CT and fluoroscopy: Toward a dual unit

A combination of computed tomography and fluoroscopy (CTF) with digital subtraction has been developed by the interventional radiology unit of the National Cancer Institute of Milan. A Diasonics OEC 9000 high performance image intensifier mounted on a Siemens DRH Somatom scanner facilitates manoeuvring needles, guides and catheters in many diagnostic and interventional procedures. The potential advantages derived by this preliminary experience are: a) concentration of procedures in one room and one session; b) smooth handling of patients at risk; c) access to highly efficient diagnostic procedures for more patients; d) greater safety and higher first-pass success rate in interventional radiology, especially in the drainage of deep-seated abscesses and transcatheter embolisation. The role of CTF has yet to be defined and there are still problems due to makeshift combinations of the equipment and to over-booking of the CT scanner for diagnostic work-routine. The authors are working on a prototype that will incorporate at factory level real-time CT scanning and fluoroscopy with all mechanical and electronic facilities including digital subtraction.