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Customer Stories Case stories Company Culture Terms Sales terms Purchasing terms Explanation of Warranty Terms Privacy and Cookies Sponsorship Blog Contact Make Claim Select Page When to Use Mobile C-arm Machines? (Guide) Nov 28, 2019 Topics to Look Forward in This Blog Post: What is a mobile C-arm machine. And what is fluoroscopy. What to use C-arm machines for. General surgery, orthopedic and urology procedures Vascular and neurology procedures Cardiac procedures Image intensifier vs Flat-panel detector Today, you’re going to learn all about mobile C-arm machines. Are you wondering what kind of C-arm to get or what C-arm image intensifier you need for certain examinations. We are going to make it clear once and for all. So, without further ado, let’s get started. Firstly, W hat Is a Mobile C-arm Machine. In brief, a C-arm machine is a piece of medical imaging equipment that operates on the basic principle of X-ray technology. This fluoroscopy device is used to visualise patients’ anatomy in the operating room during surgery. This is different from most other X-ray equipment that is used for diagnostics and therefore generates revenue. Why are they called C-arm machines. That is due to the C-shaped arm, which is used to connect the X-ray source (the X-ray tube) and X-ray detector (the image intensifier). Its special semi-circular design a llows the physician to move it more freely, covering the patient’s whole body and taking images wherever needed. And what is fluoroscopy and how does it work. C-arm machine is a fluoroscopy system. F luoroscopy is a method pr oviding real-time X-Ray imaging, which is particularly useful for guiding various diagnostic and interventional procedures. Though you should remember that C-arms are generally not used in diagnostics, they are made for surgery.
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Since the C-arm’s fluoroscopy technology enables the machine to provide real-time, high-resolution X-ray images, the surgeon can monitor the progress of the procedure and make decisions ac cordingly. C-arms are mobile, therefore, the most common use is in studies that require maximum positional flexibility. When you know the exact type of procedures you are going to use the C-arm machine for, it becomes easy to choose the right system. So, what will you use your C-arm system for. GE Fluorostar 7900 C-arms come with different types of image intensifiers. Commonly, you have to decide between 9? or 12” (though Siemens makes a 13” as well). And while bigger image intensifier doesn’t mean better, it does means more expensive. C-arm machines that come with 12” image intensifier cost more than 9” C-arms. That’s why it’s even more important to know for sure which C-arm fits your practice. In regard to general surgery, orthopedic procedures, and urology procedures, 9? image intensifier will be just right. Systems such as the Siremobil Compact L from Siemens, BV Libra from Philips, OEC 865 Brivo Plus and OEC 8800 from GE will be ideal. The C-arms employed in this type of procedures don’t need any special options. Usually, they come with a last image hold (LIH), limited image storage capacity, image printing and an export function. What about C-arms for vascular and neurology procedures. If you mainly focus on these types of examinations, 12.Although you can find 9” C-arms with vascular capabilities, you will benefit more from the 12” C-arm system. Consider C-arms such as the BV Endura and BV Pulsera from Phili ps, OEC 9900 from GE as well as the Vista Endo from Ziehm. The larger field of view makes it possible to see a larger part of the body and thus allows you to perform the procedure in one shot. This would be rather challenging to do with the 9? image intensifiers.
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Furthermore, the C-arm should come with a bigger tube and generator capacity as well as larger image storage. And to perform contrast imaging, the C-arm must have the Substruction and Road Map options. And what type of C-arm machines to use in cardiac procedures. In addition, cardiac exams require a fast acquisition rate. Suitable systems would be the OEC 9900 and OEC 9800 from GE. Another thing to keep in mind. All types of C-arms can perform general surgery, orthopedic and urology procedures, however, vascular and cardiac exams need additional storage and capabilities. GE OEC 9800 Image Intensifier (II) vs Flat-panel Detector (FPD) We have discussed image intensifiers a bit. But what about Flat-panel detectors (FPD). These are digital detectors that come with a technology that was once only available in fixed room systems. Digital imaging is a powerful tool offering benefits such as lower patient dose and enhanced image quality. Also, the image quality does not deteriorate over time. The flat panel detector is shorter than the image intensifier as it is a flat panel and not an extended tube structure. That gives you more space in the room during the surgery and makes it more comfortable to operate, especially when having larger patients. However, for C-arm machines, digital imaging it is still a relatively new technology. Why are flat panel detectors (FPD) not standard on all C-arm machines. Since C-arm machines are used for visualisation of patient’s anatomy, but not for the diagnosis, they don’t generate the same revenue as standard devices in radiology. Hence, they must be cost-effective. That’s why image intensifiers are still widely used. Don’t let this cause unnecessary concerns. Image intensifier C-arms are still the standard of care and capture high-quality images that are comparable to those captured by digital C-arm machines. Real-time fluoroscopy is possible with FPD but raises the device’s costs significantly.
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Therefore, FPD is coming slowly on the new models of C-arm machines, while they have been standard for many years on the fixed special procedure systems such as Cath Labs. Currently, the market is mainly filled with image intensifier systems and it will take some time for digital C-arms to enter the market for used equipment. When they do, the price of FPD systems will be much higher than the price of C-arms with image intensifiers. Nevertheless, after time they will become standard and the costs will reduce due to a higher volume. Conclusion So, is it now clear when to use the different types of C-arm machines. Let’s make a quick recap. For general surgery, orthopedic procedures, and urology procedures, you will need a 9? image intensifier and no special options. During vascular and neurology procedures it is better to use a C-arm with a 12. Also, remember you need the Substraction and Road Map options to perform contrast imaging. Are you looking for a C-arm machine and would you like to know how much a used C-arm machine cost. Then read our blog about mobile C-arm prices. We want you to be able to make a well-informed decision about where to spend your money. By continuing to browse the site, you are agreeing to our use of cookies. OK Privacy and Cookies Contact us Regardless of your need, LBN Medical is here to serve. Please fill out the contact form below, let us know what interests you, and we’ll get back to you as quickly as possible. Please upgrade your browser to improve your experience. We provide a real alternative to costly OEM service contracts. C-arm design consists of an x-ray source and an x-ray detector, with the characteristic C-shaped arm used to connect the two elements while allowing access to a variety of positioning capabilities. Avante's factory new and professionally refurbished C-arms, ideal for use in any imaging suite. We carry popular refurbished GE OEC C-arms, as well as our new line of high-quality, budget-friendly alternatives.
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Using either the handheld remote or onboard control panel, the Delphi can be positioned via the following motions: height, lateral tilt, Trendelenburg, longitudinal travel, and lateral travel. With a wide vertical adjustment range, the Delphi is compatible with even the largest C-arm systems. Mobile c-arms provide enough imaging power for almost every clinical application, except for cases requiring high amounts of sustained imaging power. Mini c-arms are ideal for scanning hands, feet, ankles, wrists, and elbows, and are often designed with a smaller overall footprint. Mini c-arms can also usually be operated by the surgeon, making them an ideal option for small spaces. X-ray intensifiers help to ensure low doses during imaging procedures, because they help to intensify even low-density x-rays. A relatively new feature to the C-arm market, flat panel detectors directly convert x-rays into digital values. Based on quality techniques, flat panel detectors produce better image quality because they don’t reduce scale with the use of magnification in comparison to an XRII. Use of them does not imply any affiliation with or endorsement or sponsorship by them. Learn more. It provides the ideal balance between image quality, ease of positioning and ergonomics, to make use of in the critical environment of the operating theatre. Features. Arcovis 3000. Compact size C - arm X-ray unit. MultifunctionalMobile C - arm with digital imaging. Digital C-arm X-ray unitMobile and high power C - arm system used in angiography, traumatology and orthopedics. High power generator. Ares MR Angio provides great quality of image due to high power capacity of. Rotating Anode. The rotating anode will make it possible to extend examinations. The range of high frequency generators associated with the mobile range responds to the wide range of C - arm applications. Rotating anode. A rotating anode allows the equipment to.

