase T, Kinouchi K, Take T, et al. A Characteristic of Angiographic Cone-beam CT Jap J Radiolog Technol 2009; 65: Tsuruta W, Matsumaru Y, Hamada Y,. Analysis of closedcell intracranial stent characteristics using cone-beam computed tomography with contrast material. Neuro Med Chir (Tokyo) 2013; 53: Imazeki M, Kawasaki K, Hasegawa R, Evaluation of Patients Radiation Exposure in Neuroendovascular Therapy Estimated dose by questionnaire investigation JNET 2014; 8: , Table 1) CT Figure 1)

13 Table 2) Table 3) CT Table 4) ADCT MIDDLE CBCT CTDI [ Gy ] SD Table 5) CT Gy Table 6) CT Gy Figure 2) CBCT ADCT a:cbct b:adct

16 Mode FAST MIDDLE HIGH

17 ( 110 kv AEC DOSE 77.4nC/kg) HIGH 20 MIDDLE 15 +X -X +Y -Y +X -X +Y -Y [ kv ] [ ma ] [ ] ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) 4.21 Airkerma [mgy] [ ] Airkerma [m Gy ] - ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) [ kv ] [ ma ] FAST 10 +X -X +Y -Y AEC DOSE : Automatic exposure control dose ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) Table 2 : CT

18 [ ] Airkerma [m Gy ] [ ] Airkerma [m Gy ] Table 3 : CT ( AEC DOSE 77.4nC/kg) 80[ kv ] 90[ kv ] +X -X +Y -Y +X -X +Y -Y [ ma ] ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) 100[ kv ] 110[ kv ] +X -X +Y -Y +X -X +Y -Y [ ma ] ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) AEC DOSE : Automatic exposure control dose

19 Table 4 : ADCT MIDDLE CBCT CTDI [mgy]±sd CBCT ADCT p-value center 48.00± ± X 64.56± ± X 63.16± ± Y 24.33± ± Y 94.41± ± ± ±6.090

20 Table 5 : CT ( [mgy]±sd) HIGH MIDDLE FAST 66.14± ± ± X 89.49± ± ± X 89.36± ± ± Y 34.88± ± ± Y ± ± ± ± ± ±13.345

21 Table 6 : CT ( [mgy] ± SD 80 [ kv ] 90 [ kv ] 100 [ kv ] 110 [ kv ] 65.71± ± ± ±1.876 X 96.35± ± ± ±2.222 X 93.54± ± ± ±1.619 Y 34.67± ± ± ±0.886 Y ± ± ± ± ± ± ± ±25.618

動くレントゲン

動くレントゲン FPD 1985 1998 2000 2002 FPD X X X FPD X CAD X FPD X CAD X X 1970 Autofluoroscope Toffolo RR, et al. The autofluoroscope and 133-Xe in dynamic studies of pulmonary perfusion and ventilation. Radiology,