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Intraoperative 2D C-arm and 3D O-arm in children: a comparative phantom study
M Prod'homme1,2, M Sans-Merce3,4, N Pitteloud4,5
1Medical University of Geneva, Geneva, Switzerland.
Insights
Radiation exposure during pediatric intraoperative imaging is higher with 3D O-arm than 2D C-arm fluoroscopy. Further studies are needed to assess the ionizing risks of these systems in children.
Area of Science:
- Medical Imaging
- Radiation Oncology
- Pediatric Radiology
Background:
- Intraoperative imaging in children raises concerns regarding ionizing radiation exposure.
- Assessing radiation doses from different imaging modalities is crucial for patient safety.
Purpose of the Study:
- To compare radiation exposure in pediatric patients undergoing intraoperative imaging using 2D C-arm versus 3D O-arm systems.
- To evaluate absorbed organ doses and skin entrance dose rates.
Main Methods:
- Organ doses were measured in an anthropomorphic phantom simulating a five-year-old child using thermoluminescent dosimeters.
- Radiation exposure was assessed using a C-arm for one minute of fluoroscopy and an O-arm for a single cone-beam acquisition centered on the pelvis.
- Direct and scattered radiation doses, as well as skin entrance dose rates, were measured and compared.
Main Results:
- Absorbed doses to pelvic organs were higher with the O-arm (631.22–1691.87 µGy) compared to the C-arm (214.08–737.51 µGy), though not statistically significant (p=0.07).
- Scattered radiation doses to abdominal organs showed similar trends, with higher doses for the O-arm (25.11–114.85 µGy) versus the C-arm (8.03–55.34 µGy), also not significant (p=0.07).
- Far scattered radiation to the thorax, neck, and head was significantly higher with the O-arm (0.86–6.42 µGy) compared to the C-arm (0.04–3.08 µGy) (p=0.02).
- Skin entrance dose rate was substantially higher for the O-arm (328.58 µGy/s) than the C-arm (1.90 µGy/s).
Conclusions:
- 3D O-arm imaging of the pediatric pelvis results in higher absorbed doses than one-minute 2D C-arm fluoroscopy.
- Clinical studies are necessary to compare effective doses and fully assess the ionizing risks associated with intraoperative imaging systems in children.
Purpose:
Exposure to ionizing radiation is a concern for children during intraoperative imaging. We aimed to assess the radiation exposure to the paediatric patient with 2D and 3D imaging.
Methods:
To evaluate the radiation exposure, patient absorbed doses to the organs were measured in an anthropomorphic phantom representing a five-year-old child, using thermoluminescent dosimeters. For comparative purposes, organ doses were measured using a C-arm for one minute of fluoroscopy and one acquisition with an O-arm. The cone-beam was centred on the pelvis. Direct and scattered irradiations were measured and compared (Student's t-test). Skin entrance dose rates were also evaluated.
Results:
All radiation doses were expressed in µGy. Direct radiation doses of pelvic organs were between 631.22 and 1691.87 for the O-arm and between 214.08 and 737.51 for the C-arm, and were not significant (p = 0.07). Close scattered radiation on abdominal organs were between 25.11 and 114.85 for the O-arm and between 8.03 and 55.34 for the C-arm, and were not significant (p = 0.07). Far scattered radiation doses on thorax, neck and head varied from 0.86 to 6.42 for the O-arm and from 0.04 to 3.08 for the C-arm, and were significant (p = 0.02). The dose rate at the skin entrance was 328.58 µGy.s-1 for the O-arm and 1.90 with the C-arm.
Conclusion:
During imaging of the pelvis, absorbed doses for a 3D O-arm acquisition were higher than with one minute fluoroscopy with the C-arm. Further clinical studies comparing effective doses are needed to assess ionizing risks of the intraoperative imaging systems in children.
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