Flat-panel conebeam CT in the clinic: history and current state

Rebecca Fahrig*, David A. Jaffray, Ioannis Sechopoulos, J. Webster Stayman

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review

17 Citations (Scopus)
227 Downloads (Pure)


Research into conebeam CT concepts began as soon as the first clinical single-slice CT scanner was conceived. Early implementations of conebeam CT in the 1980s focused on high-contrast applications where concurrent high resolution (<200 μm), for visualization of small contrast-filled vessels, bones, or teeth, was an imaging requirement that could not be met by the contemporaneous CT scanners. However, the use of nonlinear imagers, e.g., x-ray image intensifiers, limited the clinical utility of the earliest diagnostic conebeam CT systems. The development of consumer-electronics large-area displays provided a technical foundation that was leveraged in the 1990s to first produce large-area digital x-ray detectors for use in radiography and then compact flat panels suitable for high-resolution and high-frame-rate conebeam CT. In this review, we show the concurrent evolution of digital flat panel (DFP) technology and clinical conebeam CT. We give a brief summary of conebeam CT reconstruction, followed by a brief review of the correction approaches for DFP-specific artifacts. The historical development and current status of flat-panel conebeam CT in four clinical areas - breast, fixed C-arm, image-guided radiation therapy, and extremity/head - is presented. Advances in DFP technology over the past two decades have led to improved visualization of high-contrast, high-resolution clinical tasks, and image quality now approaches the soft-tissue contrast resolution that is the standard in clinical CT. Future technical developments in DFPs will enable an even broader range of clinical applications; research in the arena of flat-panel CT shows no signs of slowing down.

Original languageEnglish
Article number052115
JournalJournal of medical imaging
Issue number5
Publication statusPublished - 1 Sept 2021


  • breast CT
  • C-arm angiography
  • conebeam CT
  • dental conebeam CT
  • digital flat panel
  • extremity imaging
  • flat-panel CT
  • image-guided radiation therapy
  • interventional radiology


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