The range of high frequency generators associated with the mobile range responds to the wide range of C - arm applications. Rotating anode. A rotating anode allows the equipment to. The Xenox C 400 is a highly reliable, tough and enduring digital mobile system with flat panel equipped with digital angiographic memory. Xenox M300CV is a mobile c-arm, which is widely used in orthopedics, urology surgery, spinal surgery, abdominal surgery, pain management, digestive department,. Xenox C 100 is a reliable, tough and enduring mobile c-arm, with the maximum affordability; intuitive software for different configurations with user-friendly interface It also has C-arm design. Our exclusive manual C-arm vertical movements realize much quicker height adjustments in your daily. From pacemaker and biventricular implants to bypass checks and AAA repair, the BV Pulsera mobile fluoroscopy system has high image quality and power you need. It provides critical insight. Innovations. With a simple touch, focus on critical details and see more with the OEC Elite CFD C - arm portfolio. Introducing intuitive and powerful features that enhance. Responds perfectly to operator touch and feel. Suitable for all surgical procedures. Technical Specifications. Its ergonomic. The Novarex NT-20 mobile C-arm imaging system meets today’s increasing imaging demands by providing optimum image quality. High frequency 5kW generatorSensitive touch button, LCD display. CE approved Thank-you for your help. Prices are indicative only and may vary by country, with changes to the cost of raw materials and exchange rates. Purpose: Allows physician to re-familiarize themselves with radiation physics and safety principles necessary for the safe operation of fluoroscopy equipment. The name derives from the C-shaped arm used to connect the x-ray source and x-ray detector to one another.

