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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.

Studieöversikt

Studietyp

Interventionell

Inskrivning (Beräknad)

1380

Fas

  • Inte tillämpbar

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studiekontakt

Studieorter

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

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

18 år och äldre (Vuxen, Äldre vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Beskrivning

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.

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Förebyggande
  • Tilldelning: Randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Trippel

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: 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-jämförare: 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).

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Radiation dose
Tidsram: 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.

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Operation time
Tidsram: 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.
Tidsram: Through study completion, an average of 5 months.

Procedure-related intraprocedural complications.

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

Andra resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Subjective scoring
Tidsram: 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.

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Faktisk)

1 augusti 2026

Primärt slutförande (Beräknad)

30 november 2026

Avslutad studie (Beräknad)

31 december 2026

Studieregistreringsdatum

Först inskickad

21 september 2026

Först inskickad som uppfyllde QC-kriterierna

27 september 2026

Första postat (Faktisk)

29 september 2026

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

29 september 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

27 september 2026

Senast verifierad

1 september 2026

Mer information

Termer relaterade till denna studie

Plan för individuella deltagardata (IPD)

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Läkemedels- och apparatinformation, studiedokument

Studerar en amerikansk FDA-reglerad läkemedelsprodukt

Nej

Studerar en amerikansk FDA-reglerad produktprodukt

Nej

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