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In orthopedic hand surgeries C-arms are the standard imaging modalities for procedure and tool guidance. However, the currently used systems have a large footprint and high weight, which can lead to workspace restrictions and difficult positioning of the device at the desired imaging position. The aim of this paper is to present a prototype of a new, flexible, lightweight and small footprint X-ray system, which is capable to create 2D projection images from different orientations. The new design includes a miniaturized Xray tube covered in a custom-made case mounted on a flexible holding arm attached to the standard OR table rail. With that, fast positioning and fixation for the subsequent image acquisition is achieved. A flat panel detector is placed in an adjustable metal sheet construction below the table. For safety aspects an overlay of the X-ray cone beam with an integrated light source visualizes the irradiation area. The acquired images are visualized on a 2-in-1 netbook. A foot pedal initiates the imaging process. A prototype of the free movable miniaturized X-ray system FlexScan was build. Workspace restriction, usability and general imaging needs were simulated and tested. FlexScan has the potential to improve X-ray guided interventions on extremities especially for small private surgery centers. It fulfills the general imaging needs and is capable of producing 2D projection images from different orientations within a small and lightweight setup.

Radiation therapy is a valuable option for treatment of skin cancer. In order to deliver the radiation dose to the superficial skin tumor, an X-ray source, electron beam radiation therapy or a radioisotope is applied. The effectiveness of these procedures is well established in the literature. Findings of some recent studies have indicated that beta particles can be of particular interest in suppressing skin tumor growth. Betaemitting radioisotopes are favorable because of the short penetration depth of their emitted particles. Beta radiation can induce significant damage in superficial skin tumor, and at the same time, result in enhanced protection of the underlying healthy tissues. In this study, we propose the design of a patch that can be used in beta radiation therapy of skin cancer patients. For that, we describe the components of this radioactive patch, as well as a proposal for the subsequent clinical application procedure. A scaffold was used as a substrate for embedding the desired beta-emitting radioisotope, and two layers of hydrogel to provide protection and shielding for the radioactively labelled scaffold. The proposed design could provide a universal platform for all beta-emitting radioisotopes. Depending on the depth of the tumor spread, a suitable beta emitter for that specific tumor can be selected and used. This is of particular and critical importance in cases where the tumor is located directly on top of the bone and for which the depth of penetration of radiation should be limited to only the tumor volume. The proposed design has the mechanical flexibility to adapt to curved body regions so as to allow the use in anatomically challenging areas of the body.