Cone-beam CT: vascular applications

Cone-beam computed tomography (CBCT) provides three-dimensional rendering of opacified vascular structures that are very useful for catheter guidance and anatomical correlation in many arterial and venous procedures. CBCT has been shown to improve the technical success of transarterial chemoembolization (TACE), which may lead to better outcomes. Similarly, it is useful in planning for selective internal radiation therapy of the liver by defining the treatment volume and preventing misembolization. There is emerging application of CBCT fusion with magnetic resonance angiography (MRA) or computed tomographic angiography (CTA) for use in catheterization or needle puncture of otherwise difficult to opacify vascular structures. CBCT also has a role in needle guidance for type II endoleak embolization, translumbar venous catheter placement, and embolization of vascular malformations.