{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:13:35Z","timestamp":1760033615403,"version":"build-2065373602"},"reference-count":53,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,5,7]],"date-time":"2025-05-07T00:00:00Z","timestamp":1746576000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Department of Health and Human Services National Institutes of Health EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH &amp; HUMAN DEVELOPMENT-SBIR Award","award":["#R44 HD068150-01","#07-2-01","W81XWH-07-2-0113","#P.PSH.0914","#P.PSH.0915"],"award-info":[{"award-number":["#R44 HD068150-01","#07-2-01","W81XWH-07-2-0113","#P.PSH.0914","#P.PSH.0915"]}]},{"name":"US Army Medical Research and Material Command, MOVE Center Award","award":["#R44 HD068150-01","#07-2-01","W81XWH-07-2-0113","#P.PSH.0914","#P.PSH.0915"],"award-info":[{"award-number":["#R44 HD068150-01","#07-2-01","W81XWH-07-2-0113","#P.PSH.0914","#P.PSH.0915"]}]},{"name":"DoD-TATRC Contract","award":["#R44 HD068150-01","#07-2-01","W81XWH-07-2-0113","#P.PSH.0914","#P.PSH.0915"],"award-info":[{"award-number":["#R44 HD068150-01","#07-2-01","W81XWH-07-2-0113","#P.PSH.0914","#P.PSH.0915"]}]},{"name":"MLA Australian Government Meat and Livestock Australia Ltd.","award":["#R44 HD068150-01","#07-2-01","W81XWH-07-2-0113","#P.PSH.0914","#P.PSH.0915"],"award-info":[{"award-number":["#R44 HD068150-01","#07-2-01","W81XWH-07-2-0113","#P.PSH.0914","#P.PSH.0915"]}]},{"name":"Australian cattle and sheep producer levies and matched Australian Federal Government funding through the Department of Agriculture, Fisheries and Forestry (DAFF)","award":["#R44 HD068150-01","#07-2-01","W81XWH-07-2-0113","#P.PSH.0914","#P.PSH.0915"],"award-info":[{"award-number":["#R44 HD068150-01","#07-2-01","W81XWH-07-2-0113","#P.PSH.0914","#P.PSH.0915"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Imaging"],"abstract":"<jats:p>Characterizing imaging performance requires a multidisciplinary approach that evaluates various interconnected parameters, including dosage optimization and dynamic accuracy. Radiation dose and dynamic accuracy are challenged by patient motion that results in poor image quality. These challenges are more prevalent in the brain\/cardiac pediatric patient imaging, as they relate to excess radiation dose that may be associated with various complications. Scanning vulnerable pediatric patients ought to eliminate anesthesia due to critical risks associated in some cases with intracranial hemorrhages, brain strokes, and congenital heart disease. Some pediatric imaging, however, requires prolonged scanning under anesthesia. It can often be a laborious, suboptimal process, with limited field of view and considerable dose. High dynamic accuracy is also necessary to diagnose tissue\u2019s dynamic behavior beyond its static structural morphology. This study presents several performance characterization experiments from a new robotic multimodal imaging system using specially designed calibration methods at different system configurations. Additional musculoskeletal imaging and imaging from a pediatric brain stroke patient without anesthesia are presented for comparisons. The findings suggest that the system\u2019s large dynamically controlled gantry enables scanning at full patient movement and with important improvements in scan times, accuracy, radiation dose, and the ability to image brain structures without anesthesia. This could position the system as a potential transformative tool in the pediatric interventional imaging landscape.