Flexible interventional imaging system based on miniaturized X-ray tubes (FlexScan)

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.