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Tag Archives: CT

The pedCAT Weight-Bearing CT Scan Put CurveBeam a Step Ahead of the Competition

It’s hard to forget about your feet—socks and shoes, not to mention pain at the end of a long workday. As the foundation of your mobility, foot health is vital to overall health. But foot health involves more than just keeping them clean and dry. It is vital to wear properly fitted shoes—custom insoles (avoid flimsy over-the-counter insoles) and supportive sandals are also a good idea. In fact, feet are so important to us that they even get their own specialists.

An expert in the field of podiatry, Dr. Kyle Kinmon of Boca Raton, FL recently shared some advice on WPTV for maintaining optimal foot health. Kinmon used part of his television segment to introduce viewers to the latest pedCAT technology from CurveBeam: a weight-bearing CT scan for diagnosing foot and ankle issues.

In fact, Kinmon’s office is the first in South Florida to offer a 3D foot scanner, the pedCAT technology from CurveBeam. Introducing the tool to TV viewers on WPTV, Kinmon said, “This is called the pedCAT. It’s the newest technology in the world of foot and ankle. It’s a weight-bearing CT scanner that, in 19 seconds, will provide us with every possible image you could want to see in the foot and ankle.”

To learn more about Dr. Kinmon’s practice, please visit www.certifiedfoot.com.

Dr. Kinmon, a fellow of the American College of Foot and Ankle Surgeons, has contributed to research in the field of podiatry with many peer-reviewed publications, including an award-winning article in the Journal of the American Podiatric Medical Association and an article on pediatric flat foot for New Balance shoe company’s health line. Kinmon is also the Founding Director of Residency Training for Bethesda Memorial Hospital’s three-year Podiatric Surgical Residency Program, further supporting residents in surgery at three area residency training programs.

While Kinmon is highly trained in foot and ankle surgery, he always considers surgery the last resort. In the vast majority of cases, surgery is not required, and the condition is resolved using conservative treatment alone. Still, even for someone as skilled as Dr. Kinmon, diagnosing foot and ankle issues can be challenging.

The pedCAT’s bilateral, weight-bearing 3D views of the foot and ankle give specialists the information they need to create comprehensive treatment plans. Its compact (4’ x 5’), ultra-low dose (2-5 micro Sieverts per scan) CT imagine system plugs into the wall and is ideal for orthopedic and podiatric clinics. Scan time is one minute, and the pedCAT automatically generates all standard X-ray views in addition to the full CT volume. The pedCAT is PACS/DICOM compatible and supports DICOM modality worklist (HIS/RIS) and PACS integration.

One can definitely understand why Kinmon was excited to share the news about pedCAT with television viewers. With the pedCAT from CurveBeam, his job is now a lot easier and his diagnoses more accurate than ever.

To learn more about the exciting new pedCat from CurveBeam, visit http://curvebeam.com/products/pedcat today!

Discussion Looks to Provide Blueprint for Foot and Ankle Deformity Correction

Foot and Ankle Specialist (FAS), a bi-monthly journal for orthopedic surgeons and podiatrists, recently published a roundtable discussion focused on providing insight into the difficult process of deformity correction. For surgeons dealing with the lower extremities, even the central principles of understanding and treating deformities can be extremely complex. Noman Siddiqui, Guido Laporta and John Herzenberg, all of whom carry numerous distinctions in the field of podiatry, all weighed in on the discussion.

Deformity management in cases involving the lower limb can involve high levels of pain. Because of this, while analysis is fairly similar to deformity analysis in other regions of the body, treatment is as much an art as a science. Much of the discussion involves presentation of cases and remarks by the specialists as to how they would care for the patient.

The roundtable ranges from topics on improving education in the field to proper care of patients who are treated with external fixation. Of particular interest is the repeated insistence by the panel that the most essential way to improve the field is to increase the amount of information available to a surgeon before an operation occurs. They remark that, even though patients receive a thorough physical as well as a biomechanical exam, gait analysis, and functional testing, more extensive testing and imaging is needed.

All three of the medical experts point out the need for a computed tomography (CT) scan for the more difficult cases. These scans help to erase any gray areas in the diagnosis and help to evaluate the “mal-union” or “non-union” present in malformed feet and ankles. Dr. Herzenberg even recommended 3D CT technology in order to get a complete picture of the situation, and both a weight and non-weight bearing evaluation.

“[Foot] deformity is complex and may require second-level radiographic studies such as a CT scan,” remarked Herzenberg. “Recently, we have added a standing 3D CT machine in our office, which offers the same advantage from a CT standpoint that we get from plain films taken weight bearing versus non–weight bearing.”

