Region-Of-Interest Reconstruction on medical C-arms with the ATRACT Algorithm

Between 2006 and 2008, the business volume of the top 20 orthopedic manufacturers increased by 30% to about $35 Billion. Similar growth rates could be observed in the market of neurological devices, which went up in 2009 by 10.9% to a volume of $2.2 Billion in the US and by 7.0% to 500 Million in Europe.* These remarkable increases are closely connected to the fact that nowadays, many medical procedures, such as implantations in osteosynthesis or the placement of stents in neuroradiology can be performed using minimally-invasive approaches. Such approaches require elaborate interoperative imaging technology. C-arm based tomographic X-ray region-of-interest (ROI) tomography can deliver suitable imaging guidance in these circumstances: it can offer 3D information in desired patient regions at reasonably low X-ray dose. Tomographic ROI reconstruction, however, is in general challenging since projection images might be severely truncated. Recently, a novel, truncation-robust algorithm (ATRACT) has been suggested for 3D C-arm ROI imaging. In this paper, we report for the first time on the performance of ATRACT for reconstruction from real, angiographic C-arm data. Our results indicate that the resulting ROI image quality is suitable for intraoperative imaging. We observe only little differences to the images from a non-truncated acquisition, which would necessarily require significantly more X-ray dose.