Effect of automatic tube current modulation on radiation dose and image quality of robotic-assisted hip CT

doi:10.3969/j.issn.1674-8115.2025.11.009

Abstract

Abstract:

Objective ·To evaluate the feasibility of automatic tube current modulation (ATCM) in reducing radiation dose during preoperative CT imaging for robotic-assisted hip arthroplasty and to assess its impact on image quality. Methods ·A total of 106 patients undergoing CT scans for robotic-assisted hip arthroplasty at Nanjing Drum Tower Hospital (from November 2021 to October 2024) were prospectively enrolled. Participants were randomly divided into Group A (n=56) and Group B (n=50).The patients in Group A underwent ATCM scanning, and the patients in Group B underwent partial fixed tube current scanning for hip imaging. Radiation dose parameters included volume CT dose index (CTDIvol) and dose-length product (DLP). Image quality was evaluated using signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and objective noise. Age, gender, body mass index (BMI), scan length, CTDIvol, DLP, SNR, CNR,noise,and image qualification rate were compared between the two groups. Results ·No statistically significant differences were observed between the two groups in baseline characteristics (gender, age, and BMI), scan length, image qualification rate, SNR, CNR, or objective noise (all P>0.05). However, Group A demonstrated significantly lower CTDIvol and DLP compared to Group B (both P<0.001). Conclusion ·The use of ATCM in preoperative CT imaging for robotic-assisted hip surgery significantly reduces radiation dose while maintaining image quality sufficient for 3D modeling requirements.

Key words: hip joint, robotic-assistive technology, automatic tube current modulation, radiation dose

CLC Number:

R445.3

HU Jie, YANG Xianfeng. Effect of automatic tube current modulation on radiation dose and image quality of robotic-assisted hip CT[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2025, 45(11): 1502-1506.

