Ep. 498 Advanced Techniques in Cone Beam CT with Dr. Michael Miller

Cone Beam CT has become a cornerstone of modern interventional practice. Are you utilizing it to its fullest potential? Dr. Michael Miller joins host Dr. Chris Beck to discuss Cone Beam CT, sharing advanced techniques and clinical pearls. Dr. Miller is an interventional radiologist and Associate Professor of Radiology at Atrium Health, Wake Forest Baptist Hospital, North Carolina. --- This podcast is supported by: GE Healthcare Allia Image Guided Systems https://www.gehealthcare.com/products/interventional-image-guided-systems/allia --- SYNPOSIS Dr. Miller explains the importance of fundamental training and how fundamentals can be scaled across various procedures to improve outcomes, including vascular malformations and endoleaks. Dr. Miller then speaks to best practices that he has learned firsthand through his years of using Cone Beam CT. The doctors also touch on tips for setting up the IR suite and collaborating with anesthesia. --- TIMESTAMPS 00:00 - Introduction 07:22 - Advanced Uses of Cone Beam CT 15:04 - Setup and Best Practices 22:34 - Vascular Malformations 23:32 - Understanding Sclerosant Distribution 26:53 - Trajectory Guidance in Complex Cases 32:45 - Contrast Bolus Timing and Spin Techniques 40:16 - Advice for New Angio Suites --- RESOURCES BackTable VI Podcast Episode #51 - Cone Beam CT Techniques with Dr. Austin Bourgeois: https://www.backtable.com/shows/vi/podcasts/51/cone-beam-ct-techniques Shujaat, S., Alfadley, A., Morgan, N., Jamleh, A., Riaz, M., Aboalela, A.A., Jacobs, R., 2024. Emergence of artificial intelligence for automating cone-beam computed tomography-derived maxillary sinus imaging tasks. A systematic review. Clin Implant Dent Relat Res 26, 899–912. https://doi.org/10.1111/cid.13352 Orth, R.C., Wallace, M.J., Kuo, M.D., Technology Assessment Committee of the Society of Interventional Radiology, 2009. C-arm cone-beam CT: general principles and technical considerations for use in interventional radiology. J Vasc Interv Radiol 20, S538-544. https://doi.org/10.1016/j.jvir.2009.04.026 Bapst, B., Lagadec, M., Breguet, R., Vilgrain, V., Ronot, M., 2016. Cone Beam Computed Tomography (CBCT) in the Field of Interventional Oncology of the Liver. Cardiovasc Intervent Radiol 39, 8–20. https://doi.org/10.1007/s00270-015-1180-6 Wallace, M.J., Kuo, M.D., Glaiberman, C., Binkert, C.A., Orth, R.C., Soulez, G., Technology Assessment Committee of the Society of Interventional Radiology, 2008. Three-dimensional C-arm cone-beam CT: applications in the interventional suite. J Vasc Interv Radiol 19, 799–813. https://doi.org/10.1016/j.jvir.2008.02.018 Bm, K., Sm, T., Mj, S., 2023. Cone-Beam CT With Enhanced Needle Guidance and Augmented Fluoroscopy Overlay: Applications in Interventional Radiology. AJR. American journal of roentgenology 221. https://doi.org/10.2214/AJR.22.28712 Kwok, Y.M., Irani, F.G., Tay, K.H., Yang, C.C., Padre, C.G., Tan, B.S., 2013. Effective dose estimates for cone beam computed tomography in interventional radiology. Eur Radiol 23, 3197–3204. https://doi.org/10.1007/s00330-013-2934-7