C-arms have radiographic capabilities, though they are used primarily for fluoroscopic intraoperative imaging during surgical, orthopedic and emergency care procedures. The devices provide high-resolution X-ray images in real time, thus allowing the physician to monitor progress and immediately make any corrections. X-ray imaging systems use such intensifiers (like fluoroscopes) to allow converting low-intensity x-rays to a conveniently bright visible light output. The XRII requires lower absorbed doses due to more efficient conversion of x-ray quanta to visible light. The other is commonly referred to as a C-arm system that is used where greater flexibility in the examination process is needed. The C-shaped connecting element allows movement horizontally, vertically and around the swivel axes, so that X-ray images of the patient are produced from almost any angle. The image intensifier or detector converts the X-rays into a visible image displayed on the C-arm monitor. Physician can check anatomical details such as bones and the position of implants and instruments at any time. It uses two-dimensional (2D) X-ray projections acquired with a FDP C-arm system to generate CT-like images. To this end, the C-arm system performs a sweep around the patient, acquiring up to several hundred 2D views. They serve as input for 3D cone-beam reconstruction. Resulting voxel data sets can be visualized either as cross-sectional images or as 3D data sets using different volume rendering techniques. Initially targeted at 3D high-contrast neurovascular applications, 3D C-arm imaging has continuously improved over the years and now provides CT-like soft-tissue image quality. In combination with 2D fluoroscopic or radiographic imaging, 3D C-arm imaging provides valuable information for therapy planning, guidance, and outcome assessment all in the interventional suite. This would result in image degradation.
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Light generated outside the area of the image intensifier input at magnification causes additional loss of contrast of the image with increased noise. Additionally, unnecessary additional dose to the patient would result. If the C-arm or fittings are damaged, the x-ray tube and intensifier may become misaligned resulting in image degradation or loss, as well as presenting a potential injury to staff and patient if the structural integrity of the C-arm or mounted components are compromised. Its concept provides the full flexibility of a mobile C-arm combined with fixed room imaging capabilities. The technology allows for longer procedures and accommodates larger patients while virtually eliminating overheating and procedure delays. Plus the improvement in image quality makes it possible to accomplish longer, more complex exams. All systems have integrated software to automatically control contrast and brightness and also dose control to help support safety without compromising image quality. ARCADIS Orbic 3D, the high-end C-arm with isocentric design and 190-degree orbital movement, was developed for spine and neuro work. It can be equipped with NaviLink 3D1, the direct 3D navigation interface. GE has introduced several programs and enhancements around issues of particular customer interest: workflow, ergonomics, cost, and reducing clinician dose. There are more than 34,000 OEC mobile C-arms, including 10,000 OEC 9900 Elite systems, in use throughout the world. OEC has proprietary precision imaging technology using Dynamic Range Management for high-quality images in almost every situation. The company’s fixed system shares the detector technology, offering superior image quality while lowering dose. Surgeons can use these undistorted images to help place screws and other devices with precision. The flat detector on the Veradius Neo has a greater dynamic range than older II technology.

Veradius Neo incorporates a full range of dose management features that allow low X-ray dose without compromising image quality.

