Digital flat-panel detector cone-beam computed tomography has recently been adapted for use with C-arm systems. This configuration provides projection radiography, fluoroscopy, digital subtraction angiography, and volumetric computed tomography capabilities in a single patient setup, within the interventional suite. Such capabilities allow the interventionalist to perform intra-procedural volumetric imaging without the need for transporting the patient Proper use of this new cone-beam technology requires an understanding of both its advantages and limitations.
Image-guided surgery is widely used, which provides surgeons a way to navigate through the body. With the application of C-arm cone-beam CT it makes intra-operative, 3-dimensional navigation a reality. There are now available intra-operative navigation systems using 3D C-arm cone-beam CT and optical tracking system based on open source software toolkits. An automatic registration method which simplifies the surgery procedure is used to replace the conventional landmarks-based rigid registration method. In order to transmit and manage images automatically, a DICOM image transmission service is developed. Compared with traditional navigation systems, the cone-beam system is more automatic and easier to operate.
C-arm cone-beam computed tomography (CT) with a flat-panel detector represents the next generation of imaging technology available in the interventional radiology suite and is predicted to be the platform for many of the three-dimensional (3D) road-mapping and navigational tools that will emerge in parallel with its integration. The combination of current and unappreciated capabilities may be the foundation on which improvements in both safety and effectiveness of complex vascular and nonvascular interventional procedures become possible. These improvements include multi-planar soft tissue imaging, enhanced pretreatment target lesion road-mapping and guidance, and the ability for immediate multi-planar, post-treatment assessment. These key features alone may translate to a reduction in the use of iodinated contrast media, a decrease in the radiation dose to the patient and operator, and an increase in the therapeutic index. In routine practice, imaging information obtained with C-arm cone-beam CT provides a subjective level of confidence factor to the operator that has not yet been thoroughly quantified.
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