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Erschienen in: Neuroradiology 4/2010

01.04.2010 | Interventional Neuroradiology

C-arm flat detector computed tomography: the technique and its applications in interventional neuro-radiology

verfasst von: Mudassar Kamran, Sanjoy Nagaraja, James V. Byrne

Erschienen in: Neuroradiology | Ausgabe 4/2010

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Abstract

Introduction

Flat detector computed tomography (FDCT) is an imaging tool that generates three-dimensional (3-D) volumes from data obtained during C-arm rotation using CT-like reconstruction algorithms. The technique is relatively new and, at current levels of performance, lags behind conventional CT in terms of image quality. However, the advantage of its availability in the interventional room has prompted neuro-radiologists to identify clinical settings where its role is uniquely beneficial.

Methods

We performed a search of the online literature databases to identify studies reporting experience with FDCT in interventional neuro-radiology. The studies were systematically reviewed and their findings grouped according to specific clinical situation addressed.

Results

FDCT images allow detection of procedural complications, evaluation of low-radiopacity stents and assessment of endosaccular coil packing in intra-cranial aneurysms. Additional roles are 3-D angiography that provides an accurate depiction of vessel morphology with low concentrations of radiographic contrast media and a potential for perfusion imaging due to its dynamic scanning capability. A single scan combining soft tissue and angiographic examinations reduces radiation dose and examination time. Ongoing developments in flat detector technology and reconstruction algorithms are expected to further enhance its performance and increase this range of applications.

