C-Arm

Everything There Is To Know About C-Arm X-ray Machine

C-arm is a diagnostic mechanism used to intensify and produce diagnostic images. It looks like the letter "C." Hence, the primary reason for its name. Usually, this tool uses X-rays as a primary source while creating images.

C-arm is commonly used when a patient is unable to walk or make a standard X-ray examination. It is also utilized during surgery or any invasive procedures, performed with a lack of direct observation. Staff who work with C-arm machines for extended periods have an increased absorbed radiation irradiation level.

Those tools can generally work as CT scanners, but they don't produce as much radiation, as they most commonly do with only one X-ray source and receiver in their design.

History of the device

Wilhelm Conrad Roentgen discovered X-rays in 1895. This discovery was the first one to create a roentgenology diagnostic tool with higher mobility. However, a few technologies came first before the invention of these apparatuses became possible.

The invention of fluoroscopic imaging with its possibility to see everything that happened inside the human organism in real-time was a massive medical achievement. It also helped to increase the percentage of correctly diagnosed cases of lots of diseases.

The next step was the invention of proper technologies of high resolution imagining. And finally, after finding a way for X-ray beams to change their direction, the Philips company created a device that can be called a C-arm in 1955. After that, many diagnostic and treatment procedures started to perform much faster and effective and were more comfortable for patients and medical practitioners.

Types of C-arm

For those tools created more than half a century ago, there was the invention of several different standard and untypical variations. So, many different variations nowadays can be bought on the market. The most popular and useful among them are the following:

  • Various mini apparatuses
  • Different highly mobile units
  • 3D reconstruction variants
  • AI-supported devices

Nowadays, AI and IT programming are evolving with huge steps, which is the main reason most specialists nowadays prefer to work with AI-supported devices. Except for everything else, they regularly receive sets of updates from developers, which makes them better. Standard mini and mobile apparatuses do not support those features.

Indications to Use C-arm

Mainly those apparatuses are useful in two types of diagnostic procedures - a fluoroscopic and static imagining. But, as their primary feature is high mobility level and small sizes (compared to a traditional X-Ray apparatus), they are also used in many surgeries when the direct view of the operational field is impossible.

The static imagining is an alternative to traditional X-ray when patients can't walk or keep a steady standing position for even a small period. In some cases, 3-D C-arm is useful as an alternative to traditional CT scanning. Generally, many doctors prefer to use C-arm machines as an alternative for CT with patients that shouldn't contact others (mostly, they have highly contagious diseases).

Real-time imaging that medics can see on the screen of those tools can give them lots of valuable information. Here are the primary surgeries and other treatment manipulations, when these devices are useful:

  • Minimal invasive osteosynthesis
  • Minimal invasive one fractures repositioning
  • Most of the modern known renal surgeries
  • Minimal invasive surgeries on organs of the pelvic cavity

Like every other regular fluoroscopic imaging apparatus, those mechanisms can be used as an alternative to different diagnostic procedures that include contrast substance injections. In most cases, C-arm shows more significant results than traditional fixed table fluoroscopy. The number of processes requiring contrasting is endless; among them are:

  • Bronchial fluoroscopy
  • Renal fluoroscopy
  • General angiography
  • Big and medium vas size fluoroscopy
  • Bladder fluoroscopy

Those tools are also useful in controlling the results of invasive medical manipulations. Those manipulations usually include inserting various medical devices into the patient's body. Unconscious patients are the leading group of patients who most need these kinds of procedures. The most primarily presented among them are the following:

  • Trachea intubation
  • Nasogastric tube staging
  • Urinary catheter staging
  • Upflow stenting of the ureter
  • Inserting a gastrostomy tube

This list is not extensive as there are lots of other specific conditions, pathologies, and different states. There are many more cases where c-arm is not only indicated but also vitally necessary. Besides, as our scientific progress keeps inventing lots of new treatment and diagnostic techniques, the list of indications for that tool application keeps growing.

Complications of Using C-arm

The risk of any complications connected with radiation exposure for doctors and patients increases with the increasing time of the procedure and overall number. That is the main reason why C-arm computer tomography requires strong, evident-based indications to be performed.

The second major group of complications, connected with the use of C-arm devices, are connected with a lack of sanitation. Even when using the tool outside the surgical room, those apparatuses need cleaning before every next patient; otherwise, massive infectious diseases spread may happen.

Many complications may occur if there is some technical issue with the C-arm apparatus falling, like Inadvertent movement. For example, fractures and massive trauma may occur if, during the patient's examination or, even worse, treatment procedure, an upper part of the apparatus falls from the top to the patient's body.

General Specifications of C-arm

Nowadays, as lots of different types of this device is present, it is almost impossible to determine the general specifications for all of them. After researching the market, we discovered the most significant of them and created an averaged version for standard machines of that type. Here is what we got:

  • The capability of the high-frequency X-ray generator - from 40 to 110 kV
  • Cassette holder - detachable, at least 10" x 12"
  • X-ray film cassettes - at least 2
  • Imaging intensifier diameter - at least 23 cm 
  • Footswitch fluoroscopy capability - included
  • Vertical travel - not less than 40 cm
  • The capability of last image holding - included
  • Horizontal travel - at least 20 cm
  • Focus receptor distance - at least 90 cm
  • Free space distance - not less than 78 cm

It's natural that, for example, mini C-arm will have at least a few different specifications, as the overall size and usage potential of such apparatuses vary from the standard. However, the mini devices are not as good as everybody thought. For example, the comparison of the radiation exposure of mini and fixed conventional tools showed no difference between them.

How Does C-arm Work

The primary mechanism of C-arm is through the direct spread of X-ray beams through the patient's body and depending on the X-ray image intensifier. After that, the computers, which are sometimes supported with AI, can build 3D models, calibrate and repurpose signals, and show the appropriate image on the screen.

In general, the whole process is such as presented in machines for fluoroscopy. The main difference is that the C-arm has a rotating, moving arc. In some cases, the combined use of those two methods shows impressive results.

Market Leaders

Following an analysis of the existing and available models, we created the list of the best among them. Here are the best developers and sellers of those machines:

  • Siemens
  • Philips
  • Ziehm
  • GE OEC
  • Toshiba
  • Amico
  • Perlong
  • General Electric

There are lots of different used machines also selling on the web, which is commonly much cheaper, but sometimes may have technical issues.

Conclusion

The C-arm is the diagnostic machine that can potentially find some ways of use in almost any medical field. Even though sometimes they are used as a therapeutic instrument in the treatment of different superficial tumors, mostly, they are for diagnostic purposes.

We are yet to discover all the possible potential of this machine. However, with every new day, our scientific and technical progress presents us with even more different types of treatment, techniques, and tools, which we can combine with these machines. We may find that the feasible potential of the C-arms could be endless, just like progress itself. 

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