Advancements in digital technology have led to remarkable innovations in the medical field. Thanks to ingenious minds for taking medical imaging to its heights, we now have portable, lightweight Mini C-Arms that are just as good as their older brother; the conventional C-Arm. While both have their differences, they operate on basic principles of X-ray imaging to provide real-time images helpful in intraoperative and intravenous procedures.
Mobile C-Arms have been a workplace staple in orthopedic and veterinary clinics. This article talks about the types of C-Arms and their benefits. Read on to learn about maintenance factors and safety measures to protect yourself, patients, and staff from this machine’s harmful rays of radiation.
What is the C-Arm?
C-Arms are one of the best derivatives of X-ray technology. Invented in 1955, they are a workhorse of medical imaging equipment. This Computer Assisted Radio Technology (C-Aarm) earned its name due to its C-shaped arm. Connected to one end with an X-ray source and the other with a detector, it captures pictures from various angles to aid in surgical and orthopedic procedures. But what is a C-Arm, and how does it work?
Types of C-Arms
Mobile C-Arm machines are fluoroscopy devices. With many of these devices available on the market, it can be overwhelming. Therefore, it’s good to know about all the variants and their differences.
So without further ado, let’s begin.
Conventional or full-size C-Arms are more potent as they have the largest arc. They accommodate just about all kinds of procedures. With 26 inches of open space, it is flexible and versatile enough to easily fit patients and surgical tables inside. Also, having a mobile unit (C-Arm) and a separate monitor cart, it is a necessary piece of equipment for the orthopedic operating rooms (OR). The movable portion contains the image intensifier with a 6-9-inch or even 12-inch image, a rotatable C-shaped arm, an x-ray tube, and the general controls for the unit. The monitor cart has a dual monitor set, a keyboard for patient identification, and other things necessary for printing images.
These machines are usually used for spine, hips, knees, femurs, shoulders, and torso studies. Also, they greatly help urological, cardiology, and vascular cases. The movable arms move around the body and can penetrate dense anatomy to capture pictures from different angles. Some high-quality full-size C-Arms are Philips Pulsera, GE 9900, Siemens Arcadis, and many others. While there are ample advantages to having this version, the biggest drawback is space constraints. It is challenging to move around from one room to another and needs space big enough to house all the furnishings that come with it.
Mini C-Arms are the smaller version of traditional C-Arms. They are ideal for hospital settings, pet clinics, pediatric orthopedics, and sports medicine. These machines best examine the extremities, like hands, ankles, and feet, during surgical procedures. With a much smaller arc and lower generator power capacity, they cannot penetrate thicker body parts but work excellently for external body parts and produce sharp, clear, real-time footage.
Also, the mini version does not have a separate moon-shaped arc and a monitor cart. Instead, the two units are combined with the monitor, generator, console, tube, detector, and C-Arm, giving you an all-in-one compact design. Some of the most functional examples of these portable devices are the Orthoscan mobile DI and HOLOGIC Mini C Arm Machines.
The C-Arm has excellent maneuverability, with a monitor on top and an input/output system on the bottom. It also has a lock to hold the C-Arm, which disengages when pressed to spring back in the field. With several motion ranges, not only it gives under and overhead scans but also lets you take pictures of the rainbow and AP and lateral (view from the sides).
Instead of an image intensifier, it has a flat panel detector that displays the images using the new technique of pulse fluoroscopy. In its non-invasive manner, these units help analyze the fractures and dislocations precisely and accurately for better recovery options.
What is fluoroscopy?
To put it simply, fluoroscopy is a type of imaging procedure. It uses continuous pulses of an X-ray beam to take real-time footage of organs or tissues inside your body.
You must be wondering how it differs from X-rays because both capture images inside your body, and you are not wrong. The thing that tells them apart is that standard x-rays take snapshots in a single moment. In contrast, fluoroscopy provides continuous, real-time images and is like a video.
Healthcare professionals use this imaging technique for two primary purposes:
- Helps in diagnosis
- Guide treatment procedures such as real-time images help you in inserting intravenous injections, cardiac catheterization, stents, and catheter placement.