Conclusion

FDCT images provide useful information in neuro-interventional setting. If current research confirms its potential for assessing cerebral haemodynamics by perfusion scanning, the combination would redefine it as an invaluable tool for interventional neuro-radiology procedures. This facility and its existing capabilities of parenchymal and angiographic imaging would also extend its use to the triage of acute stroke patients.
Literatur
1.
Zurück zum Zitat Orth R, Wallace M, Kuo M (2008) C-arm cone-beam CT: general principles and technical considerations for use in interventional radiology. J Vasc Interv Radiol 19:814–820CrossRefPubMed Orth R, Wallace M, Kuo M (2008) C-arm cone-beam CT: general principles and technical considerations for use in interventional radiology. J Vasc Interv Radiol 19:814–820CrossRefPubMed
2.
Zurück zum Zitat Grass M, Koppe R, Klotz E et al (1999) Three-dimensional reconstruction of high contrast objects using C-arm image intensifier projection data. Comput Med Imaging Graph 23:311–321CrossRefPubMed Grass M, Koppe R, Klotz E et al (1999) Three-dimensional reconstruction of high contrast objects using C-arm image intensifier projection data. Comput Med Imaging Graph 23:311–321CrossRefPubMed
3.
Zurück zum Zitat Linsenmaier U, Rock C, Euler E et al (2002) Three-dimensional CT with a modified C-arm image intensifier: feasibility. Radiology 224:286–292CrossRefPubMed Linsenmaier U, Rock C, Euler E et al (2002) Three-dimensional CT with a modified C-arm image intensifier: feasibility. Radiology 224:286–292CrossRefPubMed
4.
Zurück zum Zitat Kalender W, Kyriakou Y (2007) Flat-detector computed tomography (FD-CT). Eur Radiol 17:2767–2779CrossRefPubMed Kalender W, Kyriakou Y (2007) Flat-detector computed tomography (FD-CT). Eur Radiol 17:2767–2779CrossRefPubMed
5.
Zurück zum Zitat Neitzel U (2005) Status and prospects of digital detector technology for CR and DR. Radiat Prot Dosim 114:32–38CrossRef Neitzel U (2005) Status and prospects of digital detector technology for CR and DR. Radiat Prot Dosim 114:32–38CrossRef
6.
Zurück zum Zitat Wallace M, Kuo M, Glaiberman C et al (2008) Three-dimensional C-arm cone-beam CT: applications in the interventional suite. J Vasc Interv Radiol 19:799–813CrossRefPubMed Wallace M, Kuo M, Glaiberman C et al (2008) Three-dimensional C-arm cone-beam CT: applications in the interventional suite. J Vasc Interv Radiol 19:799–813CrossRefPubMed
7.
Zurück zum Zitat Fahrig R, Fox AJ, Lownie S et al (1997) Use of a C-arm system to generate true three-dimensional computed rotational angiograms: preliminary in vitro and in vivo results. AJNR Am J Neuroradiol 18:1507–1514PubMed Fahrig R, Fox AJ, Lownie S et al (1997) Use of a C-arm system to generate true three-dimensional computed rotational angiograms: preliminary in vitro and in vivo results. AJNR Am J Neuroradiol 18:1507–1514PubMed
8.
Zurück zum Zitat Akpek S, Brunner T, Benndorf G, Strother C (2005) Three-dimensional imaging and cone beam volume CT in C-arm angiography with flat panel detector. Diagn Interv Radiol 11:10–13PubMed Akpek S, Brunner T, Benndorf G, Strother C (2005) Three-dimensional imaging and cone beam volume CT in C-arm angiography with flat panel detector. Diagn Interv Radiol 11:10–13PubMed
9.
Zurück zum Zitat Cowen A, Davies A, Sivananthan M (2008) The design and imaging characteristics of dynamic, solid-state, flat-panel x-ray image detectors for digital fluoroscopy and fluorography. Clin Radiol 63:1073–1085CrossRefPubMed Cowen A, Davies A, Sivananthan M (2008) The design and imaging characteristics of dynamic, solid-state, flat-panel x-ray image detectors for digital fluoroscopy and fluorography. Clin Radiol 63:1073–1085CrossRefPubMed
10.
Zurück zum Zitat Gupta R, Grasruck M, Suess C et al (2006) Ultra-high resolution flat-panel volume CT: fundamental principles, design architecture, and system characterization. Eur Radiol 16:1191–1205CrossRefPubMed Gupta R, Grasruck M, Suess C et al (2006) Ultra-high resolution flat-panel volume CT: fundamental principles, design architecture, and system characterization. Eur Radiol 16:1191–1205CrossRefPubMed
11.
Zurück zum Zitat Kyriakou Y, Kalender W (2007) X-ray scatter data for flat-panel detector CT. Phys Med 23:3–15PubMedCrossRef Kyriakou Y, Kalender W (2007) X-ray scatter data for flat-panel detector CT. Phys Med 23:3–15PubMedCrossRef
12.
