Clinical Application of CT-Fluoroscopy

Summary

Computed tomography (CT)-guided intervention has been a common procedure during the past 10 years, but real-time monitoring with CT images has not previously been available. We have developed real-time CT-fluoroscopy, of which the initial trial was reported in 1993. This chapter describes the early clinical experience with this system. A third-generation scanner equipped with a slip ring was used. Images were reconstructed and displayed at a rate of six per second with a 0.83-s delay time using a newly designed array processor. CT-fluoroscopy was carried out in 12 cases (10 brain hemorrhage, 2 tumor). Good quality fluoroscopic images were obtained in all cases. Real-time monitoring with CT-fluoroscopy of needle placement and advancement was useful for accurate puncture needle biopsy and evacuation of the lesions. No serious complication was recognized in this series. These preliminary results suggest that CT-fluoroscopy offers improved accuracy and safety in neurosurgery as a new neuronavigation system and makes it possible to do freehand puncture without stereotactic procedures.