Cone-Beam CT Area Detector CT 1 2 1-6 03-3293-1711 shimada.takashi@nihon-u.ac.jp CBCT JNET journal of Neuroendovascular Therapy
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 5 1.1 2.3 360 CT 200 CBCT 2011 (ICRP)
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
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 04-102(, ) Piranha(RTI Electronics, Molndal, Sweden) CT DOSE PROFILER(RTI Electronics, Molndal, Sweden) ) CBCT 3 FAST 10 200 MIDDLE 15 15 400 HIGH 20 20 600 bit Table Field of view(fov)
12 Source Image receptor Distance(SID) 110cm 1.8 0.6mm CT ( 120 kv 250 ma 1.5 0.5 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 5 5 5 +Y CBCT
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 5 64.60m Gy [ ]6.09 CBCT Y 94.41m Gy 24.33 Gy Y
25.62 X X 64.56 m Gy X 63.16m Gy 5 58.89 m Gy R wilcoxon 2 CBCT (Table 5) CBCT MIDDLE CBCT 58.89 Gy 24.33 Gy 20 81.83 Gy 34.88 Gy 1.39 1.43 10 32.57 Gy 13.99 Gy 0.55 0.57 CBCT (Table ) CBCT MIDDLE AEC DOSE 110 kv 58.89 Gy 24.33 Gy 80kv 10kv 100 kv 61.26m Gy 25.28m Gy 90kv 70.14m Gy 28.07m Gy 80kv 85.43m Gy
34.67m Gy ADCT CBCT ADCT CBCT ) ADCT X 1 0.275 360 160 CBCT X FPD 10 20 200 FPD (Figure 2) 360 CT (Table ) Y Y Y 6.09 Y X ) CBCT X X X 僅 Y Y Y 25.62 Y MIDDLE CBCT ADCT
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 ) )
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,
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: 420-425. 4) 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: 539-545. 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: 577 582. 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.
International Symposium on Solid State Dosimetry Leon, Guanajuato (Mexico); 26-30 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: 302-307 9) 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: 935-943 10 Takase T, Kinouchi K, Take T, et al. A Characteristic of Angiographic Cone-beam CT Jap J Radiolog Technol 2009; 65: 755-764. 11 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: 403-408. 12 Imazeki M, Kawasaki K, Hasegawa R, Evaluation of Patients Radiation Exposure in Neuroendovascular Therapy Estimated dose by questionnaire investigation JNET 2014; 8: 305-312, Table 1) CT Figure 1)
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
Mode FAST MIDDLE HIGH
( 110 kv AEC DOSE 77.4nC/kg) HIGH 20 MIDDLE 15 +X -X +Y -Y +X -X +Y -Y [ kv ] 110 110 [ ma ] 250 250 3.96 3.90 4.04 4.08 3.92 4.24 4.24 4.14 4.12 4.30 [ ] 3.98 - (4.1-3.8) (4.0-3.7) (4.2-3.9) (4.3-3.9) (4.0-3.8) (4.4-3.9) (4.4-4.0) (4.3-4.0) (4.3-3.9) (4.4-4.2) 4.21 Airkerma [mgy] 128.71 128.18 131.05 133.10 127.56 129.72 91.54 91.75 90.99 89.66 93.14 91.42 [ ] Airkerma [m Gy ] - (132.72-124.64) (132.09-122.18) (136.21-127.30) (140.05-127.30) (129.92-124.12) (94.44-85.88) (95.04-86.67) (93.51-87.66) (93.49-85.53) (95.13-91.03) [ kv ] [ ma ] FAST 10 +X -X +Y -Y AEC DOSE : Automatic exposure control dose 110 125 7.88 7.92 7.90 7.66 7.72 - (8.1-7.7) (8.1-7.7) (8.1-7.8) (7.8-7.5) (7.9-7.5) 51.40 50.81 50.98 50.13 50.23 - (52.63-50.34) (52.09-50.07) (52.45-50.16) (50.76-48.90) (51.61-48.56) Table 2 : CT 7.82 50.71
[ ] 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 ] 500 400 6.00 5.86 5.74 5.86 5.76 4.44 4.48 4.42 4.28 4.40 5.844 - (6.2-5.8) (6.2-5.7) (5.8-5.7) (6.0-5.7) (6.0-5.6) (4.7-4.3) (4.7-4.3) (4.7-4.3) (4.4-4.2) (4.5-4.3) 4.404 146.61 144.30 141.59 145.15 142.57 144.044 113.65 115.57 113.62 110.47 112.15 113.092 - (151.38-141.47) (151.06-141.02) (142.79-140.82) (147.55-141.94) (148.24-139.08) (118.49-110.51) (120.67-111.47) (118.98-110.98) (112.66-108.72) (113.94-110.42) 100[ kv ] 110[ kv ] +X -X +Y -Y +X -X +Y -Y [ ma ] 320 250 3.88 3.90 3.90 3.80 3.88 4.24 4.24 4.14 4.12 4.30 3.872 - (4.0-3.8) (4.0-3.8) (4.1-3.8) (3.9-3.7) (4.0-3.8) (4.4-3.9) (4.4-4.0) (4.3-4.0) (4.3-3.9) (4.4-4.2) 4.208 96.37 97.24 97.06 94.97 95.58 96.244 91.54 91.75 90.99 89.66 93.14 91.416 - (100.2-93.63) (99.90-94.88) (101.01-95.12) (96.98-92.97) (96.48-94.99) (94.44-85.88) (95.04-86.67) (93.51-87.66) (93.49-85.53) (95.13-91.03) AEC DOSE : Automatic exposure control dose
Table 4 : ADCT MIDDLE CBCT CTDI [mgy]±sd CBCT ADCT p-value center 48.00±1.876 61.72±0.129 0.0079 +X 64.56±2.222 65.33±1.244 0.873 -X 63.16±1.619 66.70±1.127 0.0079 +Y 24.33±0.862 72.85±0.895 0.0079 -Y 94.41±1.956 56.41±0.393 0.0079 58.89±25.618 64.60±6.090
Table 5 : CT ( [mgy]±sd) HIGH MIDDLE FAST 66.14±1.694 48.00±1.876 26.91±0.385 +X 89.49±2.871 64.56±2.222 35.61±0.549 -X 89.36±2.400 63.16±1.619 36.07±0.588 +Y 34.88±1.296 24.33±0.862 13.99±0.206 -Y 129.28±2.637 94.41±1.956 50.28±1.164 81.83±34.703 58.89±25.618 32.57±13.345
Table 6 : CT ( [mgy] ± SD 80 [ kv ] 90 [ kv ] 100 [ kv ] 110 [ kv ] 65.71±1.796 54.88±1.677 48.95±1.448 48.00±1.876 X 96.35±2.916 79.48±2.461 68.30±1.743 64.56±2.222 X 93.54±0.664 77.16±2.417 67.25±1.761 63.16±1.619 Y 34.67±0.498 28.07±0.433 25.28±0.317 24.33±0.886 Y 136.88±3.340 111.14±1.607 96.52±0.912 94.41±1.956 85.43±38.037 70.14±30.906 61.26±26.338 58.89±25.618