Radiation dose and image quality of X-ray volume imaging systems: cone-beam computed tomography, digital subtraction angiography and digital fluoroscopy

Radiation dose and image quality estimation of three X-ray volume imaging (XVI) systems. A total of 126 patients were examined using three XVI systems (groups 1-3) and their data were retrospectively analysed from 2007 to 2012. Each group consisted of 42 patients and each patient was examined using cone-beam computed tomography (CBCT), digital subtraction angiography (DSA) and digital fluoroscopy (DF). Dose parameters such as dose-area product (DAP), skin entry dose (SED) and image quality parameters such as Hounsfield unit (HU), noise, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were estimated and compared using appropriate statistical tests. Mean DAP and SED were lower in recent XVI than its previous counterparts in CBCT, DSA and DF. HU of all measured locations was non-significant between the groups except the hepatic artery. Noise showed significant difference among groups (P < 0.05). Regarding CNR and SNR, the recent XVI showed a higher and significant difference compared to its previous versions. Qualitatively, CBCT showed significance between versions unlike the DSA and DF which showed non-significance. A reduction of radiation dose was obtained for the recent-generation XVI system in CBCT, DSA and DF. Image noise was significantly lower; SNR and CNR were higher than in previous versions. The technological advancements and the reduction in the number of frames led to a significant dose reduction and improved image quality with the recent-generation XVI system. (orig.)