
REGULAR CONTENT
Final ID
640
Type
Educational Exhibit-Poster Only
Authors
L Dance1, D Aria1, C Schaefer2, R Kaye1, R Towbin3
Institutions
1Phoenix Children's Hospital, Phoenix, AZ, 2N/A, Scottsdale, AZ, 3N/A, Paradise Valley, AZ
Purpose
Illustrate the advantages and disadvantages of cone beam CT (CBCT) as an alternative to conventional CT guidance and an adjunct to angiography.
Materials & Methods
CBCT was performed on both single and biplane units for biopsy guidance. 3-D angiography was utilized to plan and guide vascular interventions. CBCT images are compared side-by- side to conventional CT images both for image quality as well as radiation dose.
Results
There is a steep learning curve to optimize utilization of CBCT. We found that CBCT reliably identifies high-contrast lesions. However, the lower dose and decreased penetration of CBCT resulted in poorer visualization of low-contrast lesions. Also CBCT can be degraded by streak artifact from hardware or dense contrast. The relatively narrow field of view can be restrictive for peripherally located lesions in larger patients. However, the anatomic display is adequate for guidance in most instances. These findings are illustrated in a series of CBCT-guided cases including pulmonary nodule localization, osteoid osteoma ablation, ABC sclerotherapy, renal AV fistula embolization, and liver lesion biopsy.
Conclusions
The advent of CBCT as an adjunct modality in the IR suite has significantly decreased the use of conventional CT guidance and significantly decreased the radiation dose in children. We have found CBCT to be a practice changer.
Final ID
640
Type
Educational Exhibit-Poster Only
Authors
L Dance1, D Aria1, C Schaefer2, R Kaye1, R Towbin3
Institutions
1Phoenix Children's Hospital, Phoenix, AZ, 2N/A, Scottsdale, AZ, 3N/A, Paradise Valley, AZ
Purpose
Illustrate the advantages and disadvantages of cone beam CT (CBCT) as an alternative to conventional CT guidance and an adjunct to angiography.
Materials & Methods
CBCT was performed on both single and biplane units for biopsy guidance. 3-D angiography was utilized to plan and guide vascular interventions. CBCT images are compared side-by- side to conventional CT images both for image quality as well as radiation dose.
Results
There is a steep learning curve to optimize utilization of CBCT. We found that CBCT reliably identifies high-contrast lesions. However, the lower dose and decreased penetration of CBCT resulted in poorer visualization of low-contrast lesions. Also CBCT can be degraded by streak artifact from hardware or dense contrast. The relatively narrow field of view can be restrictive for peripherally located lesions in larger patients. However, the anatomic display is adequate for guidance in most instances. These findings are illustrated in a series of CBCT-guided cases including pulmonary nodule localization, osteoid osteoma ablation, ABC sclerotherapy, renal AV fistula embolization, and liver lesion biopsy.
Conclusions
The advent of CBCT as an adjunct modality in the IR suite has significantly decreased the use of conventional CT guidance and significantly decreased the radiation dose in children. We have found CBCT to be a practice changer.