These orthopedic specialists are not alone in their desire for more comprehensive scanning technology when treating deformities. More and more clinics are taking similar steps to those used by Herzenberg’s clinic, The Pediatric Orthopedics Department at Sinai Hospital in Baltimore, which now uses the CurveBeam pedCAT. It is quick, efficient and thorough, and was designed with patients in mind, limiting their discomfort. This is especially important since, as mentioned earlier in the roundtable, pain can be significant when dealing with foot and ankle deformities.

The discussion presents a comprehensive look at the current practices in a complex corner of healthcare, and presents insights into the best way to manage orthopedic deformities in the lower extremities. The specialists involved even go so far as to give advice for those preparing to deal with these cases, and examine current technology that allows them to do so to the best of their ability. To read the roundtable discussion in its entirety, click here.

 

Weightbearing CT Revolutionizing Hindfoot Alignment Measurements

A new study, led by famous Belgian M.D. A. Burssens, emerged in the February issue of Foot and Ankle Surgery. The study examines the use of traditional hindfoot angle measurements versus weight bearing CT and shows how weight bearing CT can help contribute to the pre-operative planning by providing further insights into a physiological hindfoot alignment.

Hindfoot malalignment is a widely-accepted cause of foot and ankle disability and problems. For preoperative planning and clinical follow-up, reliable radiographic assessment of hindfoot alignment is of utmost importance and can affect future health. The long axial radiographic view and the hindfoot alignment view are commonly used for this purpose. The main goal of this study is to obtain measurements from a population with clinical and radiological absence of hindfoot pathology. These values were then compared to hindfoot measurements obtained from the long axial view based on the anatomical axis of the tibia and the calcaneal axis, to point out possible differences attributed to that measurement method.

The study has many key findings related to traditional hindfoot predictive measurements. One major finding questions the commonly held belief that non-symptomatic feet have a slight valgus. When traditional hindfoot angle measurements were applied, the study showed that non-symptomatic feet have a neutral alignment. These results show a more neutral alignment of the hindfoot as opposed to the generally accepted constitutional valgus.

Another major finding was that the weight bearing CT clearly showed the talus. The talus is usually superimposed in plain x-rays and hard to see and can affect the mathematical calculations of the predicted hindfoot angle. So, unlike the Saltzman view, these calculations included the talus.

The ultimate goal of all orthopedic surgeons is to influence the correct alignment of bones. Even the slightest miscalculation in measurement can have lasting consequences on post-surgery recovery and future mobility. As the study notes, “Although surgical hindfoot corrections are frequently performed either extra-articular by osteotomies or intra-articular by arthrodesis, still numerous debate exists on the amount of correction and the ideal foot position after arthrodesis.” This finding could have repercussions on hindfoot position during fusion or in quantifying the correction of a malalignment. Due to the use of weight bearing CT, the inferior calcaneus point can be used during pre-operative planning of a hindfoot correction as an anatomical landmark due to its shown influence on load transfer.

A disadvantage of the study was that it was not truly spatial, as only the coronal plane was used in measurements. In the future, 3D segmentation models will allow for better spatial calculations. Until 3D weight bearing CT is an available option, it is recommended foot & ankle specialists exercise caution when planning from 2D radiographs. This study will contribute to the pre-operative planning by providing further insights into a physiological hindfoot alignment. For more detail, access the article here.

CurveBeam Is the Innovator in 3D Orthopedic Imaging Technology

Cone beam computed topography, or CBCT, has become the standard of care in orthopedic imaging. This technology has revolutionized the practices of doctors in the orthopedic and podiatric industry. Automatic measurement tools lead to better patient outcomes with the added convenience of point-of-care advanced diagnostics. CurveBeam’s goal is to lead the way with cutting-edge innovations in orthopedic imaging. CurveBeam not only adopts new technology quickly, but is increasingly setting the standard.

CurveBeam imaging products are designed specifically to analyze extremities, especially knees, ankles, and feet. These compact, affordable units give specialists high-quality, weight-bearing 3D views of a patient’s foot and ankle. Scans are low-dose, so units don’t require shielding or dedicated facilities. Units are lightweight, mobile, and require no special power sources, so they can easily become an essential tool in virtually any practice.

In the past, doctors had to interpret images manually. CurveBeam’s software uses artificial intelligence to predict a patient’s future prognosis and recommend a comprehensive treatment plan. Providers will find this advanced capability directly impacts their practice, resulting in improved diagnostics, streamlined workflow, and greater productivity.

