Clinical Application of a Low-Dose CBCT AI Model

Low-dose AI-reconstructed CBCT Versus Full-dose CBCT for Guidance of Interventional Procedures: a Multicenter Randomized Controlled Trial

Cone Beam CT (CBCT) is an imaging modality used in interventional digital subtraction angiography (DSA). It produces three-dimensional images via cone-beam X-ray scanning and computer reconstruction. Clinically, CBCT guides puncture for pulmonary and hepatic lesions and evaluates post-intervention outcomes in liver cancer and cerebrovascular diseases. However, CBCT-guided interventions carry high patient radiation exposure; dose reduction often degrades image quality and impairs procedural results. Studies report that each 100 mGy radiation increment elevates cancer risk by 1.96-fold.

Artificial intelligence enables low-dose CBCT. Our prior DeepPriorCBCT model embedded anatomical priors using neural discrete representation learning, reducing thoracic CBCT dose to one-sixth of routine protocols while preserving image quality. We further developed DeepPriorCBCT-V2 using 55 000 pre-reconstruction CBCT datasets covering brain, thorax and abdomen. This multi-organ model maintains image quality at one-sixth standard radiation dose. Nevertheless, its real-world clinical performance remains unvalidated. We therefore designed this prospective multicenter randomized controlled trial to evaluate the clinical applicability of DeepPriorCBCT-V2.

Study Overview

Study Type

Interventional

Enrollment (Estimated)

1380

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

    • Anhui
      • Hefei, Anhui, China
        • Recruiting
        • The First Affiliated Hospital of University of Science and Technology of China
        • Contact:
    • Hubei
      • Wuhan, Hubei, China, 430022
        • Recruiting
        • Wuhan Union Hospital
        • Contact:
      • Wuhan, Hubei, China, 430022
        • Recruiting
        • Wuhan Union West Hospital
        • Contact:
      • Wuhan, Hubei, China, 430022
        • Recruiting
        • Wuhan Union Jinyin Lake Hospital
        • Contact:
    • Jiangsu
      • Nanjing, Jiangsu, China
        • Recruiting
        • Zhongda Hospital, Medical School, Southeast University
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Age ≥18 years.

    • Requires CBCT-guided interventional treatment or surgery (e.g., cerebral angiography, lung puncture biopsy, hepatic artery chemoembolization, or percutaneous liver biopsy) and meets operational indications.

      • Can understand the study's purpose, procedures, potential risks, and benefits, and voluntarily signs a written informed consent form.

Exclusion Criteria:

  • History of high-dose radiation exams or treatments.

    • Known allergies or severe adverse reactions to iodine contrast agents or other relevant medications.

      • Pregnant or breastfeeding women.

        • Severe comorbidities or chronic diseases (e.g., severe diabetes, renal insufficiency).

          • Severe mental illness or cognitive impairment preventing understanding of the study procedures or providing informed consent.

            ⑥ Participants are not suitable for the trial per investigator's opinion.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Prevention
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Triple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Participants will receive interventional procedures guided by DeepPriorCBCT-V2.

Patients underwent interventional procedures guided by CBCT images reconstructed via the DeepPriorCBCT-V2 model from low-radiation-dose scans (1/6 of the conventional dose for the thorax and abdomen, and 1/5 for the brain).

Compared with conventional CBCT-guided interventional procedures and previously reported low-dose CBCT studies, the intervention adopted in the present study has several distinct advantages. First, most existing low-dose CBCT protocols only reduce radiation for a single anatomical region, mainly the thorax, while our DeepPriorCBCT-V2 model achieves stable low-dose reconstruction for the brain, thorax, and abdomen simultaneously, with radiation reduced to 1/6 of the standard clinical level for the thorax and abdomen and 1/5 for the brain. Second, unlike general noise-reduction algorithms used in previous studies, our model embeds anatomical prior information through neural discrete representation learning, which ensures consistent and reliable image quality at extremely low radiation doses without sacrificing intraoperative guidance accuracy. Third, this study is the first prospective multicenter randomized controlled trial to systematically verify the clinical feasibility of multi-orga

Placebo Comparator: Participants will receive interventional procedures guided by clinical standard protocol.

Patients underwent interventional procedures guided by CBCT images reconstructed via clinical standard protocol (full-radiation-dose).

Interventional procedures were performed under the guidance of clinical standard protocol (Full-radiation-dose CBCT).

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Radiation dose
Time Frame: Through study completion, an average of 5 months.

Air Kerma (AK) refers to the sum of the initial kinetic energies transferred from uncharged ionizing radiation (such as X-ray photons) to charged particles in air, divided by the mass of air at that location.

Through study completion, an average of 5 months.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Operation time
Time Frame: Through study completion, an average of 5 months.

The time from the initiation to the completion of the interventional procedure.

Through study completion, an average of 5 months.
Intraoperative complications.
Time Frame: Through study completion, an average of 5 months.

Procedure-related intraprocedural complications.

Through study completion, an average of 5 months.
Post operative complications
Time Frame: Through study completion, an average of 5 months.

Procedure-related complications within 7 days after the interventional procedure.

Through study completion, an average of 5 months.

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
Subjective scoring
Time Frame: Through study completion, an average of 5 months.

Scoring of reconstructed CBCT images was performed by radiologists and interventional physicians using a 5-point Likert scale. The scale was defined as: 1 = very poor image quality; lesions cannot be assessed and the procedure cannot be guided; 2 = poor image quality; lesion assessment and procedure guidance are difficult; 3 = moderate image quality; lesion assessment is relatively difficult, but procedure guidance is feasible; 4 = good image quality; lesions can be assessed and procedure guidance is achievable; 5 = excellent image quality; lesion assessment is not compromised at all and procedure guidance is fully supported.

Through study completion, an average of 5 months.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

August 1, 2026

Primary Completion (Estimated)

November 30, 2026

Study Completion (Estimated)

December 31, 2026

Study Registration Dates

First Submitted

September 21, 2026

First Submitted That Met QC Criteria

September 27, 2026

First Posted (Actual)

September 29, 2026

Study Record Updates

Last Update Posted (Actual)

September 29, 2026

Last Update Submitted That Met QC Criteria

September 27, 2026

Last Verified

September 1, 2026

More Information

Terms related to this study

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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