Towards Diagnostic X-Ray Cone-Beam Imaging of the Entire Spine in the Weight-Bearing Position

X-ray cone-beam (CB) imaging may play a tremendous role in the future of diagnostic radiology. Recently, an innovative, versatile X-ray system (Multitom Rax, Siemens Healthcare, GmbH, Forchheim, Germany) was introduced for diagnostic radiology. This system enables taking X-ray radiographs with high patient positioning flexibility, as well as acquiring semicircular short CB scans in a variety of orientations. Here, we are interested in programming this system to enable a novel data acquisition geometry that would cover the entire spine in the weight-bearing position. Such an imaging capability has never been demonstrated so far. However, we may expect it to play an important clinical role as there is clinical evidence that spine diseases would be more accurately interpretable in the weight-bearing position. We are furthermore interested in using a geometry that provides complete data so that CB artifacts may be avoided. We report on a first implementation of such a geometry that consists of two circular arcs connected by a line segment. We assessed immediate and short-term motion reproducibility, as well as ability to image the entire spine within a Rando phantom. Strongly encouraging results were obtained. Reproducibility with sub-mm accuracy was observed and the entire spine was accurately reconstructed.