Influence of Modern Low-Dose Multislice Spiral Computed Tomography on Target Registration Errors in Image-Guided Skull Base Surgery

G. Widmann; M. Fasser; P. Schullian; A. Zangerl; W. Puelacher; M. Rasse; H. Riechelmann; R. Bale; W. Jaschke

doi:10.1055/s-0032-1314337

Journal of Neurological Surgery Part B: Skull Base, Inhaltsverzeichnis

Influence of Modern Low-Dose Multislice Spiral Computed Tomography on Target Registration Errors in Image-Guided Skull Base Surgery

G. Widmann ¹(presenter), M. Fasser ¹, P. Schullian ¹, A. Zangerl ¹, W. Puelacher ¹, M. Rasse ¹, H. Riechelmann ¹, R. Bale ¹, W. Jaschke ¹

¹Innsbruck, Austria

Abstract

Objective: The objective of the study was to evaluate whether low-dose protocols influence the target registration error (TRE) in multislice spiral computed tomography (MSCT)-guided skull base surgery.

Design: Anthropomorphic phantom study.

Materials and Methods: An optical navigation system was used to evaluate TRE in a skull phantom using three modern MSCTs (Sensation open 40-slice intraoperative, Definition Flash 128-slice, and LightSpeed VCT 64-slice), as well as the following protocols: Identical baseline protocols (BP) at 120 kV/100 mAs, low-dose protocols in care dose/dose modulation (LD-I) 100 kV/35 ref. mAs, (LD-II) 80 kV/40–41ref. mAs, and (LD-III) 80 kV/15–17 ref. mAs. CTDI_vol and DLP were obtained from the DICOM readout for all MSCT scanners and protocols.

Results: In all MSCT scanners, TRE did not significantly differ between the baseline and the lowest protocols: 1.36 versus 1.43 mm for the Sensation open, 1.31 versus 1.43 mm for the LightSpeed VCT, and 1.15 versus 1.14 mm for the Definition Flash. Compared with the reference CTDI_vol of the German Government of 9 mGy, the lowest protocols allowed approximately a 3-fold dose reduction for the Sensation open, and a 12-fold dose reduction for the LightSpeed VCT and Definition Flash.

Conclusions: Modern MSCT scanners allow substantial dose reductions, which may not influence the accuracy in image-guided skull base surgery. Implementation of optimized protocols is encouraged to reduce radiation exposure.