CurveBeam is an innovator setting the standard of care in orthopedic imaging. Check out our video below to learn more about this exciting technology!

CurveBeam’s pedCAT Imaging System Exhibited at CIRMS Annual Meeting

The Council on Ionizing Radiation Measurements and Standards (CIRMS) 25th Annual Meeting in Gaithersburg, MD will showcase new cutting edge technologies touching on the fundamental aspects of radiation measurements and focusing on the theme of ‘Past, Present, and Future’. The dynamic and diverse aspects of the importance of measurements and standards in this area will be addressed by international experts from academia, industry, and government. These experts will examine radiation protection, industrial applications and radiation effects, medical applications, homeland security, and other related areas.

CurveBeam is pleased to announce we will be participating. A CurveBeam engineer will be presenting on Tuesday, March 28 during “Breakout Session III: Real Time Imaging for Orthopedic Applications.” Her talk is titled “Why Cone Beam CT Can Make 3D the Standard of Care in Extremity Imaging.” With Cone Beam CT imaging, CurveBeam is revolutionizing the way specialists diagnose and create comprehensive treatment plans for podiatric and orthopedic issues.

The core team behind CurveBeam pioneered Cone Beam CT imaging technology for the dental specialties. The introduction of point-of-care Cone Beam CT imaging revolutionized the industry and ushered in the advent of custom dental implants and improved practices in orthodontics and oral surgery. Today, Cone Beam CT scans are virtually the standard of care for advanced oral surgery treatment planning. In the same way, CurveBeam hopes to contribute to the improvement of the orthopedic and podiatric specialties worldwide through their new product pedCAT.

One of the goals of the CIRMS Annual Meeting is to get input from audience participants on the need for developing a 3D real-time imaging tool for evaluating orthotics inside shoes with the patient in a weight bearing position. Once the orthotic has been made, an image of the patient can be taken in the weight bearing position, with the patient standing in his/her shoes with the new orthotic installed in the shoe. This type of analysis could be used to evaluate if the orthotic does what it is meant to do. The 3D weight bearing images can provide information about specific bone alignment issues using the new orthotics. The images can also reveal if the new orthotic is providing the expected amount of correction without compromising other foot anatomical issues, and if the spacing between the major foot joints is affected by the new orthotic.

CurveBeams’s pedCAT system allows specialists a unique bilateral, weight bearing 3-dimensional view of the foot and ankle to fully diagnose and create comprehensive treatment plans. The pedCAT is a compact, ultra-low dose CT imaging system ideal for orthopedic and podiatric clinics. Patients benefit from the convenience of point-of-care advanced diagnostic imaging. Scan time is one minute, and the pedCAT automatically generates all standard X-Ray views in addition to the full CT volume. Depending on the scan protocol, the patient is exposed to 2 – 5 micro Sieverts per scan. That’s about the same as a plain X-Ray study of the foot and ankle, and less than the average daily background radiation a U.S. resident is exposed to.
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To learn more about the CurveBeam pedCAT Imaging System and how it is revolutionizing the orthopedic and podiatric fields, visit curvebeam.com, or talk with our team at the CIRMS 25th Annual Meeting, March 27th to March 29th in Gaithersburg.

Using The InReach to Detect Scaphoid Fractures

Scaphoid fractures are often difficult to diagnose. The scaphoid may be difficult to visualize on X-Rays due to superimposition.  A delayed or incorrect diagnosis of a scaphoid fracture could result in grave outcomes such as nonunion, delayed union, decreased grip strength, reduced range of motion, and/or osteoarthritis of the radiocarpal joint.

X-ray is currently the standard method of diagnosis, but according to Vinti Singh, an Advanced Medical Imaging Specialist at CurveBeam, “…that particular part of the wrist is really hard to see on X-ray.  CT scans show scaphoid fractures clearly, but traditionally, patients must travel to a hospital or imaging center to access this service.” Singh adds that CurveBeam is developing the InReach, a point-of-care cone beam CT imaging system for the upper extremities. The InReach is investigational only and is not available for sale in the United States. The CurveBeam R&D team is striving to  “provide faster, more accurate detection and as a result, better patient care.”

Since scaphoid fractures rarely appear on X-rays right away, doctors often send a patient home in a splint or cast for two to three weeks if they suspect a scaphoid fracture. Typically, the patient will then return for another X-ray.  With the InReach, a patient could get a CT scan, at the physician’s discretion, for a definitive diagnosis.

