Technology and applications in interventional imaging: 2D X-ray radiography/fluoroscopy and 3D cone-beam CT

The role of X-ray imaging in interventional procedures expanded considerably over the first two decades of the 21st century. New imaging capabilities have been driven by clinical needs in a broad scope of emerging therapeutic techniques, including minimally invasive surgical approaches, an expanding spectrum of therapies delivered in interventional radiology, and the need for increasing levels of geometric accuracy in disease targeting and normal tissue avoidance. Such capabilities have been enabled by advances in X-ray tube and detector technology, advanced image processing and 3D reconstruction algorithms, and a diversity of mobile and fixed-room imaging platforms. This chapter provides a brief overview of the state-of-the-art and future directions in each of these areas, including hardware and algorithm components of the 2D and 3D imaging chain (e.g., flat-panel X-ray detectors, FPDs, and optimization-based image reconstruction, OBIR), a survey of interventional imaging platforms (e.g., C-arms, U-arms, and O-arms), and a review of clinical applications in interventional radiology, cardiology, and surgery.