Mobile Computed Tomography : Early Experience in Korea

Abstract

Objective : With improved technology, the values of intraoperative computed tomography (iCT) have been reevaluated. We describe our early clinical experience with a mobile CT (mCT) system for iCT and discuss its clinical applications, advantages and limitations. Methods : Compared with intraoperative magnetic resonance imaging, this mCT system has no need for major reconstruction of a preexisting operating room for shielding, or for specialized instruments or equipment. Patients are placed on a radiolucent head clamp that fits within the gantry. Because it consists simply of a scanner and a workstation, it can be moved between locations such as an operating room, an intensive care unit (ICU) or an emergency room without difficulty. Furthermore, it can achieve nearly all types of CT scanning procedures such as enhancement, temporal bone imaging, angiography and three-dimensional reconstruction. Results : For intracranial surgery, mCT can be used for intraoperative real-time neuronavigation by interacting with preoperative images. It can also be used for intraoperative confirmation of the extent of resection of intracranial lesions and for immediate checks for preventing intraoperative unexpected accidents. Therefore, the goals of maximal resection or optimal treatment can be achieved without any guesswork. Furthermore, mCT can achieve improved patient care with safety and faster diagnosis for patients in an ICU who might be subjected to a ventilator and/or various monitoring devices. Conclusion : Our initial experience demonstrates that mCT with high-quality imaging offers very useful information in various clinical situations.

Mobile Computed Tomography : Three Year Clinical Experience in Korea

“…This result agrees with that of Gumprecht and Lumenta2). The feasibility of mCT for assessing residual suprasellar tumors such as macroadenoma or meningioma and cerebellopontine angle tumor including vestibular schwanoma has been described in our previous report5). On the other hand, mCT has relative limitation for depicting poorly enhanced lesion such as low grade glioma5).…”

“…The feasibility of mCT for assessing residual suprasellar tumors such as macroadenoma or meningioma and cerebellopontine angle tumor including vestibular schwanoma has been described in our previous report5). On the other hand, mCT has relative limitation for depicting poorly enhanced lesion such as low grade glioma5). However, with reconstruction of three-dimensional images from mCT data, image fusion based on preoperative MRI findings can provide more valuable information on tumor margin assessment (Fig.…”

“…In our cohort, three cases of incomplete intra-ventricular catheter apposition were retargeted. With the guidance of mCT, more precise operations such as unusual insertion to the cyst or Ommaya reservoir placement can be attained5). Not limited to the neurosurgical filed, mCT can be used in other surgeries including reconstruction surgery of skull base, orbital wall12) and sinus surgery4).…”

“…mCT parameters were 120 kV, 7 mA, effective radiation dose of 1.7 mSv, 10-mm-wide collimated beam and eight 1.25-mm-wide detectors with an acquisition time of 2 s5). With regard to enhancement, a total of 90 mL of contrast agent (Iopromide, Ultravist; Schering AG, Berlin, Germany) was injected through an anterior cubital vein with a 4 mL/s flow rate with a 30 s X-ray time delay.…”

Computed tomography for the identification of a potential infectious source in critically ill surgical patients

“…Because our data were obtained in seriously critically ill patients, an increased risk of transportation must be considered. Although portable CTs exist and sometimes were recommended for the evaluation of critically ill patients [23], their quality is inferior to that of a fixed scanner and, depending on type of scanner, mostly applicable for cerebral imaging [24,25]. Hence, most hospitals prefer a fixed scanner located near the critical care floor [26].…”