C-arm based cine/fluoroscopic guidance provides simultaneous high spatial resolution (e.g. 200 micron pixel pitch) and high temporal   resolution (e.g. 33 ms).  These characteristics along with ease of  patient access and wide availability of compatible interventional tools have  positioned this technology as the defacto standard for image guidance  for many interventional neurological procedures.  However, these   systems are subject to the limitations of projection imaging including  reduced low contrast resolution and confusion due to overlapping   anatomy.  In order to overcome these limitations interventional computed tomography (CT) has been implemented by several of the major   manufacturers.  We will discuss several novel methods to improve upon the current state-of-the art including: a method for accurate surgical   tool placement combining interventional CT and fluoroscopy, a technique to reduce patient dose by an order of magnitude for multiple   interventional CT scans, and the potential for imaging contrast dynamics via limited angle tomography.