The CurveBeam InReach will provide point-of-care CT imaging of the upper extremities. The InReach is investigational only and is not available for sale in the United States.
The CurveBeam InReach will provide point-of-care CT imaging of the upper extremities. The InReach is investigational only and is not available for sale in the United States.

CurveBeam’s InReach system will scan the wrist structures in nineteen seconds. MRIs take much longer, as do bone scintigraphy processes, which also require injections of imaging dye or radioactive material. The InReach delivers high resolution images with 0.3mm slices, accounting for their improved diagnostic accuracy over the X-ray. The unit will have a small footprint and uses a regular wall outlet, unlike a traditional CT unit, which requires  more space, power and additional cooling needs of a traditional CT. Patients need only place a hand in the machine for a few seconds, as opposed to having to lie down on a CT bed. So not only does the InReach system reduce patient frustration at scheduling and waiting for multiple appointments, but it also maximizes patient comfort.

With complicated injuries like the scaphoid fracture, timely diagnosis and treatment are critical in avoiding the potential long-term wrist dysfunction resulting from misdiagnosis. Compared to the previous standards of X-rays, MRIs, bone scintigraphy, and traditional CT scans, the InReach would offer superior speed and accuracy while delivering a high level of patient care and comfort. Learn more about CurveBeam and the InReach imaging technology here.

Weightbearing CT Imaging Methodology with pedCAT by CurveBeam

 
Three-dimensional weight-bearing computed tomography (CT) can be a powerful diagnostic tool, typically used when more information is necessary (e.g. intra-articular fractures, occult fractures and small bone tumors). Unlike conventional CT, which has a fan-shaped X-ray beam, modalities in the pedCAT created by CurveBeam have a cone-shaped X-ray beam. In a Podiatry Today’s article titled “Current Concepts With Weight bearing CT”, Dr. Albert V. Armstrong Jr., dean of the Barry University School of Podiatric Medicine, reviewed three independent studies that examined the efficacy of the technology.

In the first, Yoshioka and colleagues studied 10 patients with posterior tibial tendon dysfunction and 10 control patients, using weight-bearing and non-weight-bearing CT.1 The authors noted that the study clarified part of the clinical condition of the forefoot in flatfoot deformity, saying this may be applicable in basic research of the staging advancement and sub-stage classification of flatfoot.

In the second study, Krähenbühl and coworkers used weightbearing CT to determine the subtalar vertical angle in a study of 40 patients with osteoarthritis and 20 control patients.2 The study authors found that measuring the subtalar vertical angle was a reliable and consistent method to assess the varus/valgus configuration of the posterior facet of the subtalar joint.

In the final study, Geng and colleagues studied weightbearing and non-weightbearing CT scans of 10 patients with hallux valgus and 10 control patients, reconstructing 3D models for the first metatarsal and the medial cuneiform.3 Researchers noted the study furthers an understanding of the physiological and pathological mobility of the first metatarsocuneiform joint.

Weightbearing CT is a safe imaging modality with low radiation exposure that can provide superior images in comparison to conventional CT, as evidenced by the multiple studies. Weightbearing CT can enhance biomechanical evaluation, preoperative planning, postoperative evaluation, wound management, sports medicine, treatment of arthritic conditions (especially degenerative joint disease) and trauma (especially when looking for occult or hairline fractures). It is a promising and up and coming imaging method to replace traditional CT technology.

Cone beam CT allows clinicians to obtain an image of a volume of tissue in one circumferential pass instead of having to take multiple slices with multiple exposures. This leads directly to reduced radiation exposure for patients. Studies indicate, in the example of a bilateral scan of a foot, the pedCAT machine exposes patients to one third the amount of radiation as traditional methods. Another great feature of weight-bearing CT is the ability to perform bilateral scans. One can also view the same patient with the view of the the soft tissue structures removed, leading to increasingly accurate prognosis. In addition, the pedCAT is an excellent tool to illustrate visually to a patient exactly where a bunion, for example, is located underneath the soft tissue. The generated visual displays are much easier to understand for non-trained individuals.

Performing actual weightbearing examinations is possible through pedCAT, a main advantage of the machine. In a specific instance, a podiatrist can view a foot supporting weight, viewing the 3D image and the accompanying 2D images in the sagittal, axial (transverse) and coronal (frontal) planes. This would allow the physician to observe the appendage in its most natural state, allowing a more precise diagnosis of problems.

Read “Current Concepts With Weightbearing CT” by Dr. Albert V. Armstrong Jr. here: http://www.podiatrytoday.com/current-concepts-weightbearing-ct