Image quality and effective dose of a robotic flat panel 3D C-arm vs computed tomography

Background The aim of this study was to determine the effective dose and corresponding image quality of different imaging protocols of a robotic 3D flat panel C-arm in comparison to computed tomography (CT). Methods Dose measurements were performed using a Rando-Alderson Phantom. The phantom was exposed to different scanning protocols of the 3D C-arm and the CT. Pedicle screws were inserted in a fresh swine cadaver. Images were obtained using the same scanning protocols. Results At the thoracolumbar junction, the effective dose was comparable for 3D high-dose protocols, with (4.4 mSv) and without (4.3 mSv) collimation and routine CT (5 mSv), as well as a dose-reduction CT (4.0 mSv). A relevant reduction was achieved with the 3D low-dose protocol (1.0 mSv). Focusing on Th6, a similar reduction with the 3D low-dose protocol was achieved. The image quality of the 3D protocols using titanium screws was rated as 'good' by all viewers, with excellent correlation. Conclusions Modern intra-operative 3D-C-arms produce images of CT-like quality with low-dose radiation. Copyright (C) 2015 John Wiley & Sons, Ltd.