Zurück zum Zitat Buhk J, Lingor P, Knauth M (2008) Angiographic CT with intravenous administration of contrast medium is a noninvasive option for follow-up after intracranial stenting. Neuroradiology 50:349–354CrossRefPubMed Buhk J, Lingor P, Knauth M (2008) Angiographic CT with intravenous administration of contrast medium is a noninvasive option for follow-up after intracranial stenting. Neuroradiology 50:349–354CrossRefPubMed
14.
Zurück zum Zitat Suh D, Kim J, Choi J et al (2008) Intracranial stenting of severe symptomatic intracranial stenosis: results of 100 consecutive patients. AJNR Am J Neuroradiol 29:781–785CrossRefPubMed Suh D, Kim J, Choi J et al (2008) Intracranial stenting of severe symptomatic intracranial stenosis: results of 100 consecutive patients. AJNR Am J Neuroradiol 29:781–785CrossRefPubMed
15.
Zurück zum Zitat Higashida R, Smith W, Gress D et al (1997) Intravascular stent and endovascular coil placement for a ruptured fusiform aneurysm of the basilar artery. Case report and review of the literature. J Neurosurg 87:944–949CrossRefPubMed Higashida R, Smith W, Gress D et al (1997) Intravascular stent and endovascular coil placement for a ruptured fusiform aneurysm of the basilar artery. Case report and review of the literature. J Neurosurg 87:944–949CrossRefPubMed
16.
Zurück zum Zitat Wakhloo A, Mandell J, Gounis M et al (2008) Stent-assisted reconstructive endovascular repair of cranial fusiform atherosclerotic and dissecting aneurysms: long-term clinical and angiographic follow-up. Stroke 39:3288–3296CrossRefPubMed Wakhloo A, Mandell J, Gounis M et al (2008) Stent-assisted reconstructive endovascular repair of cranial fusiform atherosclerotic and dissecting aneurysms: long-term clinical and angiographic follow-up. Stroke 39:3288–3296CrossRefPubMed
17.
Zurück zum Zitat Akpek S, Arat A, Morsi H et al (2005) Self-expandable stent-assisted coiling of wide-necked intracranial aneurysms: a single-center experience. AJNR Am J Neuroradiol 26:1223–1231PubMed Akpek S, Arat A, Morsi H et al (2005) Self-expandable stent-assisted coiling of wide-necked intracranial aneurysms: a single-center experience. AJNR Am J Neuroradiol 26:1223–1231PubMed
18.
Zurück zum Zitat Yoo E, Kim DJ, Kim DI et al (2009) Bailout stent deployment during coil embolization of intracranial aneurysms. AJNR Am J Neuroradiol 30:1028–1034CrossRefPubMed Yoo E, Kim DJ, Kim DI et al (2009) Bailout stent deployment during coil embolization of intracranial aneurysms. AJNR Am J Neuroradiol 30:1028–1034CrossRefPubMed
19.
Zurück zum Zitat Levy E, Mehta R, Gupta R et al (2007) Self-expanding stents for recanalization of acute cerebrovascular occlusions. AJNR Am J Neuroradiol 28:816–822PubMed Levy E, Mehta R, Gupta R et al (2007) Self-expanding stents for recanalization of acute cerebrovascular occlusions. AJNR Am J Neuroradiol 28:816–822PubMed
20.
Zurück zum Zitat Sadasivan C, Cesar L, Seong J et al (2009) An original flow diversion device for the treatment of intracranial aneurysms: evaluation in the rabbit elastase-induced model. Stroke 40:952–958CrossRefPubMed Sadasivan C, Cesar L, Seong J et al (2009) An original flow diversion device for the treatment of intracranial aneurysms: evaluation in the rabbit elastase-induced model. Stroke 40:952–958CrossRefPubMed
21.
Zurück zum Zitat Riedel C, Tietke M, Alfke K et al (2009) Subacute stent thrombosis in intracranial stenting. Stroke 40:1310–1314CrossRefPubMed Riedel C, Tietke M, Alfke K et al (2009) Subacute stent thrombosis in intracranial stenting. Stroke 40:1310–1314CrossRefPubMed
22.
Zurück zum Zitat Fiorella D, Chow M, Anderson M et al (2007) A 7-year experience with balloon-mounted coronary stents for the treatment of symptomatic vertebrobasilar intracranial atheromatous disease. Neurosurgery 61:236–242 discussion 242–233CrossRefPubMed Fiorella D, Chow M, Anderson M et al (2007) A 7-year experience with balloon-mounted coronary stents for the treatment of symptomatic vertebrobasilar intracranial atheromatous disease. Neurosurgery 61:236–242 discussion 242–233CrossRefPubMed
23.
Zurück zum Zitat Zaidat O, Klucznik R, Alexander M et al (2008) The NIH registry on use of the Wingspan stent for symptomatic 70–99% intracranial arterial stenosis. Neurology 70:1518–1524CrossRefPubMed Zaidat O, Klucznik R, Alexander M et al (2008) The NIH registry on use of the Wingspan stent for symptomatic 70–99% intracranial arterial stenosis. Neurology 70:1518–1524CrossRefPubMed
24.
Zurück zum Zitat Honda Y, Fitzgerald P (2003) Stent thrombosis: an issue revisited in a changing world. Circulation 108:2–5CrossRefPubMed Honda Y, Fitzgerald P (2003) Stent thrombosis: an issue revisited in a changing world. Circulation 108:2–5CrossRefPubMed
25.
