Early Clinical Experience with a Dedicated Portable Computed Tomography Scanner in a Biplane Neuroangiography Suite: Assessment of Feasibility and Utility in Neurointerventional Practice

Abstract

<jats:p> The ability to have on-site access to cross-sectional imaging in a biplane neuroangiography suite has tremendous potential for enhancing current neurointerventional practice. Although a few prototypical multimodality suites have been created, several problems/limitations have prevented widespread implementation. Recently, a portable CT scanner has been developed, which may overcome previous shortcomings. We review our recent clinical experience with this new modality, exploring numerous adjunctive diagnostic and therapeutic applications. Forty-one patients underwent periprocedural CT using the Tomoscan M/EG portable CT (Philips). The portable CT scanner is kept at the “head-end” of the biplane neuroangiography suite, being moved into position as needed before, after, or during a procedure. A pivoting angiographic table permits excellent z-plane mobility for rapid gantry to fluoroscopy positioning. Five mm slices at five mm increments were obtained. </jats:p><jats:p> High quality images were obtained in all cases. The portable CT scanner could be quickly positioned and activated within five min. Total scanning time for a typical case, including initial positioning and set-up was 10–12 min. Twelve of 41 cases were performed adjunctively during diagnostic angiography; 29/41 were performed in an interventional setting. Twenty of 29 scan evaluated baseline or post-therapeutic status of the brain (e.g., Guglielmi detachable coil aneurysm obliteration, arteriovenous malformation (AVM) embolisation, local thrombolysis); 9/29 provided cross-sectional guidance to various interventions (direct puncture embolisation, percutaneous vertebroplasty, spinal biopsy, discography). </jats:p><jats:p> Use of the portable CT scanner permitted rapidly accessible high quality cross sectional imaging within the biplane neuroangiography suite, which augmented diagnostic and therapeutic decision-making, and therapeutic intervention. </jats:p>