Cone-beam spiral computed tomography

Cone-beam spiral computed tomography (CT) is a medical imaging technology that has impacted healthcare since its development in the early 1990s.^[1][2] This technology offers advancements over traditional fan-beam CT, including faster scanning speed, higher image quality, and the ability to generate true three-dimensional volumes, even with contrast-enhancement. It is estimated that the majority of the approximately 300 million CT scans performed annually worldwide use spiral cone-beam technology.

History

The concept of cone-beam spiral CT was first proposed by Ge Wang in 1991,^[3] who also introduced algorithms for approximate image reconstruction. A number of researchers and companies have contributed to the development of this technology.^[4]

In 2002, Alexander Katsevich formulated the first theoretically exact cone-beam spiral CT algorithm.^[5][6] The work on cone-beam spiral CT has become a foundational aspect of modern medical imaging, allowing for accurate volumetric image reconstruction from truncated x-ray cone-beam projections.^[7]

Principles

Cone-beam spiral CT uses an X-ray source and multiple detector rows that rotate spirally around the patient. The cone-shaped X-ray beam captures a large volume of data in a single pass, enabling the reconstruction of high-resolution volumetric and dynamic images. Key steps in the cone-beam spiral CT scanning process include:

• Cone-Beam Projection: Unlike fan-beam CT, which uses a single detector row, cone-beam CT employs multiple detector rows, sometimes numbering in the hundreds, to capture a wider field of view.
• Spiral Scanning: The CT system performs both the rotation of the X-ray data acquisition system and the translation of the patient on a motorized table simultaneously. This creates a spiral or helical trajectory, resulting in continuous data acquisition within a short scan time.
• Image Reconstruction: Advanced algorithms such as Wang's generalized Feldkamp-Davis-Kress (FDK) algorithms and Katsevich-type formulas are used to reconstruct images from cone-beam projection data.^[8]

Applications

Cone-beam spiral CT is employed in various medical imaging tasks, including:

• Lung Cancer Screening: It plays a crucial role in early detection and monitoring of lung cancer.^[9]
• Oncology: Cone-beam CT is used to characterize tumors, plan radiation therapy, and assess treatment responses.^[10]
• Cardiology: It is useful for evaluating coronary artery disease, planning interventions, and monitoring disease progression.^[11]
• Orthopedics: The technology is effective in imaging complex bone structures and assisting in surgical planning.^[12]
• Trauma Imaging: Cone-beam CT provides rapid assessment of traumatic injuries, particularly in emergency settings.^[13]
• Interventional Radiology: It guides various minimally invasive procedures with high precision.^[14]