Zurück zum Zitat Benndorf G, Strother C, Claus B et al (2005) Angiographic CT in cerebrovascular stenting. AJNR Am J Neuroradiol 26:1813–1818PubMed Benndorf G, Strother C, Claus B et al (2005) Angiographic CT in cerebrovascular stenting. AJNR Am J Neuroradiol 26:1813–1818PubMed
26.
Zurück zum Zitat Ebrahimi N, Claus B, Lee C et al (2007) Stent conformity in curved vascular models with simulated aneurysm necks using flat-panel CT: an in vitro study. AJNR Am J Neuroradiol 28:823–829PubMed Ebrahimi N, Claus B, Lee C et al (2007) Stent conformity in curved vascular models with simulated aneurysm necks using flat-panel CT: an in vitro study. AJNR Am J Neuroradiol 28:823–829PubMed
27.
Zurück zum Zitat Trossbach M, Hartmann M, Braun C et al (2004) Small vessel stents for intracranial angioplasty: in vitro evaluation of in-stent stenoses using CT angiography. Neuroradiology 46:459–463CrossRefPubMed Trossbach M, Hartmann M, Braun C et al (2004) Small vessel stents for intracranial angioplasty: in vitro evaluation of in-stent stenoses using CT angiography. Neuroradiology 46:459–463CrossRefPubMed
28.
Zurück zum Zitat Willinsky R, Taylor S, TerBrugge K et al (2003) Neurologic complications of cerebral angiography: prospective analysis of 2,899 procedures and review of the literature. Radiology 227:522–528CrossRefPubMed Willinsky R, Taylor S, TerBrugge K et al (2003) Neurologic complications of cerebral angiography: prospective analysis of 2,899 procedures and review of the literature. Radiology 227:522–528CrossRefPubMed
29.
Zurück zum Zitat Richter G, Engelhorn T, Struffert T et al (2007) Flat panel detector angiographic CT for stent-assisted coil embolization of broad-based cerebral aneurysms. AJNR Am J Neuroradiol 28:1902–1908CrossRefPubMed Richter G, Engelhorn T, Struffert T et al (2007) Flat panel detector angiographic CT for stent-assisted coil embolization of broad-based cerebral aneurysms. AJNR Am J Neuroradiol 28:1902–1908CrossRefPubMed
30.
Zurück zum Zitat Li M, Gao B, Fang C et al (2006) Angiographic follow-up of cerebral aneurysms treated with Guglielmi detachable coils: an analysis of 162 cases with 173 aneurysms. AJNR Am J Neuroradiol 27:1107–1112PubMed Li M, Gao B, Fang C et al (2006) Angiographic follow-up of cerebral aneurysms treated with Guglielmi detachable coils: an analysis of 162 cases with 173 aneurysms. AJNR Am J Neuroradiol 27:1107–1112PubMed
31.
Zurück zum Zitat Piotin M, Spelle L, Mounayer C et al (2007) Intracranial aneurysms: treatment with bare platinum coils—aneurysm packing, complex coils, and angiographic recurrence. Radiology 243:500–508CrossRefPubMed Piotin M, Spelle L, Mounayer C et al (2007) Intracranial aneurysms: treatment with bare platinum coils—aneurysm packing, complex coils, and angiographic recurrence. Radiology 243:500–508CrossRefPubMed
32.
Zurück zum Zitat Buhk J, Kallenberg K, Mohr A et al (2009) Evaluation of angiographic computed tomography in the follow-up after endovascular treatment of cerebral aneurysms—a comparative study with DSA and TOF-MRA. Eur Radiol 19:430–436CrossRefPubMed Buhk J, Kallenberg K, Mohr A et al (2009) Evaluation of angiographic computed tomography in the follow-up after endovascular treatment of cerebral aneurysms—a comparative study with DSA and TOF-MRA. Eur Radiol 19:430–436CrossRefPubMed
33.
Zurück zum Zitat van Rooij W, Sluzewski M, Beute G et al (2006) Procedural complications of coiling of ruptured intracranial aneurysms: incidence and risk factors in a consecutive series of 681 patients. AJNR Am J Neuroradiol 27:1498–1501PubMed van Rooij W, Sluzewski M, Beute G et al (2006) Procedural complications of coiling of ruptured intracranial aneurysms: incidence and risk factors in a consecutive series of 681 patients. AJNR Am J Neuroradiol 27:1498–1501PubMed
34.
Zurück zum Zitat Gallas S, Drouineau J, Gabrillargues J et al (2008) Feasibility, procedural morbidity and mortality, and long-term follow-up of endovascular treatment of 321 unruptured aneurysms. AJNR Am J Neuroradiol 29:63–68CrossRefPubMed Gallas S, Drouineau J, Gabrillargues J et al (2008) Feasibility, procedural morbidity and mortality, and long-term follow-up of endovascular treatment of 321 unruptured aneurysms. AJNR Am J Neuroradiol 29:63–68CrossRefPubMed
35.
Zurück zum Zitat Cloft H, Kallmes D (2002) Cerebral aneurysm perforations complicating therapy with Guglielmi detachable coils: a meta-analysis. AJNR Am J Neuroradiol 23:1706–1709PubMed Cloft H, Kallmes D (2002) Cerebral aneurysm perforations complicating therapy with Guglielmi detachable coils: a meta-analysis. AJNR Am J Neuroradiol 23:1706–1709PubMed