Figures/Tables 4

TrendMD

References 15

[1]	乔高山, 顾英骏, 朱乐银, 等. 前路辅助上方关节囊入路全髋关节置换对髋臼假体位置及术后早期髋关节功能的影响[J]. 骨科, 2023, 14(6): 517-522.
	QIAO G S, GU Y J, ZHU L Y, et al. Effect of total hip arthroplasty via anterior superpath approach on acetabular prosthesis position and early postoperative hip function[J]. Orthopaedics, 2023, 14(6):517-522.
[2]	LAWSON K A, AYALA A E, LARKIN K, et al. Anterior percutaneous-assisted total hip arthroplasty: surgical technique and early outcomes[J]. Arthroplast Today, 2020, 6(4): 716-720.
[3]	郭人文, 柴伟, 李想, 等. 机器人辅助在股骨头坏死全髋关节置换术中的应用[J]. 中华骨科杂志, 2020, 40(13): 819-827.
	GUO R W, CHAI W, LI X, et al. Short-term clinical outcomes of robotic-assisted total hip arthroplasty in osteonecrosis of the femoral head patients[J]. Chinese Journal of Orthopaedics, 2020, 40(13): 819-827.
[4]	许固军, 马明阳, 张帅, 等. Mako机器人辅助人工全髋关节置换术在发育性髋关节发育不良中的应用[J]. 中国修复重建外科杂志, 2021, 35(10): 1233-1239.
	XU G J, MA M Y, ZHANG S, et al. Application of Mako robot-assisted total hip arthroplasty in developmental dysplasia of the hip[J]. Chinese Journal of Reparative and Reconstructive Surgery, 2021, 35(10): 1233-1239.
[5]	蒋栋栋, 王亚囡, 周蕾, 等. 不同扫描体位和定位像方向对单髋关节CT图像及辐射剂量影响[J]. 影像科学与光化学, 2024, 42(1):23-28.
	JIANG D D, WANG Y N, ZHOU L, et al. Effects of different scanning position and scout orientation on CT images and radiation dose of unilateral Hip[J]. Imaging Science and Photochemistry, 2024,42(1): 23-28.
[6]	KIM H S, LEE Y K, HA J H, et al. Distribution and outliers of anteversion of short-length cementless stem[J]. Int Orthop, 2022, 46(4): 725-732.
[7]	BARRACK R L, KREMPEC J A, CLOHISY J C, et al. Accuracy of acetabular component position in hip arthroplasty[J]. J Bone Jt Surg, 2013, 95(19): 1760-1768.
[8]	王晓洋, 叶楠, 张志峰, 等. 机器人辅助技术在全髋关节置换术中的应用进展[J]. 实用骨科杂志, 2023, 29(9): 814-818.
	WANG X Y, YE N, ZHANG Z F, et al. Application progress of robot-assisted technology in total hip arthroplasty[J]. Journal of Practical Orthopaedics, 2023, 29(9): 814-818.
[9]	BENDICH I, VIGDORCHIK J M, SHARMA A K, et al. Robotic assistance for posterior approach total hip arthroplasty is associated with lower risk of revision for dislocation when compared to manual techniques[J]. J Arthroplasty, 2022, 37(6): 1124-1129.
[10]	涂源源, 万大地, 汪群力. 机器人辅助与传统人工全髋关节置换术后下肢长度差异的Meta分析[J]. 中国修复重建外科杂志, 2022, 36(5): 561-566.
	TU Y Y, WAN D D, WANG Q L. Meta-analysis of leg length discrepancy after robot-assisted and traditional total hip arthroplasty[J]. Chinese Journal of Reparative and Reconstructive Surgery, 2022, 36(5): 561-566.
[11]	石泽锋, 孙可, 金先跃, 等. 国产机器人辅助全髋关节置换假体定位精准性的计算机体层成像评估[J]. 中国医疗器械信息, 2024, 30(15): 89-92.
	SHI Z F, SUN K, JIN X Y, et al. A CT study of accuracy and precision of prosthesis positioning in domestic robot-assisted total hip arthroplasty[J]. China Medical Device Information, 2024, 30(15): 89-92.
[12]	王静, 梁保辉, 王梦廷, 等. 定位像参数对智能管电压辅助技术联合自动管电流调制技术性能的影响[J]. 中国医疗设备, 2023, 38(3):21-25.
	WANG J, LIANG B H, WANG M T, et al. Influence of scanning parameters of the scout view on the performance of kV assist technology combined with automatic tube current modulation technology[J]. China Medical Equipment, 2023, 38(3): 21-25.
[13]	刘士远, 于红. CT低剂量扫描的研究和应用现状[J]. 中华放射学杂志, 2013, 47(4): 295-300.
	LIU S Y, YU H. Research and application status of low-dose CT scanning[J]. Chinese Journal of Radiology, 2013, 47(4): 295-300.
[14]	中华医学会放射学分会质量管理与安全管理学组. CT辐射剂量诊断参考水平专家共识[J]. 中华放射学杂志, 2017, 51(11): 817-822.
	Quality Management and Safety Management Section, Chinese Society of Radiology, Chinese Medical Association. Expert consensus on diagnostic reference levels for CT radiation dose[J]. Chinese Journal of Radiology, 2017, 51(11): 817-822.
[15]	王晨思, 洪瑶, 方慧敏, 等. 基于自动管电流调制技术下不同螺距对颈部CTA辐射剂量及图像质量影响的研究[J]. CT理论与应用研究, 2024, 33(3): 309-315.
	WANG C S, HONG Y, FANG H M, et al. Based on the effect of different pitches on neck CTA radiation dose and image quality under automatic tube current modulation technology[J]. CT Theory and Applications, 2024, 33(3): 309-315.

Index	Group A (n=56)	Group B (n=50)	Statistics	P value
Male/female/n	19/37	23/27	χ²=1.609	0.205
Age/year	51.71±15.33	52.02±14.25	z=0.180	0.857
BMI/kg·m^-2	25.76±4.30	26.01±3.74	t=-0.312	0.755
Scan length/mm	651.90±38.94	664.20±41.12	t=-1.580	0.117
Hip-DLP/(mGy·cm)	119.70±12.39	134.70±13.51	t=-5.971	<0.001
Hip-CTDIvol/mGy	3.04±0.22	3.21±0.25	z=-3.90	<0.001
Knee-DLP/mGy·cm	88.80±13.75	89.12±13.76	z=-1.73	0.084
Knee-CTDIvol/mGy	2.72±0.01	2.72±0.01	z=-0.91	0.361

Index	Group A (n=56)	Group B (n=50)	Statistics	P value
Male/female/n	19/37	23/27	χ²=1.609	0.205
Age/year	51.71±15.33	52.02±14.25	z=0.180	0.857
BMI/kg·m^-2	25.76±4.30	26.01±3.74	t=-0.312	0.755
Scan length/mm	651.90±38.94	664.20±41.12	t=-1.580	0.117
Hip-DLP/(mGy·cm)	119.70±12.39	134.70±13.51	t=-5.971	<0.001
Hip-CTDIvol/mGy	3.04±0.22	3.21±0.25	z=-3.90	<0.001
Knee-DLP/mGy·cm	88.80±13.75	89.12±13.76	z=-1.73	0.084
Knee-CTDIvol/mGy	2.72±0.01	2.72±0.01	z=-0.91	0.361