Cone-beam CT with a noncircular (sine-on-sphere) orbit: imaging performance of a clinical system for image-guided interventions

Purpose: We aim to compare the imaging performance of a cone-beam CT (CBCT) imaging system with noncircular scan protocols (sine-on-sphere) to a conventional circular orbit. Approach: A biplane C-arm system (ARTIS Icono; Siemens Healthineers) capable of circular and noncircular CBCT acquisition was used, with the latter orbit (sine-onsphere, "Sine Spin") executing a sinusoidal motion with ±10 deg tilt amplitude over the half-scan orbit. A test phantom was used for the characterization of image uniformity, noise, noise-power spectrum (NPS), spatial resolution [modulation transfer function (MTF) in axial and oblique directions], and cone-beam artifacts. Findings were interpreted using an anthropomorphic head phantom with respect to pertinent tasks in skull base neurosurgery. Results: The noncircular scan protocol exhibited several advantages associated with improved 3D sampling evident in the NPS as filling of the null cone about the f z spatial frequency axis and reduction of cone-beam artifacts. The region of support at the longitudinal extrema was reduced from 16 to ∼12 cm at a radial distance of 6.5 cm. Circular and noncircular orbits exhibited nearly identical image uniformity and quantum noise, demonstrating cupping of ∼16.7% and overall noise of ∼27 HU. Although both the radially averaged axial MTF (f_x;y ) and 45 deg oblique MTF (f_x;y;z) were ∼20% lower for the noncircular orbit compared with the circular orbit at the default full reconstruction field of view (FOV), there was no difference in spatial resolution for the medium reconstruction FOV (smaller voxel size). Differences in the perceptual image quality for the anthropomorphic phantom reinforced the objective, quantitative findings, including reduced beam-hardening and cone-beam artifacts about structures of interest in the skull base. Conclusions: Image quality differences between circular and noncircular CBCT orbits were quantitatively evaluated on a clinical system in the context of neurosurgery. The primary performance advantage for the noncircular orbit was the improved sampling and elimination of cone-beam artifacts.