Ultra-Low Radiation Dose CT Fluoroscopy for Percutaneous Interventions: A Porcine Feasibility Study

Area of Science:

• Medical Imaging
• Radiology
• Interventional Radiology

Background:

• Percutaneous CT-guided interventions require precise needle placement.
• Conventional CT fluoroscopy involves significant radiation exposure for patients and staff.
• Metal artifacts can degrade image quality during interventions.

Purpose of the Study:

• To assess the feasibility of ultra-low-dose (ULD) CT fluoroscopy for percutaneous CT-guided interventions.
• To compare radiation dose, spatial accuracy, and metal artifacts between ULD CT fluoroscopy and conventional CT.
• To evaluate ULD CT fluoroscopy in an in vivo porcine model.

Main Methods:

• Simulated ULD CT fluoroscopic acquisitions using a fraction of conventional CT projections.
• Comparison of needle tip reconstruction accuracy between ULD CT fluoroscopy and conventional CT.
• Quantitative analysis of radiation dose reduction for patients and physicians.
• Assessment of metal artifact reduction using statistical models.

Main Results:

• ULD CT fluoroscopy demonstrated high spatial accuracy with an average needle tip reconstruction difference of 1.06 mm.
• Significant radiation dose reduction: 21% for patients (effective dose) and 97% for physicians (scattered dose).
• Statistically significant reduction in metal artifacts (P < .001).

Conclusions:

• ULD CT fluoroscopy is a feasible technique for percutaneous CT-guided interventions.
• This method offers substantial radiation dose reduction (approx. 500x) for patients and staff.
• ULD CT fluoroscopy maintains image quality and reduces metal artifacts, enhancing safety and efficacy.