光子计数计算机断层扫描可在超低辐射剂量下实现鼻旁窦的图像引导导航：一项初步尸体研究
Photon-Counting Computed Tomography Enables Image-Guided Navigation of the Paranasal Sinuses at Ultra-Low Radiation Dose: An Initial Cadaveric Study.
文献信息
| PMID | 42938119 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Friederike Bärhold |
| 作者单位 | Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Tübingen, 72076 Tübingen, Germany. |
| 期刊 | Diagnostics (Basel, Switzerland) |
| SCI 分区 | Q1 |
| IF | 3.6 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻科 |
中文摘要
背景/目的： 光子计数计算机断层扫描（PCCT）能够在保持高空间分辨率的同时显著降低辐射剂量。其在鼻内镜手术（ESS）图像引导导航中的潜力，尤其是在超低剂量水平下，仍未被充分探索。本研究旨在评估PCCT在四种不同手术导航系统中、在逐步降低辐射剂量下的可行性。
方法： 使用标准方案从两具尸体标本获取鼻旁窦的PCCT数据集，随后逐步降低剂量至参考剂量的5%。这些数据集被用于四种系统（一种光学系统、三种电磁系统）的图像引导导航。在100%和5%剂量水平下，使用线性混合效应模型评估配准成功率、导航准确性和用户满意度（视觉模拟量表）。
结果： 在所有剂量水平下，所有导航系统的配准均成功。尽管剂量降低，平均导航准确性保持稳定（100%剂量下为2.22 ± 1.16 mm，5%辐射剂量下为1.93 ± 1.05 mm；p = 0.364）。用户对导航的满意度始终较高（平均8.8 ± 0.75），且在不同剂量水平之间无显著差异。
结论： 在这项初步研究中，PCCT即使在低至标准曝光量5%的超低辐射剂量下也能实现图像引导导航，且不损害导航准确性。这些发现凸显了PCCT在保持临床性能的同时大幅降低辐射负担的潜力。尚需进一步的人体研究。
英文摘要
Background/Objectives: Photon-counting computed tomography (PCCT) enables substantial radiation dose reduction while preserving high spatial resolution. Its potential for image-guided navigation in endoscopic sinus surgery (ESS), particularly at ultra-low dose levels, remains insufficiently explored. This study aimed to evaluate the feasibility of PCCT for four different surgical navigation systems at progressively reduced radiation doses. Methods: PCCT datasets of the paranasal sinuses were acquired from two cadaveric specimens using a standard protocol followed by stepwise dose reductions down to 5% of the reference dose. The datasets were used for image-guided navigation with four systems (one optical, three electromagnetic). Registration success, navigation accuracy, and user satisfaction (visual analog scale) were assessed at 100% and 5% dose levels using linear mixed-effects models. Results: Registration was successful for all navigation systems at every dose level. Mean navigation accuracy remained stable despite dose reduction (2.22 ± 1.16 mm at 100% vs. 1.93 ± 1.05 mm at 5% radiation dose; p = 0.364). User satisfaction regarding navigation was consistently high (mean 8.8 ± 0.75) and showed no significant differences between dose levels. Conclusions: PCCT enabled image-guided navigation even at ultra-low radiation doses down to 5% of standard exposure, without compromising navigation accuracy in this initial study. These findings highlight the potential of PCCT to substantially reduce radiation burden while maintaining clinical performance. Further in-human studies are needed.