The resultant volumes are arranged in a movement hierarchy that models bone movements (eg, rotation around center, dislocation from center) according to the joint area involved (eg, the right or left hip) ( Fig 6, Movie 1 ). This feature allows trainees to obtain practice in positioning patients appropriately to obtain optimal procedure-specific intraoperative radiographic views (eg, an axial Lauenstein view of the hip). Figure 6 Composite of screen captures demonstrates the effect on DRRs of the right hip with the C-arm positioned directly above the hip (left) and at progressively more acute angles while the virtual patient's right leg is moved through various positions. Figure 6 Download as PowerPoint Open in ImageThese simulated implants may be selected for inclusion in the patient model (or deselected) by the user at any time during completion of an exercise. Operating room staff who use a C-arm to monitor surgical implantations may benefit greatly from procedure-specific training. In the placement of intramedullary nails, for example, the insertion of locking screws is especially difficult and often requires extensive imaging time, with a resultant high radiation dose. To allow accurate insertion of locking screws into a femoral nail, the C-arm must be precisely positioned over the nail so that each screw hole appears as a perfect circle ( Fig 7, Movie 4 ). If the locking screws are inserted at even a slight angle, they will not be properly seated to provide stability. When the C-arm is properly positioned, the x-ray beam (ie, the line between the image intensifier and the radiation source) marks the direction of drilling for the surgeon. Figure 7 Composite of screen captures shows various C-arm positions and the corresponding DRRs obtained during a virtX training exercise for radiographic evaluation of retrograde left femoral nail placement.

Figure 7 Download as PowerPoint Open in ImageFigure 8 Composite of screen captures from a virtX training exercise depicts the focus of the x-ray beam and the progress bar for direct radiation exposure. Figure 8 Download as PowerPoint Open in ImageThe intensity of the scattered radiation is depicted by the maximum size of three pulsating spheres in the virtX display ( Fig 9 ). Although the circumference of the spheres is not a physically accurate representation of radiation propagation, it is indicative of the relative intensity of the simulated radiation, which is calculated on the basis of the tube voltage, distance between the radiation source and the patient, width of the aperture, and other imaging parameters. The distribution and intensity of scattered radiation are also affected by the viewing angle, table position, and structure of the patient; however, because of the difficulty of incorporating these variables into real-time simulations, they are not yet included in the virtX calculations. Although the virtX display does not represent precise isodose curves, it visually demonstrates to the trainee which adjustments in C-arm position and aperture diminish the radiation exposure and which ones do not. Figure 9 Successive screen captures represent a single pulsation phase of the color-shaded spheres at a fixed C-arm position. The maximum size of the pulsating spheres depicts the overall intensity of scattered radiation. Figure 9 Download as PowerPoint Open in ImageThe effectiveness of the virtX system has been evaluated in a number of studies involving the training of operating room personnel. The first study ( 13 ), a prospective investigation, was focused on evaluating the usability and acceptability of virtX and its effects on learning. The study was conducted during a course for operating room personnel that was offered by AOTrauma, in Gottingen, Germany.

The study participants were enrolled randomly in one of three training groups: intervention group 1 (using virtX on a PC), intervention group 2 (using virtX with input from an actual C-arm), and a control group (undergoing traditional training without virtX). The participants in all groups completed the same training exercise. The participants in the control group needed significantly more time to complete the exercise than did those in the group trained with virtX and a real C-arm as an input device. Trainees who used the virtX program on a PC also performed better than the control group, but the difference in performance was not statistically significant. Virtual radiography was judged helpful for understanding C-arm operation, with an acceptance rate of 91. A second study ( 14 ) was focused predominantly on evaluating the realism of changes in the DRR effected by interactive repositioning of the patient on the operating table ( Fig 6 ). The effectiveness of a recently introduced feature (the depiction of scattered radiation by using pulsating spheres) also was assessed. This study was conducted by distributing questionnaires to participants in a course offered by AOTrauma, in Gottingen, Germany. During the course, each participant had the opportunity to practice C-arm operation by using virtX in both virtual and real modes. After finishing the course, each participant was asked to complete a questionnaire. A total of 78 thought the translation of changes in the positioning of the mannequin on the operating table to the simulated DRRs was sufficiently realistic, 1 disagreed, 17 had a neutral opinion, and 4 did not respond to the question. A total of 79 stated that they acquired new knowledge about the avoidance of unnecessary radiation exposure, 10 said they did not, and 11 gave a neutral response.

