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Proceedings Paper

Multimode C-arm fluoroscopy, tomosynthesis, and cone-beam CT for image-guided interventions: from proof of principle to patient protocols
Author(s): J. H. Siewerdsen; M. J. Daly; G. Bachar M.D.; D. J. Moseley; G. Bootsma; K. K. Brock; S. Ansell; G. A. Wilson; S. Chhabra; D. A. Jaffray; J. C. Irish M.D.
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Paper Abstract

High-performance intraoperative imaging is essential to an ever-expanding scope of therapeutic procedures ranging from tumor surgery to interventional radiology. The need for precise visualization of bony and soft-tissue structures with minimal obstruction to the therapy setup presents challenges and opportunities in the development of novel imaging technologies specifically for image-guided procedures. Over the past ~5 years, a mobile C-arm has been modified in collaboration with Siemens Medical Solutions for 3D imaging. Based upon a Siemens PowerMobil, the device includes: a flat-panel detector (Varian PaxScan 4030CB); a motorized orbit; a system for geometric calibration; integration with real-time tracking and navigation (NDI Polaris); and a computer control system for multi-mode fluoroscopy, tomosynthesis, and cone-beam CT. Investigation of 3D imaging performance (noise-equivalent quanta), image quality (human observer studies), and image artifacts (scatter, truncation, and cone-beam artifacts) has driven the development of imaging techniques appropriate to a host of image-guided interventions. Multi-mode functionality presents a valuable spectrum of acquisition techniques: i.) fluoroscopy for real-time 2D guidance; ii.) limited-angle tomosynthesis for fast 3D imaging (e.g., ~10 sec acquisition of coronal slices containing the surgical target); and iii.) fully 3D cone-beam CT (e.g., ~30-60 sec acquisition providing bony and soft-tissue visualization across the field of view). Phantom and cadaver studies clearly indicate the potential for improved surgical performance - up to a factor of 2 increase in challenging surgical target excisions. The C-arm system is currently being deployed in patient protocols ranging from brachytherapy to chest, breast, spine, and head and neck surgery.

Paper Details

Date Published: 21 March 2007
PDF: 11 pages
Proc. SPIE 6510, Medical Imaging 2007: Physics of Medical Imaging, 65101A (21 March 2007); doi: 10.1117/12.713642
Show Author Affiliations
J. H. Siewerdsen, Princess Margaret Hospital (Canada)
Univ. of Toronto (Canada)
M. J. Daly, Princess Margaret Hospital (Canada)
G. Bachar M.D., Princess Margaret Hospital (Canada)
D. J. Moseley, Princess Margaret Hospital (Canada)
Univ. of Toronto (Canada)
G. Bootsma, Univ. of Toronto (Canada)
K. K. Brock, Univ. of Toronto (Canada)
Princess Margaret Hospital (Canada)
S. Ansell, Princess Margaret Hospital (Canada)
G. A. Wilson, Princess Margaret Hospital (Canada)
S. Chhabra, Univ. of Toronto (Canada)
D. A. Jaffray, Princess Margaret Hospital (Canada)
Univ. of Toronto (Canada)
J. C. Irish M.D., Princess Margaret Hospital (Canada)

Published in SPIE Proceedings Vol. 6510:
Medical Imaging 2007: Physics of Medical Imaging
Jiang Hsieh; Michael J. Flynn, Editor(s)

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