Guidance of Nonvascular Interventional Procedures with Real-Time CT-Fluoroscopy: Early Clinical Experience with C.A.R.E. Vision CT

Abstract

Nonvascular interventional radiological procedures may be guided by various imaging techniques such as ultrasonography, fluoroscopy, computed tomography (CT), and magnetic resonance imaging (MRI). Because of high spatial resolution, superior reproducibility, a wide field of view, and applicability to air-filled and bone structures, CT-guided interventional procedures have become important clinical tools in recent years. A great disadvantage with CT-guided interventions, however, has been the lack of real-time imaging capability, which is available with ultrasound and fluoroscopy. Especially in body regions where extensive respiratory movement is present, small target lesions may shift and disappear during conventional CT-guided punctures. This seems to be one of the most important reasons why CT-guided interventions are unsuccessful or must be repeated [12]. To overcome this limitation, C.A.R.E. Vision CT (Combined Applications to Reduce Exposure), a CT-fluoroscopy system, was developed and installed on a Siemens Somatom Plus 4 CT scanner providing real-time image reconstruction and display of CT images on a monitor at a frame rate of three or six images per second.