Extended Intraoperative Longitudinal 3-Dimensional Cone Beam Computed Tomography Imaging With a Continuous Multi-Turn...

Area of Science:

• Medical Imaging
• Radiology
• Surgical Technology

Background:

• Intraoperative Cone Beam Computed Tomography (CBCT) is crucial, but limited field of view restricts visualization of extensive anatomical regions.
• Extending the field of view is essential for enhancing the clinical utility of CBCT in complex interventional procedures.

Purpose of the Study:

• To demonstrate the longitudinal extension of the intraoperative CBCT field of view using a multi-turn reverse helical scan.
• To assess the clinical utility and accuracy of this extended field of view technique in interventional procedures.

Main Methods:

• A fixed-room robotic CBCT system performed multi-turn reverse helical scans involving C-arm rotation and table translation.
• Geometric accuracy was evaluated using a phantom, and clinical utility was assessed in an ovine cadaver model during thoracic spine pedicle screw fixation.

Main Results:

• The multi-turn reverse helical scan increased longitudinal coverage by 370% (17 cm to 80 cm) in 100 seconds with submillimeter and sub-degree accuracy.
• The technique successfully identified screw misplacements in an ovine model and demonstrated excellent inter-observer reliability (ICC > 0.900).

Conclusions:

• Multi-turn reverse helical scanning enables feasible, extended longitudinal field-of-view intraoperative 3D imaging on a clinical robotic CBCT system.
• This technique allows visualization of long anatomical sites in a single image, even with metallic hardware, enhancing intraoperative assessment.