Translation of technology developments from the lab to the clinic is the goal.
The Interventional Radiology group at Stanford University has spearheaded the use of C-arm CT in several applications, with a focus on therapies for hepatic carcinoma including guidance of transarterial chemoembolization and for detection of hepatic-entero collaterals for SIRsphere-based radiochemoembolization (PI: Nishita Kothary). This work demonstrated that some tumors not visible on either prior clinical CT or DSA could be visualized using C-arm CT. Other studies include use of C-arm CT with 2D-3D overlay to guide needle placement, and C-arm C for frameless stereotactic radiosurgery (PI: Dimitre Hristov).
The Neurointerventional Radiology group at Stanford University is 'first to clinic' with the potential to accurately quantify cerebral blood flow. This study is currently recruiting subjects. Other investigations include use of 2D-3D overlay for accurate measurement of intracranial stents and C-arm CT for intracranial blood volume measurement (PI: Michael Marks).
The EP suite benefits from in-room access to C-arm CT for accurate guidance of radiofrequency and cryo-ablation of pulmonary veins during treatment of atrial fibrillation. The ability to accurately locate the catheter tip during the procedure is key to successful outcomes. Evaluating the relative accuracy of x-ray based and other navigation techniques is ongoing (PI: Amin Al-Ahmad). First in human images of ECG-gated cardiac C-arm CT were obtained in the Axiom lab. The images demonstrated that the location of the oesophagus could be visualized relative to the pulmonary veins.
The additional flexibility of the C-arm system is exploited in diagnostic applications. The open geometry of the C-arm and the high resolution of the reconstructed CT volumes provide the ability to image the deformation of stents placed in the superficial artery during leg and hip flexion. The zeego can acquire images in weight-bearing geometry, permitting the evaluation of knee kinematics and joint conformation in clinically relevant positions.