European Spine Journal

, Volume 26, Issue 3, pp 651–657 | Cite as

Radiation exposure using the O-arm® surgical imaging system

  • Nicolas Pitteloud
  • Axel Gamulin
  • Christophe Barea
  • Jerome Damet
  • Guillaume Racloz
  • Marta Sans-Merce
Original Article

Abstract

Purpose

This study was conducted to characterise the O-arm® surgical imaging system in terms of patient organ doses and medical staff occupational exposure during three-dimensional thoracic spine and pelvic examinations.

Methods

An anthropomorphic phantom was used to evaluate absorbed organ doses during a three-dimensional thoracic spine scan and a three-dimensional pelvic scan with the O-arm®. Staff occupational exposure was evaluated by constructing an ambient dose cartography of the operating theatre during a three-dimensional pelvic scan as well as using an anthropomorphic phantom to simulate the O-arm® operator.

Results

Patient organ doses ranged from 30 ± 4 μGy to 20.0 ± 3.0 mGy and 4 ± 1 μGy to 6.7 ± 1.0 mGy for a three-dimensional thoracic spine and pelvic examination, respectively. For a single three-dimensional acquisition, the maximum ambient equivalent dose at 2 m from the iso-centre was 11 ± 1 μSv.

Conclusion

Doses delivered to the patient during a three-dimensional thoracic spine image acquisition were found to be significant with the O-arm®, but lower than those observed with a standard computed tomography examination. The detailed dose cartography allows for the optimisation of medical staff positioning within the operating theatre while imaging with the O-arm®.

Keywords

O-arm Staff and patient radiation exposure Dosimetry Organ dose 3D surgical imaging system 

References

  1. 1.
    Medtronic (2007) O-arm user manual, MNGoogle Scholar
  2. 2.
    Jin M, Liu Z, Liu X, Yan H, Han X, Qiu Y, Zhu Z (2015) Does intraoperative navigation improve the accuracy of pedicle screw placement in the apical region of dystrophic scoliosis secondary to neurofibromatosis type I: comparison between O-arm navigation and free-hand technique. Eur Spine J [Epub ahead of print] Google Scholar
  3. 3.
    Van de Kelft E, Costa F, Van der Planken D, Schils F (2012) A prospective multicenter registry on the accuracy of pedicle screw placement in the thoracic, lumbar and sacral level with the use of the O-arm imaging system and StealthStation navigation. Spine (Phila Pa 1976) 37:E1580–E1587CrossRefGoogle Scholar
  4. 4.
    Beir VII (2006) Health risks from exposure to low levels of ionizing radiation, National Research Council of the National Academies, Washington D.CGoogle Scholar
  5. 5.
    Park MS, Lee KM, Lee B, Min E, Kim Y, Jeon S, Huh Y, Lee K (2012) Comparison of operator radiation exposure between C-arm and O-arm fluoroscopy for orthopaedic surgery. Radiat Prot Dosimetry 148:431–438CrossRefPubMedGoogle Scholar
  6. 6.
    Lange J, Karellas A, Street J, Eck JC, Lapinsky A, Connolly PJ, Dipaola CP (2013) Estimating the effective radiation dose imparted by intraoperative cone-beam computed tomography in thoracolumbar spinal surgery. Spine (Phila Pa 1976) 38:E306–E312CrossRefGoogle Scholar
  7. 7.
    Zhang J, Weir V, Fajardo L, Lin J, Hsiung H, Ritenour ER (2009) Dosimetric characterization of a cone-beam O-arm imaging system. J Xray Sci Technol 17:305–317PubMedGoogle Scholar
  8. 8.
    CIRS (2012) ATOM dosimetry phantoms, VAGoogle Scholar
  9. 9.
    ICRP (1975) Report on the task group on reference man. Publication 23, OttawaGoogle Scholar
  10. 10.
    ICRU (1992) Phantoms and computational models in therapy, diagnosis and protection. Publication 48, MDGoogle Scholar
  11. 11.
    JCGM-W (2008) Guide to the expression of uncertainty in measurement. International Organization for Standardization, GenevaGoogle Scholar
  12. 12.
    APVL (2011) Manuel d’utilisation AT1123 V1. Saint-Cyr-sur-Loire, FranceGoogle Scholar
  13. 13.
    Hadelsberg UP, Harel R (2012) Hazards of ionizing radiation and its impact on spine surgery. World Neurosurg [Epub ahead of print] Google Scholar
  14. 14.
    Qureshi S, Lu Y, McAnany S, Baird E (2014) Three-dimensional intraoperative imaging modalities in orthopaedic surgery: a narrative review. J Am Acad Orthop Surg 22:800–809CrossRefPubMedGoogle Scholar
  15. 15.
    Söderberg M, Abul-Kasim K, Ohlin A, Gunnarsson M (2011) Estimation of organ and effective dose to the patient during spinal surgery with a cone-beam O-arm system. Proc SPIE 7961:79613G1-G6Google Scholar
  16. 16.
    Zhang D, Li X, Gao Y, Xu X, Liu B (2013) A method to acquire CT organ dose map using OSL dosimeters and atom anthropomorphic phantoms. Med Phys 40:081918CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    ICRP (2007) Radiological protection in medicine. Publication 105, OttawaGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  1. 1.Physics SectionUniversity of GenevaGenevaSwitzerland
  2. 2.Division of Orthopaedic and Trauma Surgery, Department of SurgeryUniversity Hospitals of GenevaGenevaSwitzerland
  3. 3.Institute of Radiation PhysicsLausanne University HospitalLausanneSwitzerland
  4. 4.Department of Imagery and Medical Science InformationUniversity Hospitals of GenevaGenevaSwitzerland
  5. 5.Department of RadiologyUniversity of OtagoChristchurchNew Zealand

Personalised recommendations