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Radiation dose reduction in computer assisted navigation for functional endoscopic sinus surgery--cadaver head
P Dubach1, A Eichenberger, M Caversaccio
1Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern University Hospital, and University of Bern, Switzerland. patrick.dubach@insel.ch
Rhinology
|November 2, 2010
Summary
Radiation dose reduction for computed tomography-based navigation in endoscopic sinus surgery is feasible. Reduced radiation doses maintained registration accuracy, limited only by surgeon-determined image quality needs.
Area of Science:
- Medical Imaging
- Otolaryngology
- Radiation Oncology
Background:
- Computed tomography (CT)-based navigation is widely used in endoscopic sinus surgery.
- Concerns exist regarding iatrogenic radiation exposure and cancer risk.
- Limited research addresses radiation dose reduction for CT-based navigation systems.
Purpose of the Study:
- To validate the use of reduced radiation dose CT for surface registration in computer-aided sinus surgery (CAS-CT).
- To assess the impact of dose reduction on the precision of surface registration techniques.
Main Methods:
- Human cadaver heads were scanned using dose-reduced CAS-CT protocols (1.1-9.6 mGy) compared to a reference dose (65 mGy CTDI).
- Target registration error (TRE) was measured to evaluate registration accuracy at different dose levels.
- Dose reduction protocols were tested in clinical practice for 12 months.
Main Results:
- Registration accuracy (TRE) did not significantly differ between the highest and lowest radiation doses.
- Technical registration accuracy was preserved across tested dose reduction protocols.
- The primary limitation to dose reduction was the surgeon's tolerance for diminished image quality.
Conclusions:
- Surface registration accuracy is not the limiting factor for dose reduction in CAS-CT.
- Significant radiation dose reduction (6-fold, from 65 mGy to 9.6 mGy CTDI) is achievable for most procedures.
- This demonstrates potential for dose reduction in similar radiological applications.
