Three-Dimensional C-arm Cone-beam CT: Applications in the Interventional Suite

Abstract

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) roadmapping 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 multiplanar soft tissue imaging, enhanced pretreatment target lesion roadmapping and guidance, and the ability for immediate multiplanar posttreatment 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 (increase in the safety-vs-benefit ratio). 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.

Impact of Intra-Arterial Injection Parameters on Arterial, Capillary, and Venous Time-Concentration Curves in a Canine Model

“…Recent reports describe the utility of these C-arm CT techniques for the detection of central nervous system hemorrhages, for visualization of endoluminal devices and their relationship to the arterial wall and lumen, and for pretreatment planning and post-treatment evaluations. [1][2][3] Because these applications, along with others that will likely emerge (eg, functional imaging), are often used in association with the intra-arterial administration of iodinated contrast medium, it is necessary to understand the influence of injection parameters that may affect arterial, tissue, and venous opacification.…”

Advanced Techniques for Removal of Retrievable Inferior Vena Cava Filters

“…Fortunately, most retrievals are usually uneventful, even in the setting of an extruded leg residing in the paracaval tissues. If during the course of the retrieval complexity is identified (e.g., suspected transcaval component extension), then several approaches can provide additional useful information, particularly CT; or, increasingly, cone-beam angiographic CT [24,67]; or perhaps rotational angiography [68,69]. CT has shown excellent ability to demonstrate filter-leg penetration of the cava wall; in one series, it was demonstrated in 85.9% of 64 filter retrievals, and 89% of these filters were retrieved [67].…”

Cache-Aware GPU Optimization for Out-of-Core Cone Beam CT Reconstruction of High-Resolution Volumes

“…The Feldkamp-Davis-Kress (FDK) algorithm [1] is the de facto standard for cone beam CT reconstruction and is widely adopted in medical and industrial applications [2]- [4]. Because reconstruction time is critical, especially for real-time medical applications such as imageguided surgery [5], [6], research activities on accelerating the FDK algorithm have been ongoing ever since its advent in 1984.…”