Assessing the impact of a magnetic field generator on fluoroscopic image quality

Many spinal operations are performed using fluoroscopic guidance; however, its efficacy is conditional on accurate needle placement. Image-guided surgical navigation systems allow for intraoperative localization of surgical tools, significantly improving patient outcomes. Electromagnetic navigation systems require a field generator (FG) whose placement must be near the patient and may partially obstruct the x-ray beam, potentially degrading image quality due to x-ray scatter interactions from the FG. This may reduce image contrast, add noise and decrease spatial resolution. These scatter interactions can be assessed in terms of the scatter-to-primary ratio and its effect on image quality can be described using the modulation transfer function and the detective quantum efficiency. This work aims to quantify the effect of the FG on image quality using the aforementioned parameters to ensure minimal deterioration, with the goal to move towards the seamless integration of EM tracking for fluoroscopy-guided interventions.