Hybrid CT Angiography (Angio-CT) in Trauma and Emergency Care

The utilization of hybrid computed tomography (CT) angiography systems has allowed for enhanced efficiency in diagnostic and interventional procedures. These hybrid systems, also referred to as Angio-CT, 4DCT, or hybrid CT, are the integration of a multidetector computed tomography (MDCT) scanner and a fluoroscopy unit within a single procedural room.

Traditionally, image-guided fluoroscopic and CT interventions are performed in separate suites. However, this may complicate logistics when a patient's care requires both modalities. The transfer between rooms prolongs treatment time, potentially compromises patient safety, disrupts workflow by requiring coordination with multiple teams in different locations, and can increase the overall allocation of resources.[1] [2] Fluoroscopy units without hybrid MDCT scanners may employ cone-beam CT (CBCT); however, the use of such technology has a limited field of view, increased artifacts and susceptibility to motion, and lack of true multiphase imaging.[1] Although the idea of Angio-CT was first introduced in 1992, it has become a more attractive option recently due to lower costs and improved designs.[3]

Angio-CT systems allow for smooth and immediate transitions between the two modalities, enabling combination CT/fluoroscopy procedures and/or separate “CT-only” and “fluoroscopy-only” procedures in one room. Typically, these systems involve a sliding gantry system with a C-arm fluoroscope. The CT scanner is located closer to the head of the imaging table, with the rails positioned parallel to the sides of the table. The sliding capability of the CT scanner permits the C-arm machine to retain full 270-degree rotation. This rapid conversion between modalities leads to better patient safety by removing the risk of harm during patient transfer and fosters streamlined communication by minimizing the involvement of additional personnel. Overlaying CT data onto the fluoroscopic display allow for improved planning and intraprocedural adjustments. The benefits of Angio-CT systems extend more broadly by maximizing the volume of diagnostic CT and interventional procedures, as each room can remain dedicated to their primary functions, ultimately leading to increased revenue.[4] [5]

Publication History

Article published online:
10 April 2025

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