Because of a rapid evolution in intra-operative imaging, it is challenging to maintain an overview of the new technology and systems which are currently available. New implants and the trend for minimally invasive surgery and approaches made progression in intra-operative imaging inevitable. Standard C-arms are equipped with a radiograph source and image intensifier. Most surgical procedures are highly dependent on optimal intra-operative visualization. Without intra-operative imaging, modern orthopaedic trauma surgery would not be possible. This evolution does not stop at the gates of medicine, which has also led to major advances in intra-operative imaging. Whether it is electric self-driving cars, drone transportation or outer space travel, it is difficult to keep up with all the novelties we are confronted with on a daily basis. Due to immediate control of the osteosynthesis, revision surgery at a later time can be prevented.Ĭite this article: EFORT Open Rev 2018 3 DOI: 10.1302/2058-5255Ī rapid evolution in technology can be observed all over the world. The possibility of high-quality 3D imaging in combination with navigation can assure optimal implant placement. The introduction of flat-panel detectors has led to improvements in intra-operative image quality combined with dose reduction. The use of standard intra-operative CT scanners results in high 3D image quality but, in comparison with a cone-beam CT scanner, fluoroscopy is not possible. Due to their mobility, they are not bound to a specific operating room. Different mobile intra-operative CT scanners were recently introduced. Fixed systems are typically placed on a sliding gantry. In recent years there has been a revival of standard fan beam CT technology in operating rooms. Immediate control of fracture reduction and implant positioning in high image quality can reduce the need for secondary revision surgery due to implant malposition. Intra-operative cone-beam CT can be a very helpful tool in orthopaedic surgery. For cone-beam CT acquisition, the flat-panel detector rotates around the patient lying on the operating table. The cone-shaped beam is used for 3D data generation. Flat-panel detectors have proved to be superior to standard C-arms (= C-arm with radiograph source and image intensifier).Ĭone-beam computed tomography (cone-beam CT) is a 3D data set, which can be acquired with a flat-panel detector. The major benefits of this technology are a higher image quality and dose reduction. The invention of flat-panel detectors led to a revolution in medical imaging.
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