Flat-panel conebeam CT in the clinic: history and current state

Abstract

. Research into conebeam CT concepts began as soon as the first clinical single-slice CT scanner was conceived. Early implementations of conebeam CT in the 1980s focused on high-contrast applications where concurrent high resolution ( ), for visualization of small contrast-filled vessels, bones, or teeth, was an imaging requirement that could not be met by the contemporaneous CT scanners. However, the use of nonlinear imagers, e.g., x-ray image intensifiers, limited the clinical utility of the earliest diagnostic conebeam CT systems. The development of consumer-electronics large-area displays provided a technical foundation that was leveraged in the 1990s to first produce large-area digital x-ray detectors for use in radiography and then compact flat panels suitable for high-resolution and high-frame-rate conebeam CT. In this review, we show the concurrent evolution of digital flat panel (DFP) technology and clinical conebeam CT. We give a brief summary of conebeam CT reconstruction, followed by a brief review of the correction approaches for DFP-specific artifacts. The historical development and current status of flat-panel conebeam CT in four clinical areas—breast, fixed C-arm, image-guided radiation therapy, and extremity/head—is presented. Advances in DFP technology over the past two decades have led to improved visualization of high-contrast, high-resolution clinical tasks, and image quality now approaches the soft-tissue contrast resolution that is the standard in clinical CT. Future technical developments in DFPs will enable an even broader range of clinical applications; research in the arena of flat-panel CT shows no signs of slowing down.

Flat‐panel detector CT to assess intracranial hemorrhage immediately following mechanical thrombectomy

“…Thanks to technologies that have been newly developed, the FDCT performance has increased in the past few years; however, the Food and Drug Administration has labeled no FDCT system as a CT capable system. 13…”

Advances in cerebral perfusion imaging techniques in acute ischemic stroke

“…CBCT is a new technology performed with the C‐arm fluoroscopic system that offers three‐dimensional (3D) information on a patient's anatomy and can be used in conjunction with traditional DSA and fluoroscopy during interventional procedures 59 . As traditional DSA has a small dynamic range and low detection rate of low‐contrast tissues, it might not accurately display non‐angiographic procedures involving complicated anatomical relationships 60 .…”

“…CBCT is a new technology performed with the C-arm fluoroscopic system that offers three-dimensional (3D) information on a patient's anatomy and can be used in conjunction with traditional DSA and fluoroscopy during interventional procedures. 59 As traditional DSA has a small dynamic range and low detection rate of low-contrast tissues, it might not accurately display non-angiographic procedures involving complicated anatomical relationships. 60 CBCT could provide morphology characteristics and details about lesions and surrounding tissues by C-arm rotation, acquisition of flat-panel detector, and computer reconstruction, making it a remarkable alternative to traditional DSA due to its higher soft tissue resolution.…”

Residual W-shape network (ResWnet) for dual-energy cone-beam CT imaging

“…Another widely used CT is cone-beam CT (CBCT) [7]. Taking advantages of high spatial resolution, large volume coverage and open structure, CBCT provides flexible image guidance in image-guided radiotherapy [8] and image-guided intervention [9], and the flexible geometry is also well suitable for some dedicated clinical tasks, such as breast CT, extremity CT and dental CT [10].…”