Bearing Computed Tomography Devices

, Francois Lintz², Cesar de Cesar Netto³, Alexej Barg⁴, Arne Burssens⁵ and Scott Ellis⁶

(1)

Department for Foot and Ankle Surgery, Hospital Rummelsberg, Schwarzenbruck, Germany

(2)

Foot and Ankle Surgery Centre, Clinique de l’Union, Toulouse, France

(3)

Department of Orthopedics and Rehab, University of Iowa, Iowa City, IA, USA

(4)

University Orthopedic Center, University of Utah, Salt Lake City, UT, USA

(5)

Department of Orthopedics and Trauma, University Hospital of Ghent, Ghent, OVL, Belgium

(6)

Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA

Keywords

Weight bearing CT scanCone beam CT scanMusculoskeletal imaging techniques

Beginning of Weight Bearing Computed Tomography Devices

The necessity for weight bearing computed tomography (CT) devices has already been demonstrated in the mid-1990s by Greisberg et al. [1]. This pivotal paper reported on the peritalar subluxation occurring in flatfoot deformities using a simulated weight bearing CT device containing a custom-built loading frame with the patient positioned supine. It soon became a stepping stone for other reports to follow, incorporating a similar setup [2, 3]. Despite these important findings, limitations regarding patient positioning, amount of load, and a high radiation dose were inevitable [4]. This advocated the development toward the weight bearing CT devices currently used in clinical practice.

Foot and Ankle Weight Bearing Computed Tomography Devices

The first weight bearing CT devices were available beginning of the 2010s [5–7]. They incorporate cone beam CT technology, which in essence uses a rotating X-ray to obtain the field of view. It was initially popularized in the dental area, but technical improvements caused it to be widely used across the majority of medical disciplines. The main advantages include a low radiation dose, the absence of superimposition, and a high image resolution. One of the first applications of weight bearing musculoskeletal scanning was dedicated to the foot and ankle [8, 9].

Currently, three companies are on the market offering weight bearing CT devices in this area (in alphabetical order): Carestream (Rochester, NY, USA), CurveBeam (Philadelphia, PA, USA) and Planmed (Helsinki, SF, FI). Their physical properties as well as the concomitant landmark studies will be discussed for each device (Figs. 20.1, 20.2, and 20.3).