Volume CT with a flat‐panel detector on a mobile, isocentric C‐arm: Pre‐clinical investigation in guidance of minimally invasive surgery

Siewerdsen, Jeffrey H.; Moseley, D; Burch, Sandra E.; Bisland, Stuart K.; Bogaards, Arjen; Wilson, Brian C.; Jaffray, David A.

doi:10.1118/1.1836331

Cited by 283 publications

(222 citation statements)

References 56 publications

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“…Both the use of an anti-scatter grid and of scatter correction algorithms yield a more homogeneous display and improved CT value accuracy. Nevertheless, the use of anti-scatter grids is not generally accepted [10], since their employment results in a dose penalty. An increase of mA values is necessary to make up for their absorption of primary photons.…”

Section: Dose Considerationsmentioning

confidence: 99%

“…An increase of mA values is necessary to make up for their absorption of primary photons. The use of anti-scatter grids in FD-CT is generally considered beneficial in the case of large objects since these are accompanied by high scatter fractions [10].…”

Section: Dose Considerationsmentioning

confidence: 99%

“…Modern C-arm CT systems presently find rapid acceptance since they offer improved image quality, versatility and dedicated applications for planning, guiding, monitoring and assessing interventional procedures [5][6][7][8][9][10][11][12]. These are above all their use in interventional procedures and in intra-operative imaging.…”

Section: Introductionmentioning

confidence: 99%

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Flat-detector computed tomography (FD-CT)

2007

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Flat-panel detectors or, synonymously, flat detectors (FDs) have been developed for use in radiography and fluoroscopy with the defined goal to replace standard X-ray film, filmscreen combinations and image intensifiers by an advanced sensor system. FD technology in comparison to X-ray film and image intensifiers offers higher dynamic range, dose reduction, fast digital readout and the possibility for dynamic acquisitions of image series, yet keeping to a compact design. It appeared logical to employ FD designs also for computed tomography (CT) imaging. Respective efforts date back a few years only, but FD-CT has meanwhile become widely accepted for interventional and intraoperative imaging using C-arm systems. FD-CT provides a very efficient way of combining two-dimensional (2D) radiographic or fluoroscopic and 3D CT imaging. In addition, FD technology made its way into a number of dedicated CT scanner developments, such as scanners for the maxillo-facial region or for micro-CT applications. This review focuses on technical and performance issues of FD technology and its full range of applications for CT imaging. A comparison with standard clinical CT is of primary interest. It reveals that FD-CT provides higher spatial resolution, but encompasses a number of disadvantages, such as lower dose efficiency, smaller field of view and lower temporal resolution. FD-CT is not aimed at challenging standard clinical CT as regards to the typical diagnostic examinations; but it has already proven unique for a number of dedicated CT applications, offering distinct practical advantages, above all the availability of immediate CT imaging in the interventional suite or the operating room.

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Section: Dose Considerationsmentioning

confidence: 99%

Section: Dose Considerationsmentioning

confidence: 99%

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Flat-detector computed tomography (FD-CT)

2007

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“…Comparatively low dosing requirements and a relatively compact design have also led to intense interest in surgical planning and intraoperative CBCT applications, particularly in the head and neck but also in spinal, thoracic, abdominal, and orthopedic procedures. [7][8][9][10][11] Diagnostic applications in CT mammography and head and neck imaging are also under evaluation. [12][13][14] The technical and clinical considerations pertaining to CBCT imaging in many of these applications have been the subjects of several recent reviews.…”