36.
Zurück zum Zitat Li M, Gao B, Fang C et al (2006) Prevention and management of intraprocedural rupture of intracranial aneurysm with detachable coils during embolization. Neuroradiology 48:907–915CrossRefPubMed Li M, Gao B, Fang C et al (2006) Prevention and management of intraprocedural rupture of intracranial aneurysm with detachable coils during embolization. Neuroradiology 48:907–915CrossRefPubMed
37.
Zurück zum Zitat Engelhorn T, Struffert T, Richter G et al (2008) Flat panel detector angiographic CT in the management of aneurysmal rupture during coil embolization. AJNR Am J Neuroradiol 29:1581–1584CrossRefPubMed Engelhorn T, Struffert T, Richter G et al (2008) Flat panel detector angiographic CT in the management of aneurysmal rupture during coil embolization. AJNR Am J Neuroradiol 29:1581–1584CrossRefPubMed
38.
Zurück zum Zitat Heran N, Song J, Namba K et al (2006) The utility of DynaCT in neuroendovascular procedures. AJNR Am J Neuroradiol 27:330–332PubMed Heran N, Song J, Namba K et al (2006) The utility of DynaCT in neuroendovascular procedures. AJNR Am J Neuroradiol 27:330–332PubMed
39.
Zurück zum Zitat Struffert T, Richter G, Engelhorn T et al (2009) Visualisation of intracerebral haemorrhage with flat-detector CT compared to multislice CT: results in 44 cases. Eur Radiol 19:619–625CrossRefPubMed Struffert T, Richter G, Engelhorn T et al (2009) Visualisation of intracerebral haemorrhage with flat-detector CT compared to multislice CT: results in 44 cases. Eur Radiol 19:619–625CrossRefPubMed
40.
Zurück zum Zitat Söderman M, Babic D, Holmin S et al (2008) Brain imaging with a flat detector C-arm: technique and clinical interest of XperCT. Neuroradiology 50:863–868CrossRefPubMed Söderman M, Babic D, Holmin S et al (2008) Brain imaging with a flat detector C-arm: technique and clinical interest of XperCT. Neuroradiology 50:863–868CrossRefPubMed
41.
Zurück zum Zitat Arakawa H, Marks M, Do H et al (2008) Experimental study of intracranial hematoma detection with flat panel detector C-arm CT. AJNR Am J Neuroradiol 29:766–772CrossRefPubMed Arakawa H, Marks M, Do H et al (2008) Experimental study of intracranial hematoma detection with flat panel detector C-arm CT. AJNR Am J Neuroradiol 29:766–772CrossRefPubMed
42.
Zurück zum Zitat Doelken M, Struffert T, Richter G et al (2008) Flat-panel detector volumetric CT for visualization of subarachnoid hemorrhage and ventricles: preliminary results compared to conventional CT. Neuroradiology 50:517–523CrossRefPubMed Doelken M, Struffert T, Richter G et al (2008) Flat-panel detector volumetric CT for visualization of subarachnoid hemorrhage and ventricles: preliminary results compared to conventional CT. Neuroradiology 50:517–523CrossRefPubMed
43.
Zurück zum Zitat White P, Gilmour J, Weir N et al (2008) AngioCT in the management of neurointerventional patients: a prospective, consecutive series with associated dosimetry and resolution data. Neuroradiology 50:321–330CrossRefPubMed White P, Gilmour J, Weir N et al (2008) AngioCT in the management of neurointerventional patients: a prospective, consecutive series with associated dosimetry and resolution data. Neuroradiology 50:321–330CrossRefPubMed
44.
Zurück zum Zitat Ernemann U, Grönewäller E, Duffner F et al (2003) Influence of geometric and hemodynamic parameters on aneurysm visualization during three-dimensional rotational angiography: an in vitro study. AJNR Am J Neuroradiol 24:597–603PubMed Ernemann U, Grönewäller E, Duffner F et al (2003) Influence of geometric and hemodynamic parameters on aneurysm visualization during three-dimensional rotational angiography: an in vitro study. AJNR Am J Neuroradiol 24:597–603PubMed
45.
Zurück zum Zitat Jou L, Mohamed A, Lee D et al (2007) 3D rotational digital subtraction angiography may underestimate intracranial aneurysms: findings from two basilar aneurysms. AJNR Am J Neuroradiol 28:1690–1692CrossRefPubMed Jou L, Mohamed A, Lee D et al (2007) 3D rotational digital subtraction angiography may underestimate intracranial aneurysms: findings from two basilar aneurysms. AJNR Am J Neuroradiol 28:1690–1692CrossRefPubMed
Metadaten
Titel
C-arm flat detector computed tomography: the technique and its applications in interventional neuro-radiology
verfasst von
Mudassar Kamran
Sanjoy Nagaraja
James V. Byrne
Publikationsdatum
01.04.2010
Verlag
Springer-Verlag
Erschienen in
Neuroradiology / Ausgabe 4/2010
Print ISSN: 0028-3940
Elektronische ISSN: 1432-1920
DOI
https://doi.org/10.1007/s00234-009-0609-5

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