Approximately 75 of the participants agreed (43 strongly agreed) that their understanding of the effect of the position of the image intensifier on scattered radiation was improved by the depiction of x-ray distribution. The results of the study confirmed that the translation of patient positioning changes to DRRs was sufficiently realistic and that the visualization of scattered radiation helped trainees understand the basic concepts underlying radiation exposure. Similar results were achieved among residents in courses offered by AOTrauma in Greece, Dubai, and Switzerland. Future Prospects of Computer-based Training Computer-based methods are advancing the state of the art of training in medicine generally ( 10 ) and in radiology specifically ( 11 ). Maleck et al ( 19 ) conducted a prospective study to define the role of computers in teaching radiology to medical students and found that computer-based training with case studies improves students’ problem-solving ability. They identified interactivity as a key factor in the potential success of computer-based training. Critics have expressed concern that the substitution of computer-based simulation for face-to-face interaction has important negative implications for training in radiology and may undermine the emphasis on the patient ( 20 ). However, the use of live volunteers for hands-on training in surgical and radiologic procedures (especially those that involve the placement of implants) is impossible, and the cost of cadavers is prohibitive. Computer-based simulations give trainees the opportunity to practice procedures in a realistic environment. The results of a number of studies, in addition to those we have described for virtX, have shown positive effects on learning with the use of simulation-based training systems. Nilsson et al ( 21 ) evaluated the results of using a simulator for training students in an oral radiology program in the interpretation of spatial relations on parallax radiographs.

Their conclusion was that training with the simulator led to an improvement in skill when trainee performance was evaluated immediately after the completion of training. In particular, trainees with limited ability in spatial differentiation profited more from simulator-based training than from conventional training. A review article about simulation-based training in radiology ( 12 ) concluded that it may play an increasingly important role in procedural training in the future, although it is no substitute for experience with real patients. The degree of realism of the simulations and their effectiveness for training must be evaluated. The results of studies of virtX and similar systems ( 21 ) provide evidence of a positive short-term effect of simulation-based training in radiology, but the long-term effects of such training on knowledge internalization are as yet unknown. One current project to further refine the virtX system is aimed at improving the physical accuracy of the integrated simulation and visualization of scattered radiation ( 14 ). Because of computational complexity, the simulation of scattered radiation in real time is challenging. An improved simulation was recently introduced that uses Monte Carlo methods to simulate the passage of particles through matter ( Fig 10 ) ( 16 ). This simulation is based on the Geant ( ge ometry an d t racking) toolkit, version 4.9.3 ? 1 (available at ). Figure 10 Composite of screen captures from a virtX training exercise shows the recently introduced, improved simulation of scattered radiation for different C-arm positions. In the first row, only air is irradiated; in the second, one-half of the ankle joint is irradiated; and in the third, the ankle joint is centered within the imaging area. The imaging dataset was obtained in a normal joint without implants. Figure 10 Download as PowerPoint Open in ImageEfforts are under way to further develop and refine the system in this regard.

In addition, a drill dummy could be equipped with a tracking sensor to allow training in the real mode. The virtX system can provide a higher degree of realism by allowing the integration of real surgical devices with the computer-based simulation. Recipient of Summa Cum Laude and Excellence in Design awards for an education exhibit at the 2009 RSNA Annual Meeting. All authors have no other financial relationships to disclose. References 1 Harris I, Walker PM, Trieu L. Radiation exposure using laser aiming guide in orthopaedic procedures. Crossref, Medline, Google Scholar 2 Robinson AH, Moiz M, Hallett JP. Use of a laser guide to reduce screening time for the dynamic hip screw. Crossref, Medline, Google Scholar 3 Perisinakis K, Theocharopoulos N, Damilakis J et al.. Estimation of patient dose and associated radiogenic risks from fluoroscopically guided pedicle screw insertion. Google Scholar 4 Theocharopoulos N, Perisinakis K, Damilakis J, Papadokostakis G, Hadjipavlou A, Gourtsoyiannis N. Occupational exposure from common fluoroscopic projections used in orthopaedic surgery. Google Scholar 5 Bahari S, Morris S, Broe D, Taylor C, Lenehan B, McElwain J. Radiation exposure of the hands and thyroid gland during percutaneous wiring of wrist and hand procedures. Medline, Google Scholar 6 Fuchs M, Modler H, Schmid A, Dumont C, Sturmer KM. Crossref, Medline, Google Scholar 7 Fuchs M, Schmid A, Eiteljorge T, Modler H, Sturmer KM. Medline, Google Scholar 8 Singh PJ, Perera NS, Dega R. Measurement of the dose of radiation to the surgeon during surgery to the foot and ankle. Crossref, Medline, Google Scholar 9 Blattert TR, Fill UA, Kunz E, Panzer W, Weckbach A, Regulla DF. Skill dependence of radiation exposure for the orthopaedic surgeon during interlocking nailing of long-bone shaft fractures: a clinical study. Crossref, Medline, Google Scholar 10 Garde S, Heid J, Haag M, Bauch M, Weires T, Leven FJ.