CT-Guided Interventions: Current Practice and Future Directions
Computed tomography (CT) plays an important role in interventional procedures such as biopsy, abscess drainage, tumor ablation, catheter placement, and orthopedic instrumentation. All these procedures involve precise incremental advancement of a needle or a probe. This chapter reviews the current state of the art and advanced applications of CT in interventional procedures, including the use of C-arm CT, multi-detector CT, and ultrahigh-resolution flat-panel CT. Interventional capabilities of C-arm CT, which combines the advantages of a digital flat-panel detector with the versatility of a C-arm, are described. Ultrahigh-resolution flat-panel CT, another technology-based flat-panel detector, is also described. Recent development of portable CT not only provides on-site imaging for critically ill patients; it also enables faster response to imaging requests and increased productivity of the care team. The new advancements covered by this chapter introduce robot-assisted image-guided interventions. The current CT-guided intervention only provides 3D data in a discontinuous, manipulate, and rescan fashion. A new paradigm for real-time 4D imaging, which could play an important role in intervention guidance in the near future, is described and illustrated with the help of examples.
KeywordsCompute Tomography Guidance Entrance Skin Dose Stapes Prosthesis Dynamic Compute Tomography Scanning Portable Compute Tomography
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