Universal non-circular cone beam CT orbits for metal artifact reduction imaging during image-guided procedures

Area of Science:

• Medical Imaging
• Robotics
• Orthopedic Surgery

Background:

• Metal artifacts are a significant challenge in Cone Beam Computed Tomography (CBCT) imaging, particularly in procedures involving surgical tools and orthopedic implants.
• Current CBCT systems struggle to provide clear visualization of anatomy and soft tissues obscured by these artifacts.

Purpose of the Study:

• To implement and evaluate two universal non-circular imaging orbits optimized for metal artifact reduction in real-time on clinical robotic CBCT systems.
• To demonstrate the clinical utility of these novel orbits in orthopedic procedures.

Main Methods:

• Developed and implemented two universal non-circular imaging orbits designed for metal artifact reduction.
• Integrated these orbits into a clinical robotic CBCT system for real-time application.
• Tested the orbits during simulated pedicle screw cervical spine fixation and hip arthroplasty procedures on cadavers.

Main Results:

• The universal non-circular orbits successfully reduced metal artifacts surrounding implanted orthopedic hardware in both simulated procedures.
• Improved visualization of surrounding anatomy and soft tissues was achieved compared to conventional CBCT imaging.
• Demonstrated the feasibility of real-time implementation on clinical robotic CBCT systems.

Conclusions:

• Clinically translating universal orbits is a crucial step towards enhancing robotic CBCT systems.
• High-quality in-room procedural verification is now more achievable, potentially increasing the adoption of robotic CBCT.
• This advancement may lead to a reduction in secondary corrective surgeries by improving intraoperative imaging accuracy.