Section: Onebeam Ct (Cbct) Is An Advancement In Ct Imagingmentioning

confidence: 99%

Conebeam CT of the Head and Neck, Part 2: Clinical Applications

Miracle¹,

Mukherji²

2009

AJNR Am J Neuroradiol

301

207

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SUMMARY: Conebeam x-ray CT (CBCT) is being increasingly used for point-of-service head and neck and dentomaxillofacial imaging. This technique provides relatively high isotropic spatial resolution of osseous structures with a reduced radiation dose compared with conventional CT scans. In this second installment in a 2-part review, the clinical applications in the dentomaxillofacial and head and neck regions will be explored, with particular emphasis on diagnostic imaging of the sinuses, temporal bone, and craniofacial structures. Several controversies surrounding the emergence of CBCT technology will also be addressed. C onebeam CT (CBCT) is an advancement in CT imagingthat has begun to emerge as a potentially low-dose crosssectional technique for visualizing bony structures in the head and neck. The physical principles, image quality parameters, and technical limitations relevant to CBCT imaging were discussed in Part 1 of this 2-part series. The second part presented here will highlight the evidence related to CBCT applications in head and neck as well as dentomaxillofacial imaging. Controversial aspects of this technology will also be addressed, including limitations in image quality and its often officebased operational model.CBCT was first adapted for potential clinical use in 1982 at the Mayo Clinic Biodynamics Research Laboratory. 1 Initial interest focused primarily on applications in angiography in which soft-tissue resolution could be sacrificed in favor of high temporal and spatial-resolving capabilities. Since that time, several CBCT systems have been developed for use both in the interventional suite and for general applications in CT angiography. 2,3 Exploration of CBCT technologies for use in radiation therapy guidance began in 1992, 4,5 followed by integration of the first CBCT imaging system into the gantry of a linear accelerator in 1999. 6 The first CBCT system became commercially available for dentomaxillofacial imaging in 2001 (NewTom QR DVT 9000; Quantitative Radiology, Verona, Italy). Comparatively low dosing requirements and a relatively compact design have also led to intense interest in surgical planning and intraoperative CBCT applications, particularly in the head and neck but also in spinal, thoracic, abdominal, and orthopedic procedures. [7][8][9][10][11] Diagnostic applications in CT mammography and head and neck imaging are also under evaluation. 12-14 The technical and clinical considerations pertaining to CBCT imaging in many of these applications have been the subjects of several recent reviews. [15][16][17][18][19] The recent review by Dörfler et al 16 of the neurointerventional applications of CBCT is of particular interest to the field of neuroradiology.The discussion below will focus on the diagnostic and treatment-planning applications of CBCT in dentomaxillofacial and head and neck imaging. Commercially available CBCT systems for dentomaxillofacial imaging include the CB MercuRay and CB Throne (Hitachi Medical, Kashiwi-shi, Chiba-ken, Japan), 3D Accuitomo products (J. Mor...

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“…A further development of the well-established mobile Carm devices, referred to as isocentric C-arm, integrates a flat panel [106] and has the ability to acquire a small 3D volume of 20 x 20 x 15 cm 3 in cone-beam CT imaging quality within 32 seconds [31]. Recently, Feuerstein et al introduced a laparoscopic navigation system, which combines the isocentric C-arm and optical tracking [31].…”

Section: Current Approaches For Soft Tissue Navigation In Endoscmentioning

confidence: 99%

Navigation in Endoscopic Soft Tissue Surgery: Perspectives and Limitations

Baumhauer

Feuerstein

Meinzer

et al. 2008

Journal of Endourology

163

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Abstract-Despite rapid developments in the research areas medical imaging, medical image processing and robotics, the use of computer assistance in surgical routine is still limited to diagnostics, surgical planning, and interventions on mostly rigid structures. In order to establish a computer aided workflow from diagnosis to surgical treatment and follow-up, several proposals for computer assisted soft tissue interventions have been made in recent years. By means of different pre-and intraoperative information sources, like surgical plannings, intraoperative imaging, and tracking devices, surgical navigation systems aim at supporting surgeons in localizing anatomical targets, observing critical structures, and sparing healthy tissue. Current research in particular addresses the problem of organ shift and tissue deformation, and obstacles in communication between navigation system and surgeon.In this article, we review computer assisted navigation systems for soft tissue surgery. We concentrate on approaches which can be applied in endoscopic thoracic and abdominal surgery, as endoscopic surgery has special needs for image guidance due to limitations in perception. Furthermore, this article provides the reader with new trends and technologies in the area of computer assisted surgery. Finally, a balancing of key challenges and possible benefits of endoscopic navigation refines the perspectives of this increasingly important discipline of computer aided medical procedures.

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Volume CT with a flat‐panel detector on a mobile, isocentric C‐arm: Pre‐clinical investigation in guidance of minimally invasive surgery

Cited by 283 publications

References 56 publications

Flat-detector computed tomography (FD-CT)

Flat-detector computed tomography (FD-CT)

Conebeam CT of the Head and Neck, Part 2: Clinical Applications

Navigation in Endoscopic Soft Tissue Surgery: Perspectives and Limitations

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