Abdullah@ Yong, Ariz Chong@Chong Chee
(2016)
Limitation of mobile head CT scanner (ceretom) image quality in a neurosurgery center.
Masters thesis, Universiti Sains Malaysia.
Abstract
Introduction: Computed tomography (CT) has become the preferred technique in the
diagnostic toolkit for head and brain imaging and superior to Magnetic Resonance
Imaging (MRI) for the assessment of head injury. Indications for head imaging
includes head injury, acute stroke, subarachnoid haemorrhage etc. A more recent
development in CT imaging has been the development of a mobile CT scanner
which can be beneficial from clinical and economical point of views.
Objective: To compare the image quality of CT brain images produced by portable
head CT scanner, CereTom, to standard fixed CT scanner.
Methods: This was a single center retrospective study involving CT brain images
of112 neurosurgical patients admitted to Hospital Sultanah Aminah Johor Bahrufrom
December 2014 until March 2015. Hounsfield unit(HU) of all the selected images
from CereTom were measured for: air, water and bone. Three observers (2
neurosurgeons and 1 radiologist) evaluated independently the CT brain images
acquired on standard fixed CT scanner within 48 hours apart with the CereTom.
Each images were evaluated for visualization of lesions, grey-white matterdifferentiation and streak artifacts at 3 different levels which were centrum
semiovale, basal ganglia and middle cerebellar peduncles. Each evaluation was
scored either 1 (poor), 2 (average) or 3 (good). The scores were sum up forming an
ordinal reading of 3 to 9.
Results:Hounsfield unit (HU) for measured air, water and bone from CereTom were
within the range of recommendedby ACR. Evaluation of streak artifacts
demonstrated scores of 8.54 (IQR 0.24) with fixed CT scanner versus 7.46 (IQR 1.16)
for CereTom at centrum semiovale (z -5.67), 8.38 ± 1.12 versus 7.32± 1.63 at the
basal ganglia and 8.21 ± 1.30 versus 6.97 ± 2.77 at the middle cerebellar peduncles.
Comparison of grey-white matter differentiation showed scores of 8.27 ± 1.04 with
fixed CT scanner versus 7.21 ±1.41 for CereTom at centrum semiovale, 8.26 ±1.07
versus 7.00 ±1.47 at the basal ganglia and 8.38± 1.11 versus 6.74 ± 1.55 at the
middle cerebellar peduncles. Evaluation for visualization of lesions showed scores of
8.86 (IQR 0.09) with fixed CT scanner compared to 8.21 (IQR 0.34) for CereTom at
centrum semiovale (z -4.24), 8.93 (IQR 0) versus 8.18 (IQR 0.57) at the basal
ganglia (z -5.32) and 8.79 (IQR 0.11) versus 8.06 (IQR 0.41) at the middle cerebellar
peduncles (z -4.93). All the results were significant with p value < 0.01.
Conclusions: The results of this study showed there wassignificant difference in
terms of image quality between the images produced by fixed standard CT scanner
and CereTom with the latter being more inferior. However, Hounsfield unit (HU) of
images produced by CereTom do fulfil the recommendation by ACR.
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