C-arm computed tomography for guiding hepatic vascular interventions.

C-arm computed tomography (C-arm CT) represents the next generation of imaging technology available in the angiography suite that is predicted to be the platform for many of the three-dimensional (3D) road mapping and navigational tools that will emerge in conjunction with its implementation. The combination of current and unappreciated capabilities may be the foundation on which improvements in both safety and effectiveness of complex hepatic vascular interventional procedures become possible. These improvements include multiplanar soft tissue imaging, pretreatment target lesion vascular road mapping, and the ability for immediate posttreatment assessment. These key features alone may translate into a reduction in the utilization of iodinated contrast used by the operator, as well as a decrease in the radiation dose to the patient and the operator, in addition to increasing the therapeutic index (increase in the safety versus benefit ratio). In routine practice, imaging information obtained with C-arm CT provides a subjective level of confidence factor to the operator that has not yet been quantified.