Flat-Detector Computed Tomography Technologies in Neuro-Oncology: The Experience of the N.N. Petrov National Medical Research Center of Oncology

Relevance: The growing burden of central nervous system tumors increases the need for accurate and minimally invasive intraoperative imaging and navigation technologies. Flat-detector computed tomography (FDCT) provides volumetric and crossectional CT-imaging directly in the angiography suite and can be integrated with fluoroscopy and navigation.

Purpose: To assess the capabilities and principal applications of flat-detector computed tomography in neuro-oncology based on the experience of a single tertiary cancer center.

Materials and methods: A single-center retrospective descriptive analysis included 207 interventional procedures performed in 207 patients at the N.N. Petrov National Medical Research Center of Oncology from November 2021 to December 2025. Procedures were carried out using an Artis Zee Floor angiographic system (Siemens). Statistical analysis was performed with Microsoft Excel 2016 and STATISTICA 12.

Results: The median patient age was 58 years (45; 69); 95 patients were men and 112 were women. FDCT was used for stereotactic brain tumor biopsy (n = 159), diagnostic cerebral angiography (n = 14), drainage of tumor cysts (n = 11), Ommaya reservoir implantation (n = 7), ventriculoperitoneal shunting (n = 6), vertebroplasty (n = 5), drainage of brain abscesses (n = 3), and preoperative meningioma embolization (n = 2). The technology provided real-time intraoperative three-dimensional visualization, navigation planning, instrument position control, and immediate assessment of procedural results. The most convincing advantages were observed in stereotactic brain tumor biopsy.

Conclusions: FDCT is a promising universal intraoperative platform for minimally invasive neuro-oncological procedures. Its use may improve procedural accuracy, controllability, and safety, with the strongest current rationale seen for stereotactic brain tumor biopsy.

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