The fluoroscopy technology penetrates the extremities to provide high-resolution images in real-time. It helps surgeons perform procedures more accurately as a continuous snapshot of what is happening inside the tissue is visible on the monitor.
Image Intensifier vs. Flat Panel Detector
Over the last few years, C-Arm technology is also embracing the digitalization trend by moving to imaging systems with fast-processing speed. There are two ways C-Arm devices display their output; image intensifier and flat panel detector. They both produce images to guide various surgical procedures yet are not the same. So what really makes them different? Let’s explain to you all the aspects that vary between these two picture-producing technologies.
Image intensifier (II)
- Works on the principle of analog technology.
- Provides high-quality images for many years, but the picture quality decreases over time.
- Uses a high radiation dose as a field is larger, thus increasing the risk of exposure.
- Produces a large amount of heat and thus needs to cool down often, which causes delays in imaging.
- Has a large size due to its extended tube structure, so it encounters difficulty in settling into tight spaces.
Flat panel detector (FPD)
- Operates on the principle of digital imaging.
- High-resolution images with minimal image deterioration.
- Produces a more consistent, sharp, and clear image.
- Has a smaller profile, so it doesn’t hinder the doctor’s access to the patient.
- Lower radiation dose thus limits the exposure of harmful rays.
- Images maintain clarity even when you magnify the image.
- There is no need to cool it down because it emits less heat.
- It can break if roughly handled.
Benefits of Mini C-Arm
Easy to handle: It is lightweight, portable, and easy to move around.
Size: Its ultra-small size gives medical personnel better workplace access and more room to move around.
Independence: Mini C-Arms are surgeon operated as there is no need for optical conversion to see images. This eliminates the need for a radiographer.
Design: With its collapsible design, it is easy to transport the machine between different rooms.
Cost-effective: The device is cost-effective since it is easier to use and requires no radiological staff.
Fast results: The images are produced digitally on a flat panel detector immediately, thus reducing the delay. It produces instant results compared to its counterpart, the conventional C-Arm, which needs to convert x-ray images to light photons first and then to electrons to create images.
Safety: The gap between the x-ray source and detector is shorter. Thanks to the mini size, the radiation exposure is less than full-size C-Arms with larger fields.
Less laser power: With a lower power generator, the beams are narrower and target only a smaller area for better imaging.
Dose reduction: Pulse fluoroscopy limits the exposure and is an excellent tool for intelligent dose reduction technology. The main benefit of a Mini C-Arm over a full-sized one is the reduced risk of scattered radiation to patients, surgeons, and theater personnel.
Rotation: The Mini C-Arm allows for an orbital rotation of 150 degrees, along with many other options.
Safety Tips Against Radiation
Although there are many benefits of using C-Arms, we cannot deny the fact that they emit radiation. We all know radiation exposure is harmful and might lead to cancer. Therefore, taking all the precautionary measures is imperative if you are in a sterile field.
- Wear lead aprons of at least 0.5mm equivalence to guard yourself against radiation.
- Test your aprons every six months by placing them under a C-Arm machine for the examination of any cracks.
- Wear protective eyewear with lead lining to protect your eyes.
- Wear lead protective gloves while doing the surgical procedures.
- Stand at least 2 meters or 6 feet away from the C-Arm as the radiation intensity becomes less with the distance.
- Employ C-Arm drapes to reduce the danger of radiation scattering.
- Never position your hands under the primary X-ray beam directly.
- Place the patients as far from the X-ray source as possible.
How to Maintain Your Mini C-Arm Machine
You must take care of your C-Arm machine if you want to maintain its efficiency up to its full life. Here is how to take care of your Mini C-Arm machine:
- Wipe the external parts of the machine regularly and cover them when not in use.
- Clean the wheels and filters.
- Make sure no dust or debris is lingering around.
- During inactivity, switch the monitor to sleep mode.
- If there is any issue with your machine, refer to the manufacturer’s manual or call for professional help. Do not try to fix it on your own without any credible guidance.