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SIR 2026

Traditional Poster

Interventional Oncology

Imaging

Session: Traditional Poster Presentations

565 - Spectral Cone-beam CT as a Tool for Thermal Ablation Guidance and Confirmation

Monday, April 13, 2026
12:10 PM - 1:10 PM ET
Purpose: To investigate the potential utility of dual energy cone-beam CT (CBCT) technologies in hepatic imaging and assessment of thermal ablation zones.

Materials and Methods: Under Institutional ACUC approval, 3 healthy swine underwent dual energy CBCT imaging (Azurion, Philips) at 90kVp and 125kVp and dual-layer Spectral CT (IQon, Philips), with breath holds post liver MWA, without and with contrast. CBCTs were processed with elastic registration and virtual mono-energetic (VMI), virtual non-contrast (VNC), and iodine no-water images were generated. Metal artifact reduction (MAR) algorithms were applied in the presence of the probe. Conspicuity of the MWA zone vs. surrounding liver tissue was quantified with contrast-to-noise ratio (CNR), image quality using signal-to-noise (SNR), and iodine density maps. CBCT results were compared to dual-layer spectral CT images.

Results: VMIs, VNC images, and iodine density maps were successfully generated from spectral CBCT following MWA. Elastic registration, and noise and metal artifact reduction algorithms were required to improve image quality. With the probe in, liver image quality was best using 200keV VMIs with MAR, reflected by a SNR of 3.0±3.6. Without contrast, MWA visualization was best using low-energy scans with a CNR of 2.3±3.0. Image quality of the MWA zone was higher with contrast using low-energy scans with a CNR of 5.4±2.9. Both without and with contrast, 40keV VMIs had the greatest lesion conspicuity with attenuation differences between the ablated and healthy liver tissue of 54.7±59.9 HU and 128.7±114.7 HU, respectively. Compared to standard CBCT images, image quality and conspicuity was worse with a CNR of 1.3±1.2 and attenuation difference of 28.6±28.0 HU. Renal iodine concentration after contrast was calculated as 8.5±2.0mg/ml.


Conclusion: Spectral CBCT imaging could prove a useful tool for ablation monitoring or ablation zone confirmation. Image quality and MWA zone conspicuity was improved MAR algorithms and spectral VMIs. Spectral CBCT holds promise as a tool for ablation, enabling CBCT to function as a hybrid modality for angiography and ablation guidance requisite for combination needle and catheter therapies.