<\/jats:p>","DOI":"10.3390\/jimaging11050147","type":"journal-article","created":{"date-parts":[[2025,5,7]],"date-time":"2025-05-07T04:20:26Z","timestamp":1746591626000},"page":"147","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Towards the Performance Characterization of a Robotic Multimodal Diagnostic Imaging System"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-2580-7759","authenticated-orcid":false,"given":"George","family":"Papaioannou","sequence":"first","affiliation":[{"name":"New Bedford Research & Robotics, Downtown New Bedford, New Bedford, MA 02740, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christos","family":"Mitrogiannis","sequence":"additional","affiliation":[{"name":"New Bedford Research & Robotics, Downtown New Bedford, New Bedford, MA 02740, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Schweitzer","sequence":"additional","affiliation":[{"name":"Office of the Vice President of Health Affairs, School of Medicine, Wayne State University, 1241 Scott Hall, 540 E. Canfield, Detroit, MI 48201, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4291-5327","authenticated-orcid":false,"given":"Nikolaos","family":"Michailidis","sequence":"additional","affiliation":[{"name":"School of Mechanical Engineering, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2991-7456","authenticated-orcid":false,"given":"Maria","family":"Pappa","sequence":"additional","affiliation":[{"name":"School of Mechanical Engineering, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3497-2820","authenticated-orcid":false,"given":"Pegah","family":"Khosravi","sequence":"additional","affiliation":[{"name":"Biomedical AI, New York City College of Technology, Graduate Center, CUNY, 285 Jay Street, Brooklyn, NY 11201, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0927-2403","authenticated-orcid":false,"given":"Apostolos","family":"Karantanas","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging, University Hospital, 71500 Heraklion, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sean","family":"Starling","sequence":"additional","affiliation":[{"name":"Level 1, Meat and Livestock Australia, 40 Mount Street, P.O. Box 1961, North Sydney, NSW 2059, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Ruberg","sequence":"additional","affiliation":[{"name":"Level 1, Meat and Livestock Australia, 40 Mount Street, P.O. Box 1961, North Sydney, NSW 2059, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,7]]},"reference":[{"key":"ref_1","unstructured":"(2025, April 03). O-am Surgical Imaging System. Available online: https:\/\/europe.medtronic.com."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2078","DOI":"10.1001\/archinternmed.2009.427","article-title":"Radiation dose associated with common computed tomography examinations and the associated lifetime attributable risk of cancer","volume":"169","author":"Lipson","year":"2009","journal-title":"Arch. Intern. Med."},{"key":"ref_3","unstructured":"National Cancer Institute (2025, April 03). Radiation Risks and Pediatric Computed Tomography (CT): A Guide for Health Care Providers, Available online: https:\/\/www.cancer.gov\/about-cancer\/causesprevention\/risk\/radiation\/pediatric-ct-scans."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1093\/rpd\/ncr149","article-title":"Comparison of operator radiation exposure between c-arm and o-arm fluoroscopy for orthopaedic surgery","volume":"148","author":"Park","year":"2012","journal-title":"Radiat. Prot. Dosim."},{"key":"ref_5","first-page":"1315","article-title":"Estimating Effective Dose to Pediatric Patients Undergoing Interventional Radiology Procedures Using Anthropomorphic Phantoms and MOSFET Dosimeters","volume":"194","author":"Miksys","year":"2010","journal-title":"Med. Phys. Inform."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Teubner, U., and Br\u00fcckner, H.J. (2024). Characterization of imaging systems. Optical Imaging and Photography, De Gruyter.","DOI":"10.1515\/9783110789966"},{"key":"ref_7","unstructured":"American Association of Physicists in Medicine (1993). Specification and Acceptance Testing of Computed, Tomography Scanners, AAPM. Report No. 39."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Ng, C.K.C. (2022). Artificial Intelligence for Radiation Dose Optimization in Pediatric Radiology: A Systematic Review. Children, 9.","DOI":"10.3390\/children9071044"},{"key":"ref_9","first-page":"e63016","article-title":"Enhancing Radiological Diagnosis: A Comprehensive Review of Image Quality Assessment and Optimization Strategies","volume":"16","author":"Varghese","year":"2024","journal-title":"Cureus"},{"key":"ref_10","unstructured":"Zarembo, A. (2025, April 03). Cedars-Sinai Radiation Overdoses Went Unseen at Several Points. LA Times, 14 October 2010. Available online: http:\/\/articles.latimes.com\/2009\/oct\/14\/local\/me-cedars-sinai14."