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Dose and Image Quality of Cone-Beam Computed Tomography as Compared With Conventional Multislice Computed Tomography in Abdominal Imaging

Schegerer, Alexander A. PhD*; Lechel, Ursula MPhys*; Ritter, Manuel PhD; Weisser, Gerald PhD; Fink, Christian PhD§; Brix, Gunnar PhD*

doi: 10.1097/RLI.0000000000000069
Original Articles

Objectives Recent technical developments have facilitated the application of cone-beam computed tomography (CBCT) for interventional and intraoperative imaging. The aim of this study was to compare the radiation doses and image quality in CBCT with those of conventional multislice spiral computed tomography (MSCT) for abdominal and genitourinary imaging.

Methods Different CBCT and MSCT protocols for imaging soft tissues and hard-contrast objects at different dose levels were investigated in this study. Local skin and organ doses were measured with thermoluminescent dosimeters placed in an anthropomorphic phantom. Moreover, the contrast-to-noise ratio, the noise-power spectrum, and the high-contrast resolution derived from the modulation transfer function were determined in a phantom with the same absorption properties as those of anthropomorphic phantom.

Results The effective dose of the examined abdominal/genitourinary CBCT protocols ranged between 0.35 mSv and 18.1 mSv. As compared with MSCT, the local skin dose of CBCT examinations could locally reach much higher doses up to 190 mGy. The effective dose necessary to realize the same contrast-to-noise ratio with CBCT and MSCT depended on the MSCT convolution kernel: the MSCT dose was smaller than the corresponding CBCT dose for a soft kernel but higher than that for a hard kernel. The noise-power spectrum of the CBCT images at tube voltages of 85/90 kV(p) is at least half of that of images measured at 103/115 kV(p) at any arbitrarily chosen spatial frequency. Although the pixel size and slice thickness of CBCT were half of those of the MSCT images, high-contrast resolution was inferior to the MSCT images reconstructed with a hard convolution kernel.

Conclusions As compared with MSCT using a medium-hard convolution kernel, CBCT produces images at medium noise levels and, simultaneously, medium spatial resolution at approximately the same dose. It is well suited for visualizing hard-contrast objects in the abdomen with relatively low image noise and patient dose. For the detection of low-contrast objects at standard tube voltages of approximately 120 kV(p), however, MSCT should be preferred.

From the *Department of Medical and Occupational Radiation Protection, Federal Office for Radiation Protection, Neuherberg; †Department of Urology, ‡Institute of Clinical Radiology and Nuclear Medicine, Medical Centre Mannheim, Mannheim; and §Abteilung für Radiologie, Allgemeines Krankenhaus Celle, Celle, Germany.

Received for publication February 13, 2014; and accepted for publication, after revision, March 25, 2014.

Johannes Berndt and Markus Oechsner, Klinikum rechts der Isar, Munich, Germany, supported the measurements at the multislice spiral computed tomography system.

Conflicts of interest and sources of funding: none declared.

Reprints: Alexander A. Schegerer, PhD, Bundesamt für Strahlenschutz, Abteilung für medizinischen und beruflichen Strahlenschutz, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany. E-mail:

© 2014 by Lippincott Williams & Wilkins