Evidence map›Paper›PMID 41016018›Full record

ArticleJournal of applied clinical medical physics2025

Evaluation of image quality in mobile cone-beam CT with dose modulation using automatic exposure control: A phantom study.

Keita Okazaki, Wenchao Cao, Reza Taleei, Firas Mourtada, Jun Li, Karen Mooney, Pramila Rani Anne, Yingxuan Chen

Abstract readEvaluation Study
In one paragraph

Article in Journal of applied clinical medical physics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Integration of a mobile robotic cone beam CT scanner in pediatric neurosurgery.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2026
    Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Keita OkazakiDepartment of Radiation Oncology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Wenchao CaoDepartment of Radiation Oncology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Reza TaleeiDepartment of Radiation Oncology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Firas MourtadaDepartment of Radiation Oncology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.ORCID https://orcid.org/0000-0002-4388-5334
Jun LiDepartment of Radiation Oncology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Karen MooneyDepartment of Radiation Oncology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Pramila Rani AnneDepartment of Radiation Oncology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Yingxuan ChenDepartment of Radiation Oncology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.ORCID https://orcid.org/0000-0003-1617-9001

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe integration of mobile cone-beam computed tomography (CBCT) into brachytherapy workflows offers clinical advantages such as immediate verification of applicator placement and adaptive treatment planning. These benefits require sufficient image quality to delineate applicators, target volumes, and organs at risk. A systematic evaluation of automatic exposure control (AEC) settings, radiation dose, and image quality is essential to ensure clinically acceptable imaging while minimizing patient exposure. PURPOSE: This study evaluates the characteristics of AEC and its impact on image quality and radiation dose in a mobile CBCT system used for brachytherapy.

methodsThe Elekta ImagingRing CBCT system was used to scan a CatPhan phantom under two imaging protocols: Medium Dose Limit (MDL) and Ultra-High Dose Limit (UHDL). This system employs a two-layer mAs modulation process, consisting of preset mA values based on body mass index (BMI) and adjusted mA based on real-time AEC. A bolus was used to simulate larger patient sizes. Real-time x-ray tube current at 10 degrees intervals was recorded. Image quality was evaluated using image noise, noise power spectrum (NPS), modulation transfer function (MTF), Hounsfield Unit (HU) linearity, uniformity index (UI), and contrast-to-noise ratio (CNR) across different protocols.

resultsAEC effectively modulated x-ray tube current in the MDL protocol after x-ray attenuation through the scanned phantom was measured. The UHDL protocol demonstrated greater noise reduction than the MDL. MTF values were comparable between protocols, indicating preserved spatial resolution in the MDL protocol. HU linearity was consistent across all protocols, with R

conclusionAEC in mobile CBCT optimized radiation dose and image quality by adjusting tube current based on attenuation. The MDL protocol reduced radiation exposure while maintaining image quality, making it a viable option for verifying applicator placement and treatment planning in brachytherapy. The UHDL protocol achieved noise reduction with the maximum available tube current.

Indexed as

BrachytherapyCone-Beam Computed TomographyImage Processing, Computer-AssistedPhantoms, ImagingRadiotherapy Planning, Computer-AssistedHumansRadiation DosageRadiotherapy Dosageautomatic exposure controlCBCTHDR brachytherapyimage quality

Identifiers

PMID41016018
PMCPMC12476867

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.