{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T14:14:34Z","timestamp":1773670474717,"version":"3.50.1"},"reference-count":9,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,8,14]],"date-time":"2020-08-14T00:00:00Z","timestamp":1597363200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,8,14]],"date-time":"2020-08-14T00:00:00Z","timestamp":1597363200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med Imaging"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Intraoperative 3-dimensional (3D) navigation is increasingly being used for pedicle screw placement. For this purpose, dedicated mobile 3D C-arms are capable of providing intraoperative fluoroscopy-based 3D image data sets. Modern 3D C-arms have a large field of view, which suggests a higher radiation exposure. In this experimental study we therefore investigate the radiation exposure of a new mobile 3D C-arm with large flat-panel detector to a previously reported device with regular flat-panel detector on an Alderson phantom.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We measured the radiation exposure of the Vision RFD 3D (large 30\u2009\u00d7\u200930 cm detector) while creating 3D image sets as well as standard fluoroscopic images of the cervical and lumbar spine using an Alderson phantom. The dosemeter readings were then compared with the radiation exposure of the previous model Vision FD Vario 3D (smaller 20\u2009\u00d7\u200920 cm detector), which had been examined identically in advance and published elsewhere.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The larger 3D C-arm induced lower radiation exposures at all dosemeter sites in cervical 3D scans as well as at the sites of eye lenses and thyroid gland in lumbar 3D scans. At \u200b\u200bmale and especially female gonads in lumbar 3D scans, however, the larger 3D C-arm showed higher radiation exposures compared with the smaller 3D C-arm. In lumbar fluoroscopic images, the dosemeters near\/in the radiation field measured a higher radiation exposure using the larger 3D C-arm.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The larger 3D C-arm offers the possibility to reduce radiation exposures for specific applications despite its larger flat-panel detector with a larger field of view. However, due to the considerably higher radiation exposure of the larger 3D C-arm during lumbar 3D scans, the smaller 3D C-arm is to be recommended for short-distance instrumentations (mono- and bilevel) from a radiation protection point of view. The larger 3D C-arm with its enlarged 3D image set might be used for long instrumentations of the lumbar spine. From a radiation protection perspective, the use of the respective 3D C-arm should be based on the presented data and the respective application.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12880-020-00495-y","type":"journal-article","created":{"date-parts":[[2020,8,14]],"date-time":"2020-08-14T17:03:12Z","timestamp":1597424592000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Radiation exposure of a mobile 3D C-arm with large flat-panel detector for intraoperative imaging and navigation - an experimental study using an anthropomorphic Alderson phantom"],"prefix":"10.1186","volume":"20","author":[{"given":"Yashar","family":"Naseri","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulrich","family":"Hubbe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph","family":"Scholz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johannes","family":"Br\u00f6nner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marie T.","family":"Kr\u00fcger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3469-9027","authenticated-orcid":false,"given":"Jan-Helge","family":"Klingler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,8,14]]},"reference":[{"key":"495_CR1","doi-asserted-by":"publisher","first-page":"585","DOI":"10.1016\/j.nec.2017.06.002","volume":"28","author":"SE Adamczak","year":"2017","unstructured":"Adamczak SE, Bova FJ, Hoh DJ. Intraoperative 3D computed tomography: spine surgery. Neurosurg Clin N Am. 2017;28:585\u201394.","journal-title":"Neurosurg Clin N Am"},{"key":"495_CR2","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1186\/s13037-017-0142-0","volume":"11","author":"J Riis","year":"2017","unstructured":"Riis J, Lehman RR, Perera RA, Quinn JR, Rinehart P, Tuten HR, et al. A retrospective comparison of intraoperative CT and fluoroscopy evaluating radiation exposure in posterior spinal fusions for scoliosis. Patient Saf Surg. 2017;11:32\u20136.","journal-title":"Patient Saf Surg"},{"key":"495_CR3","doi-asserted-by":"publisher","first-page":"E669","DOI":"10.1097\/BSD.0000000000000187","volume":"30","author":"JH Klingler","year":"2017","unstructured":"Klingler JH, Sircar R, Scheiwe C, Kogias E, Kr\u00fcger MT, Scholz C, et al. Comparative study of C-arms for intraoperative 3-dimensional imaging and navigation in minimally invasive spine surgery part II - radiation exposure. Clin Spine Surg. 2017;30:E669\u201376.","journal-title":"Clin Spine Surg"},{"key":"495_CR4","doi-asserted-by":"publisher","first-page":"524","DOI":"10.5312\/wjo.v8.i7.524","volume":"8","author":"AS Narain","year":"2017","unstructured":"Narain AS, Hijji FY, Yom KH, Kudaravalli KT, Haws BE, Singh K. Radiation exposure and reduction in the operating room: perspectives and future directions in spine surgery. World J Orthop. 2017;8:524\u201330.","journal-title":"World J Orthop"},{"key":"495_CR5","doi-asserted-by":"publisher","first-page":"264","DOI":"10.1097\/BSD.0b013e3181eed618","volume":"24","author":"TE Mroz","year":"2011","unstructured":"Mroz TE, Abdullah KG, Steinmetz MP, Klineberg EO, Lieberman IH. Radiation exposure to the surgeon during percutaneous pedicle screw placement. 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Clin Spine Surg. 2017;30:276\u201384.","journal-title":"Clin Spine Surg"},{"key":"495_CR8","unstructured":"Joint Committee for Guides in Metrology, 2008. Evaluation of measurement data - guide to the expression of uncertainty in measurement. GUM 1995 with minor corrections. JCGM. 2008;100:1\u2013120."},{"key":"495_CR9","doi-asserted-by":"publisher","first-page":"1033","DOI":"10.1148\/radiographics.21.4.g01jl271033","volume":"21","author":"M Mahesh","year":"2001","unstructured":"Mahesh M. Fluoroscopy: patient radiation exposure issues. Radiographics. 2001;21:1033\u201345.","journal-title":"Radiographics"}],"container-title":["BMC Medical Imaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12880-020-00495-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12880-020-00495-y\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12880-020-00495-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,8,13]],"date-time":"2021-08-13T23:25:48Z","timestamp":1628897148000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcmedimaging.biomedcentral.com\/articles\/10.1186\/s12880-020-00495-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,14]]},"references-count":9,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["495"],"URL":"https:\/\/doi.org\/10.1186\/s12880-020-00495-y","relation":{},"ISSN":["1471-2342"],"issn-type":[{"value":"1471-2342","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,8,14]]},"assertion":[{"value":"22 April 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 August 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 August 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Ethics approval was waived because exclusively an experimental setup with an Alderson phantom was used. No human was exposed to additional ionizing radiation during this investigation.According to the local Ethics Committee (Freiburg, Germany, no. 10027\/20), no approval is required for this study.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The clinic (Department of Neurosurgery, Freiburg) had a cooperation agreement for system development with Stryker and Ziehm. UH has received honoraria and travel expenditures for technical consultancy and lectures from Medtronic and has received honoraria and travel expenditures for lectures from Ziehm.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"96"}}