Cranial Computed Tomography Angiography With Automated Bone Subtraction

Abstract

Automatic subtraction provides diagnostic image quality for 3D visualization of intracranial vessels, free from over projecting bone in a fully automatic way. Aneurysms can be evaluated from all angles, and ICA stenoses at the skull base were easily visualized.

Subtraction CT angiography for evaluation of intracranial aneurysms: comparison with conventional CT angiography

“…More recently, fully automated bone subtraction CTA was developed by Lell el al. [25] who found that bone subtraction CTA may speed up vascular assessment and improve diagnosis. In another study of 100 patients, Morhard et al demonstrated that bone subtraction CTA can improve the delineation of vasculature closely adjacent to bony structures [26].…”

Diagnostic Impact of Bone-Subtraction CT Angiography for Patients with Acute Subarachnoid Hemorrhage

“…17,21 Bone-subtraction CTA 22,23 has been developed to overcome this problem. A feasibility study 22 and a study with 100 patients 24 showed that BSCTA can improve the detection of vascular pathology closely adjacent to bony structures. These studies, however, did not use DSA as the reference standard to determine the diagnostic accuracy of BSCTA under clinical conditions.…”

Improved Arterial Visualization in Cerebral CT Perfusion–Derived Arteriograms Compared with Standard CT Angiography: A Visual Assessment Study

“…These techniques can be based on subtraction of a nonenhanced scan from the CTA 12,13 or on masking highly attenuating bony structures from the data. 14,15 Although multiple studies have shown that bone removal in CTA improves vascular analysis, 13,16,17 it is not routinely used in clinical practice because either the required techniques are not available (eg, dual-energy) or the removal is too time-consuming when user interaction is required. Furthermore, some methods remove part of the vessel wall, 12 which decreases diagnostic confidence.…”