Inverse treatment planning for Gamma Knife radiosurgery

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Surface radiation dose comparison of a dedicated extremity cone beam computed tomography (CBCT) device and a multidetector computed tomography (MDCT) machine in pediatric ankle and wrist phantoms

<div><p>Objectives</p><p>To evaluate and compare surface doses of a cone beam computed tomography (CBCT) and a multidetector computed tomography (MDCT) device in pediatric ankle and wrist phantoms.</p><p>Methods</p><p>Thermoluminescent dosimeters (TLD) were used to measure and compare surface doses between CBCT and MDCT in a left ankle and a right wrist pediatric phantom. In both modalities adapted pediatric dose protocols were utilized to achieve realistic imaging conditions. All measurements were repeated three times to prove test-retest reliability. Additionally, objective and subjective image quality parameters were assessed.</p><p>Results</p><p>Average surface doses were 3.8 ±2.1 mGy for the ankle, and 2.2 ±1.3 mGy for the wrist in CBCT. The corresponding surface doses in optimized MDCT were 4.5 ±1.3 mGy for the ankle, and 3.4 ±0.7 mGy for the wrist. Overall, mean surface dose was significantly lower in CBCT (3.0 ±1.9 mGy vs. 3.9 ±1.2 mGy, p<0.001). Subjectively rated general image quality was not significantly different between the study protocols (p = 0.421), whereas objectively measured image quality parameters were in favor of CBCT (p<0.001).</p><p>Conclusions</p><p>Adapted extremity CBCT imaging protocols have the potential to fall below optimized pediatric ankle and wrist MDCT doses at comparable image qualities. These possible dose savings warrant further development and research in pediatric extremity CBCT applications.</p></div

Objective image quality assessment.

<p>CNR, SNR and noise in a) ankle and b) wrist phantom across all exposure settings.</p

Box plots displaying surface doses in mGy for both examined devices.

<p>a) ankle and wrist, and b) for the different exposure settings “low”, “medium”, and “high”. c) Mean surface doses at different positions around the joints in CBCT and MDCT.</p

Measured surface doses at the six positions around the ankle and wrist.

<p>Measured surface doses at the six positions around the ankle and wrist.</p

Independent samples t-test results between CBCT and MDCT (routine).

<p>Independent samples t-test results between CBCT and MDCT (routine).</p