Rotational flat-panel computed tomography in diagnostic and interventional neuroradiology

Originally aimed at improving standard radiography by providing higher absorption efficiency and a wider dynamic range than available with X-ray film or film-screen combinations, flat-panel detector technology has become widely accepted for neuroangiographic imaging. In particular flat-panel detector computed tomography (FD-CT) which uses rotational C-arm-mounted flat-panel detector technology is capable of volumetric imaging with high spatial resolution. As "Angiographic CT" FD-CT may be helpful during many diagnostic and neurointerventional procedures, i.e. intracranial stenting for cerebrovascular stenoses, stent-assisted coil embolization of wide-necked cerebral aneurysms and embolizations of arteriovenous malformations. By providing morphologic, CT-like images of the brain within the angio suite, FD-CT is able to rapidly visualize periprocedural hemorrhage and may thus improve rapid complication management without the need for patient transfer. In addition, myelography and postmyelographic FD-CT imaging can be carried out using a single machine. Spinal interventions, such as kyphoplasty or vertebroplasty might also benefit from FD-CT. This paper briefly reviews the technical principles of FD technology and then focuses on possible applications in diagnostic and interventional neuroradiology.