CBCT

Endodontics
On CBCT, an impacted wisdom tooth was visible.

The most significant benefit of the CBCT in endodontics is the 3D visualization of crucial root canal anatomical elements that are not visible on intraoral or panoramic pictures.

There are numerous particular circumstances in which 3D pictures generated by CBCT improve diagnosis and have an   impact on therapy, and that its usage is indisputable as opposed to conventional intraoral radiology based on the ALARA principles.

Implantology

When evaluating and planning surgical implants, a dental cone beam scan provides helpful information. Cone-beam CT is recommended by the American Academy of Oral and Maxillofacial Radiology (AAOMR) as the best presurgical technique for evaluating dental implant sites.

Orthodontics

In contrast to standard 2D radiography, CBCT provides an undistorted picture of the dentition that can be utilized to precisely visualize both erupted and non-erupted teeth, tooth root orientation, and abnormal features.

Orthopedics

The extremities can be seen clearly in the CBCT scanning. The ability to take weight-bearing pictures of the lower limbs with orthopedic CBCT is one benefit. Weight bearing CBCT is becoming more popular, especially in the field of the foot and ankle, because it combines 3D and weight bearing data, both of which are crucial for diagnosis and surgical planning. Following the initial scientific papers on the topic, WBCT for Weight Bearing CT has become the predominant word used for CBCT in the lower leg.

Image-guided radiation therapy

In order to lower the dose to surrounding organs that are not being treated, image-guided radiation therapy places the patient in such a way that the organs to be treated are precisely matched in position to the treatment field. A CBCT scanner mounted on the head of the radiotherapy unit is used right before treatment  to make sure the patient’s organs are precisely in the right position to match the treatment field and to adjust the position of the treatment table if necessary. This is because many internal organs within the body move by millimeters relative to the external skin surfaces. Additionally, the images may be utilized to check for additional treatment requirements like a full or empty bladder, an empty rectum, etc. If the organ appears exceptionally well on X-ray or if Fiducial markers have been placed inside the organ, it is possible to acquire basic X-ray positioning images using the same cone beam beam source and detector.

Interventional radiology

In the interventional radiology (IR) suite, the CBCT scanner is installed on a C-arm fluoroscopy device, providing real-time imaging with a stationary patient. This makes it unnecessary to wait for patients to be transferred from an angiography suite to a conventional computed tomography scanner, and it makes it possible to use CBCT for a variety of IR treatments. Treatment planning, device or implant location and evaluation, intra-procedural localization, and evaluation of procedure endpoints are some of the clinical uses of CBCT in IR. As a primary and secondary imaging method, CBCT is helpful. It is a great supplement to DSA and fluoroscopy for vascular and soft tissue visualisation during challenging procedures. The use of CBCT prior to fluoroscopy may lessen the radiation exposure to the patient.

Clinical applications

Chemoembolization for Hepatocellular Carcinoma: A contrast-enhanced computed tomography scan (CBCT) verifies that the right artery was chosen to give the treatment. The contrast highlights the parenchyma that the chosen artery supplies, revealing whether or whether the tumour is also nourished by the vasculature. The tumor’s lipiodol staining is confirmed by post-treatment noncontrast CBCT, increasing the operator’s confidence in full tumour coverage or additional therapy.

CBCT offers the soft tissue detail required to visualise prostatic enlargement, identify duplicated prostatic arteries, and prevent nontarget embolization. Prostatic artery embolization for benign prostatic hypertrophy. As a result of the overlapping pelvic structures and variable artery anatomy, CBCT is preferable to DSA for this therapy since it makes it easier to see the enhanced patterns on DSA.

Abscess drainage: CBCT confirms the location of the needle tip after ultrasound placement, and confirms the placement of the drain by displaying the contrast injection in the intended site.

Contrast-enhanced CBCT demonstrates adrenal gland perfusion to validate catheter placement for getting an acceptable sample during adrenal vein sampling for an adenoma.

Stent placement: Compared to conventional DSA and digital radiography, CBCT improves the visibility of intracranial and extracranial stents by providing a better portrayal of the interaction between the stents and adjacent structures

Percutaneous transthoracic needle biopsy of a lung nodule: CBCT guided needle placement and demonstrated 98.2% diagnostic accuracy, 96.8% sensitivity, and 100% specificity. Technically difficult conditions had no effect on the accuracy of the diagnostics.

Vascular anomalies: CBCT sensitively detects tiny infarcts in tissue that has been “sacrificed” during the process to stop additional shunting after coiling has corrected arteriovenous malformations. There is a little area of contrast retention that represents the infarcted tissue.

• Vascular Interventions in the Periphery
• Interventions in the Biliary
• spinal procedures
• Enterostomy Interventions