Emerging technologyThree-Dimensional C-arm Cone-beam CT: Applications in the Interventional Suite
Section snippets
Early Reported Clinical Experience
Reports of the use of C-arm cone-beam CT are beginning to emerge in the medical literature, with early case reports of its advantages coming from its use for neurologic interventions. For example, Heran and coworkers (2) used C-arm cone-beam CT to detect intracranial hemorrhages during three neurologic interventions, and Benndorf and coworkers (3, 4) used C-arm cone-beam CT to improve the visualization of intracranial and extracranial stents in four patients. In the study by Benndorf et al (4)
General Considerations
Potential vascular applications of C-arm cone-beam CT include its use for preprocedure anatomic diagnosis and treatment planning, intraprocedure device or implant positioning assessment, and postprocedure assessment of procedure endpoints. Most of these applications require the use of iodinated contrast medium to opacify the vascular system and make its corresponding soft tissue structures opaque. However, the acquisition of implant devices (eg, stents, stent-grafts, and stent filters) to
Spine Interventions
Fluoroscopic guidance, used alone to provide a real-time overview of a large area, usually provides sufficient information to guide appropriate needle placement for the injection of cement in lower thoracic or lumbar spine interventions. However, both C-arm cone-beam and conventional CT can be helpful in difficult spine procedures by revealing, in more detail than fluoroscopy, areas suitable for safe needle placement; C-arm cone-beam CT provides exact needle locations in three dimensions.
Technical Issues
The set-up time required for C-arm cone-beam CT image acquisition can range from 5 to 10 minutes, depending on the experience of the team and the frequency of C-arm cone-beam CT use. This time interval, the main impediment to integrating C-arm cone-beam CT into routine clinical practice, includes the time required to position the patient, examination table, and C-arm so that the area of interest is in the isocenter; the time required to prepare contrast media (eg, contrast medium dilution), if
References (13)
- et al.
Comparison of flat-panel detector and image-intensifier detector for cone-beam CT
Comput Med Imaging Graph
(2002) - et al.
Translumbar type II endoleak repair using angiographic CT
J Vasc Interv Radiol
(2006) - et al.
Adjunctive use of C-arm CT may eliminate technical failure in adrenal vein sampling
J Vasc Interv Radiol
(2007) - et al.
Impact of C-arm CT on hepatic arterial interventions for hepatic malignancies
J Vasc Interv Radiol
(2007) - et al.
Angiographic considerations in patients undergoing liver-directed therapy
J Vasc Interv Radiol
(2005) - et al.
The utility of DynaCT in neuroendovascular procedures
AJNR Am J Neuroradiol
(2006)
Cited by (163)
TIME-Net: Transformer-Integrated Multi-Encoder Network for limited-angle artifact removal in dual-energy CBCT
2023, Medical Image AnalysisCitation Excerpt :And the interest in applying the dual-energy technique to optimize radiotherapy also is increasing as DECT imaging has gained widespread acceptance in the diagnostic radiology community (Van Elmpt et al., 2016). On the other hand, cone-beam computed tomography (CBCT) is an effective imaging modality using the flat-panel detector and has been widely utilized in clinical practice, including dentistry (Kiljunen et al., 2015), radiotherapy (Jaffray et al., 2002) and interventions (Wallace et al., 2008). However, the x-ray scattering and beam hardening may lead to image inhomogeneity, compromising the visibility of soft tissues and the accuracy of CT numbers.
Percutaneous kidney stone surgery and radiation exposure: A review
2020, Asian Journal of UrologyCitation Excerpt :Cone beam CT (CBCT) is a novel C-arm that capable of obtaining both FL images and CT scans intra-operatively. The next systems are available on the market for clinical use: DynaCT (Siemens Medical Solutions, Forchheim, Germany), XperCT (Philips Medical Systems, Eindhoven, the Netherlands), and Innova CT (GE Healthcare, Waukesha, Wisconsin, USA) [22]. In 2012 Roy et al. [23] reported their retrospective study of 52 patients in whom PCA was done using CBCT (UroDyna, Siemens).
Optimization of X-ray image acquisition and reconstruction for a C-arm CBCT system with a flat-panel detector
2019, Nuclear Instruments and Methods in Physics Research, Section A: Accelerators, Spectrometers, Detectors and Associated EquipmentSuper Resolution Dual-Energy Cone-Beam CT Imaging with Dual-Layer Flat-Panel Detector
2024, IEEE Transactions on Medical Imaging
M.J.W. received an honorarium for speaking and grant support from Siemens Medical Solutions.