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Cone-Beam CT With Enhanced Needle Guidance and Augmented Fluoroscopy Overlay: Applications in Interventional Radiology. AJR Am J Roentgenol 2023 Jul;221(1):92-101

Date

04/25/2023

Pubmed ID

37095661

DOI

10.2214/AJR.22.28712

Scopus ID

2-s2.0-85163922815 (requires institutional sign-in at Scopus site)   4 Citations

Abstract

Digital flat-panel detector cone-beam CT (CBCT), introduced in the early 2000s, was historically used in interventional radiology primarily for liver-directed therapies. However, contemporary advanced imaging applications, including enhanced needle guidance and augmented fluoroscopy overlay, have evolved substantially over the prior decade and now work synergistically with CBCT guidance to overcome limitations encountered with other imaging modalities. CBCT with advanced imaging applications has become increasingly used to facilitate a broad range of minimally invasive procedures, particularly relating to pain and musculoskeletal interventions. Potential advantages of CBCT with advanced imaging applications include greater accuracy for complex needle paths, improved targeting in the presence of metal artifact, enhanced visualization during injection of contrast medium or cement, increased ease when space in the gantry is limited, and reduced radiation doses versus conventional CT guidance. Nonetheless, CBCT guidance remains underutilized, partly relating to lack of familiarity with the technique. This article describes the practical implementation of CBCT with enhanced needle guidance and augmented fluoroscopy overlay and depicts the technique's application for an array of interventional radiology procedures, including epidural steroid injections, celiac plexus block and neurolysis, pudendal block, spine ablation, percutaneous osseous ablation fixation and osteoplasty, biliary recanalization, and transcaval type II endoleak repair.

Author List

Key BM, Tutton SM, Scheidt MJ

Authors

Brandon Key MD Assistant Professor in the Radiology department at Medical College of Wisconsin
Matthew J. Scheidt MD, FSIR Associate Professor in the Radiology department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Cone-Beam Computed Tomography
Fluoroscopy
Humans
Needles
Radiography, Interventional
Radiology, Interventional
Spine