Image quality and localization accuracy in C-arm tomosynthesis-guided head and neck surgery
- Department of Otolaryngology-Head and Neck Surgery, Princess Margaret Hospital, Toronto, Ontario, M5G 2M9 (Canada)
The image quality and localization accuracy for C-arm tomosynthesis and cone-beam computed tomography (CBCT) guidance of head and neck surgery were investigated. A continuum in image acquisition was explored, ranging from a single exposure (radiograph) to multiple projections acquired over a limited arc (tomosynthesis) to a full semicircular trajectory (CBCT). Experiments were performed using a prototype mobile C-arm modified to perform 3D image acquisition (a modified Siemens PowerMobil). The tradeoffs in image quality associated with the extent of the source-detector arc ({theta}{sub tot}), the number of projection views, and the total imaging dose were evaluated in phantom and cadaver studies. Surgical localization performance was evaluated using three cadaver heads imaged as a function of {theta}{sub tot}. Six localization tasks were considered, ranging from high-contrast feature identification (e.g., tip of a K-wire pointer) to more challenging soft-tissue delineation (e.g., junction of the hard and soft palate). Five head and neck surgeons and one radiologist participated as observers. For each localization task, the 3D coordinates of landmarks pinpointed by each observer were analyzed as a function of {theta}{sub tot}. For all tomosynthesis angles, image quality was highest in the coronal plane, whereas sagittal and axial planes exhibited a substantial decrease in spatial resolution associated with out-of-plane blur and distortion. Tasks involving complex, lower-contrast features demonstrated steeper degradation with smaller tomosynthetic arc. Localization accuracy in the coronal plane was correspondingly high, maintained to <3 mm down to {theta}{sub tot}{approx}30 deg. , whereas sagittal and axial localization degraded rapidly below {theta}{sub tot}{approx}60 deg. . Similarly, localization precision was better than {approx}1 mm within the coronal plane, compared to {approx}2-3 mm out-of-plane for tomosynthesis angles below {theta}{sub tot}{approx}45 deg. . An overall 3D localization accuracy of {approx}2.5 mm was achieved with {theta}{sub tot}{approx} 90 deg. for most tasks. The high in-plane spatial resolution, short scanning time, and low radiation dose characteristic of tomosynthesis may enable the surgeon to collect near real-time images throughout the procedure with minimal interference to surgical workflow. Therefore, tomosynthesis could provide a useful addition to the image-guided surgery arsenal, providing on-demand, high quality image updates, complemented by CBCT at critical milestones in the surgical procedure.
- OSTI ID:
- 21032874
- Journal Information:
- Medical Physics, Vol. 34, Issue 12; Other Information: DOI: 10.1118/1.2799492; (c) 2007 American Association of Physicists in Medicine; Country of input: International Atomic Energy Agency (IAEA); ISSN 0094-2405
- Country of Publication:
- United States
- Language:
- English
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