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1148\/radiol.2021211241","article-title":"U.S. Diagnostic Reference Levels and Achievable Doses for 10 Pediatric CT Examinations","volume":"302","author":"Kanal","year":"2022","journal-title":"Radiology"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1431","DOI":"10.1161\/STROKEAHA.110.583815","article-title":"The \u201cGolden Hour\u201d and Acute Brain Ischemia Presenting Features and Lytic Therapy in >30 000 Patients Arriving Within 60 Minutes of Stroke Onset","volume":"41","author":"Saver","year":"2010","journal-title":"Stroke"},{"key":"ref_13","first-page":"734506","article-title":"Pediatric Stroke: A Review","volume":"1","author":"Tsze","year":"2011","journal-title":"Emerg. Med. Int."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Tabarki, B. (2021). Inherited Metabolic Causes of Stroke in Children: Mechanisms, Types, and Management. Front. Neurol., 12.","DOI":"10.3389\/fneur.2021.633119"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1016\/S1474-4422(14)70227-3","article-title":"Pediatric stroke: Pressing issues and promising directions","volume":"14","author":"Kirton","year":"2015","journal-title":"Lancet Neurol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"4972","DOI":"10.1120\/jacmp.v16i2.4972","article-title":"CT image quality over time: Comparison of image quality for six different CT scanners over a six-year period","volume":"16","author":"Roa","year":"2015","journal-title":"J. Appl. Clin. Med. Phys."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e735","DOI":"10.1002\/mp.13763","article-title":"Performance evaluation of computed tomography systems: Summary of AAPM Task Group 233","volume":"46","author":"Samei","year":"2019","journal-title":"Med. Phys."},{"key":"ref_18","first-page":"118","article-title":"Radiation dose in pediatric computed tomography: Risks and benefits","volume":"8","author":"Ogbole","year":"2010","journal-title":"Ann. Ib. Postgrad. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1038\/s41390-022-02063-2","article-title":"Neuromonitoring, neuroimaging, and neurodevelopmental follow-up practices in neonatal congenital heart disease: A European survey","volume":"93","author":"Feldmann","year":"2023","journal-title":"Pediatr. Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e223088","DOI":"10.1148\/radiol.223088","article-title":"Photon-counting versus Dual-Source CT of Congenital Heart Defects in Neonates and Infants: Initial Experience","volume":"307","author":"Dirrichs","year":"2023","journal-title":"Radiology"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"951","DOI":"10.1542\/peds.112.4.951","article-title":"Computed tomography and radiation risks: What pediatric health care providers should know","volume":"112","author":"Frush","year":"2003","journal-title":"Pediatrics"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"359","DOI":"10.4103\/0971-3026.169466","article-title":"Problems and preferences in pediatric imaging","volume":"25","author":"Thukral","year":"2015","journal-title":"Indian J. Radiol. Imaging"},{"key":"ref_23","unstructured":"American College of Radiology, ACR Appropriateness Criteria (2018, December 28). Radiation Dose Assessment Introduction. Available online: https:\/\/www.acr.org."},{"key":"ref_24","unstructured":"(2024, August 09). World Health Organisation, The WHO Child Growth Standards. Available online: https:\/\/www.who.int\/childgrowth\/standards\/en\/."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Ng, C.K.C. (2023). Generative Adversarial Network (Generative Artificial Intelligence) in Pediatric Radiology: A Systematic Review. Children, 10.","DOI":"10.3390\/children10081372"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1177\/0146645317717209","article-title":"ICRP Publication 135: Diagnostic Reference Levels in Medical Imaging","volume":"46","author":"Miller","year":"2017","journal-title":"Ann. ICRP"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Huang, X., Cheng, Z., Xu, Y., Xia, L., Zhan, Z., Xu, T., Cao, Y., and Han, Z. (2021). Associations of Clinical Characteristics and Etiology With Death in Hospitalized Chinese Children After Spontaneous Intracerebral Hemorrhage: A Single-Center, Retrospective Cohort Study. Front. Pediatr., 8.","DOI":"10.3389\/fped.2020.576077"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1111\/j.1460-9592.2006.02097.x","article-title":"Pediatric anesthesia\u2014Potential risks and their assessment: Part I","volume":"17","author":"Habre","year":"2007","journal-title":"Paediatr. Anaesth."