Design and optimization of a dedicated cone-beam CT system for musculoskeletal extremities imaging

W. Zbijewski, P. De Jean, P. Prakash, Y. Ding, J. W. Stayman, N. Packard, R. Senn, D. Yang, J. Yorkston, A. MacHado, J. A. Carrino, J. H. Siewerdsen

Research output: Chapter in Book/Report/Conference proceedingConference contribution

6 Scopus citations


The design, initial imaging performance, and model-based optimization of a dedicated cone-beam CT (CBCT) scanner for musculoskeletal extremities is presented. The system offers a compact scanner that complements conventional CT and MR by providing sub-mm isotropic spatial resolution, the ability to image weight-bearing extremities, and the capability for integrated real-time fluoroscopy and digital radiography. The scanner employs a flat-panel detector and a fixed anode x-ray source and has a field of view of ∼ (20×20×20) cm3. The gantry allows a "standing" configuration for imaging of weight-bearing lower extremities and a "sitting" configuration for imaging of upper extremities and unloaded lower extremities. Cascaded systems analysis guided the selection of x-ray technique (e.g., kVp, filtration, and dose) and system design (e.g., magnification factor), yielding input-quantum-limited performance at detector signal of 100 times the electronic noise, while maintaining patient dose below 5 mGy (a factor of ∼2-3 less than conventional CT). A magnification of 1.3 optimized tradeoffs between source and detector blur for a 0.5 mm focal spot. A custom antiscatter grid demonstrated significant reduction of artifacts without loss of contrast-to-noise ratio or increase in dose. Image quality in cadaveric specimens was assessed on a CBCT bench, demonstrating exquisite bone detail, visualization of intra-articular morphology, and soft-tissue visibility approaching that of diagnostic CT. The capability to image loaded extremities and conduct multi-modality CBCT/fluoroscopy with improved workflow compared to whole-body CT could be of value in a broad spectrum of applications, including orthopaedics, rheumatology, surgical planning, and treatment assessment. A clinical prototype has been constructed for deployment in pilot study trials.

Original languageEnglish (US)
Title of host publicationMedical Imaging 2011
Subtitle of host publicationPhysics of Medical Imaging
StatePublished - 2011
EventMedical Imaging 2011: Physics of Medical Imaging - Lake Buena Vista, FL, United States
Duration: Feb 13 2011Feb 17 2011

Publication series

NameProgress in Biomedical Optics and Imaging - Proceedings of SPIE
ISSN (Print)1605-7422


OtherMedical Imaging 2011: Physics of Medical Imaging
Country/TerritoryUnited States
CityLake Buena Vista, FL


  • cascaded system analysis
  • cone-beam CT
  • extremities imaging
  • flat-panel detector
  • musculoskeletal radiology
  • orthopaedics
  • rheumatology
  • system optimization

ASJC Scopus subject areas

  • Electronic, Optical and Magnetic Materials
  • Atomic and Molecular Physics, and Optics
  • Radiology Nuclear Medicine and imaging
  • Biomaterials


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