H.15 Improving Arm Positioning for Conebeam CT

Project Statement

Conebeam CT (CBCT) has become a mainstay of advanced imaging in interventional radiology (IR) across the United States and the world. During outpatient minimally invasive image-guided procedures ranging from treatment of cancers in the liver to endovascular treatment of enlarged prostate glands, CBCT is used to confirm target location of treatment (such as tumors) and provide 3D roadmaps to steers microwires and microcatheters to a destination for treatment. The xray device must spin around the patient capturing images to generate a CT-like data set.

Several advances have been made in this space. For instance, given the rapid rise of transradial procedures (therapies that use the left radial artery as an approach to the liver, prostate, or other location in the body), CBCT has been advanced in some rooms with newer imaging equipment to avoid crossing the left arm. This allows the left arm to remain in position and not obstruct the geospatial rotation of the equipment. In older rooms, however, this remains a challenge. 

Nevertheless, the need to move a patients arm mid-procedure to avoid obstruction the rotation remains a central challenge. Arm boards providing stability often have to be removed. Many patients have osteoarthritis of the shoulder, making positioning difficult to hold for the length of the “spin” and uncomfortable. Patients may be of size, further limiting positioning and visualization. Older equipment may still require crossing the left arm, further complicating positioning. In tall patients for pelvic interventions, such as prostate artery embolization, the spin rotation may have to be altered, also adding to the complexity.

An ideal solution would position the arms in such a way as to be out of the field-of-view and rotation of the equipment, maintain a level of comfort for patients, have versatility to address the aforementioned issues, and be fast to set up and restore.

The mentorship/sponsorship team have innumerable years of experience and are seen as leaders in the use of advanced imaging like CBCT for image-guided interventions. They have had over 7 years of experience working with Capstone Design teams to foster new solutions in this dynamic but exponential growing space.