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Matthes, K., Laubach, A.E., Wang, E., and Anderson, T.A. (2015). Pediatric Anesthesiology: A Comprehensive Board Review, Oxford University Press.","DOI":"10.1093\/med\/9780199398348.001.0001"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1161\/CIRCULATIONAHA.110.958405","article-title":"European Surveillance of Congenital Anomalies (EUROCAT) Working Group. Congenital heart defects in Europe: Prevalence and perinatal mortality, 2000 to 2005","volume":"123","author":"Dolk","year":"2011","journal-title":"Circulation"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1143","DOI":"10.1161\/CIR.0b013e318265ee8a","article-title":"American Heart Association Congenital Heart Defects Committee, Council on Cardiovascular Disease in the Young, Council on Cardiovascular Nursing, and Stroke Council. Neurodevelopmental outcomes in children with congenital heart disease: Evaluation and management: A scientific statement from the American Heart Association","volume":"126","author":"Marino","year":"2012","journal-title":"Circulation"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/j.clp.2015.11.012","article-title":"Neurodevelopmental outcomes of the child with congenital heart disease","volume":"43","author":"Atal","year":"2016","journal-title":"Clin. Perinatol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1007\/s00431-021-04212-x","article-title":"Acute ischemic stroke in childhood: A comprehensive review","volume":"181","author":"Mastrangelo","year":"2022","journal-title":"Eur. J. Pediatr."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1038\/s41566-023-01207-y","article-title":"Stable perovskite single-crystal X-ray imaging detectors with single-photon sensitivity","volume":"17","author":"Sakhatskyi","year":"2023","journal-title":"Nat. Photon."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"14006","DOI":"10.1021\/acsami.4c00232","article-title":"High-Performance Flat-Panel Perovskite X-ray Detectors Enabled by Defect Passivation in Ruddlesden-Popper Perovskites","volume":"16","author":"Lu","year":"2024","journal-title":"ACS Appl. Mater. Interfaces"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1109\/42.929617","article-title":"In vivo measurement of 3-D skeletal kinematics from sequences of biplane radiographs: Application to knee kinematics","volume":"20","author":"You","year":"2001","journal-title":"IEEE Trans. Med. Imaging"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Dilmanian, F.A., Krishnan, S., McLaughlin, W.E., Lukaniec, B., Baker, J.T., Ailawadi, S., Hirsch, K.N., Cattell, R.F., Roy, R., and Helfer, J. (2019). Merging Orthovoltage X-Ray Minibeams spare the proximal tissues while producing a solid beam at the target. Sci. Rep., 9.","DOI":"10.1038\/s41598-018-37733-x"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"2633","DOI":"10.1016\/j.jbiomech.2008.06.027","article-title":"Patient-specific knee joint finite element model validation with high-accuracy kinematics from biplane dynamic Roentgen stereogrammetric analysis","volume":"41","author":"Papaioannou","year":"2008","journal-title":"J. Biomech."},{"key":"ref_39","first-page":"41","article-title":"An Improved Tracking Technique for assessment of high-Resolution Dynamic Radiography kinematics","volume":"8","author":"Papaioannou","year":"2008","journal-title":"Comput. Model. Eng. Sci. (CMES)"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"43","DOI":"10.3892\/ijo.2020.5063","article-title":"Artificial intelligence radiogenomics for advancing precision and effectiveness in oncologic care (Review)","volume":"57","author":"Trivizakis","year":"2020","journal-title":"Int. J. Oncol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1016\/j.jbiomech.2013.09.022","article-title":"Evaluation of automated statistical shape model based knee kinematics from biplane fluoroscopy","volume":"47","author":"Baka","year":"2014","journal-title":"J. Biomech."