Weight-bearing cone-beam computed tomography in the foot and ankle specialty: where we are and where we are going - an update

Abstract Cone-beam computed tomography (CBCT) has been applied in dentistry and medicine for nearly two decades. Its application in the foot and ankle specialty has grown exponentially in recent years. Weight-bearing CBCT allows clinicians to obtain weight-bearing images that can be viewed in all three planes and to construct three-dimensional models, similar to those constructed from traditional CT scans, as well as exposing patients to less radiation than do traditional CT scans. This technology has revolutionized diagnoses, improving the understanding of various lesions and surgical planning in the foot and ankle specialty. Ongoing studies of the use of weight-bearing CBCT in foot and ankle surgery are focused on fully automated and semi-automated three-dimensional measurements, as well as bone segmentation, mapping of the distances/orientation of the joints, and the production of customized implants. The aims of this review article are to show the evolution of this emerging tool in the foot and ankle specialty, to update those in related specialties on its use in current clinical practice, and to indicate where the research community is heading.

摘要：锥形束计算机断层扫描（Cone-beam computed tomography, CBCT）在牙科与临床医学领域的应用已近二十年。近年来，其在足踝专科的应用呈指数级增长。负重锥形束计算机断层扫描（Weight-bearing CBCT）可使临床医师获取负重位影像，此类影像可在三个正交平面上进行观察，并能构建与传统计算机断层扫描（Computed Tomography, CT）所得三维模型类似的三维模型，同时患者所受辐射剂量低于传统CT扫描。该技术彻底革新了诊断流程，加深了足踝专科对各类病变的认知水平，并优化了手术规划方案。当前针对足踝外科中负重CBCT应用的研究，主要聚焦于全自动化与半自动化三维测量、骨分割、关节距离/方位映射以及定制化植入物的研发。本篇综述旨在阐述这一新兴技术在足踝专科领域的发展历程，向相关专科从业者介绍其当前临床应用的最新进展，并指明该领域的未来研究方向。