},{"key":"ref_42","unstructured":"Torres, J.J.C., Mitrogiannis, C., Nianios, G., and Papaioannou, G. (2013, January 26\u201329). Comparison between Computed Tomography-based amputee geometry and standard geometry measures of socket fit. Proceedings of the Annual Meeting of the Orthopedic Research Society, San Antonio, TX, USA."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.knee.2009.05.001","article-title":"Predicting the effects of knee focal articular surface injury with a patient- specific finite element model","volume":"17","author":"Papaioannou","year":"2010","journal-title":"Knee"},{"key":"ref_44","unstructured":"Tavares, M.R.S., and Natal Jorge, R.M. (2011). Dynamic radiography imaging as a tool in the design and validation of a novel intelligent amputee socket. Computational Vision & Medical Image, Springer. [1st ed.]."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1016\/j.jbiomech.2009.11.013","article-title":"Assessment of amputee socket-stump-residual bone kinematics during strenuous activities using Dynamic Roentgen Stereogrammetric Analysis","volume":"43","author":"Papaioannou","year":"2010","journal-title":"J. Biomech."},{"key":"ref_46","unstructured":"Papaioannou, G. (2024). Method for the Control of Collimation, Penumbra, Dynamic Exposure, and Dosage in a Number of Robotics-driven 2D Radiology and 3D Computer Tomography and Other Multimodality Imaging. (#2013,010,0822), Patent."},{"key":"ref_47","unstructured":"Papaioannou, G., and Bafas, C. (2023, January 15\u201318). Robotics-driven two, three and four dimensional imaging enhances dosage and image resolution for a number of diagnostic modalities. Proceedings of the Invited Paper at 12th Scientific Conference of the Medical School of Aristotle University of Thessaloniki, Thessaloniki, Greece."},{"key":"ref_48","first-page":"66","article-title":"Tracking high speed arthrokinematics using a new and high resolution Biplane Dynamic Roentgen Stereogrammetric method","volume":"2","author":"Papaioannou","year":"2009","journal-title":"Int. J. Imaging Robot."},{"key":"ref_49","unstructured":"Papaioannou, G. (2024, January 18\u201324). A Robotics-driven Multimodal Imaging System for Quality Inspection. Proceedings of the Plenary Technical Invited Talk and Paper at the 73rd College International pour la Recherche en Productique (CIRP) General Assembly in Thessaloniki, Thessaloniki, Greece."},{"key":"ref_50","unstructured":"(2018, August 05). ANSA BETA CAE Systems, Lucerne, Switzerland. Available online: https:\/\/www.beta-cae.com\/."},{"key":"ref_51","unstructured":"(2024). KINEMAGINE-Achilles Robotic Imaging System, Brochure and KINEDOSE Operating Manual, ATLAS Robotics. Available online: https:\/\/atlasimaging.eu\/."},{"key":"ref_52","unstructured":"(2019, January 21). 3DNet Medical Cloud. Biotronics 3D Inc.: Boston, MA, USA. Available online: https:\/\/www.3dnetmedical.com\/public\/."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1433","DOI":"10.1088\/0031-9155\/58\/5\/1433","article-title":"To bin or not to bin? The effect of CT system limiting resolution on noise and detectability","volume":"58","author":"Baek","year":"2013","journal-title":"Phys. Med. Biol."}],"container-title":["Journal of Imaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2313-433X\/11\/5\/147\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:28:27Z","timestamp":1760030907000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2313-433X\/11\/5\/147"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,7]]},"references-count":53,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,5]]}},"alternative-id":["jimaging11050147"],"URL":"https:\/\/doi.org\/10.3390\/jimaging11050147","relation":{},"ISSN":["2313-433X"],"issn-type":[{"type":"electronic","value":"2313-433X"}],"subject":[],"published":{"date-parts":[[2025,5,7]]}}}