Principles, techniques and applications of high resolution cone beam CT angiography in the neuroangio suite

Raz, Eytan; Nossek, Erez; Sahlein, Daniel; Sharashidze, Vera; Narayan, Vinayak; Ali, Aryan; Esparza, Rogelio; Peschillo, Simone; Chung, Charlotte Y.; Diana, Francesco; Syed, Safia; Nelson, Peter Kim; Shapiro, Maksim

doi:10.1136/jnis-2022-018722

Cited by 18 publications

(8 citation statements)

References 34 publications

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“…In fact, it will further improve the overall dose efficiency by increasing the geometric efficiency. A PCD with W = 2.5 cm requires only 2 gantry sweeps and a 15 s scan time, which will be shorter than the existing 20 s clinical FPD-CBCT scans widely used in neuro and body interventions (Fahrig et al 2006, Heran et al 2006, Namba et al 2009, Raz et al 2022. Compared with replacing the whole FPD by a full-FOV PCD, limiting the width of the PCD below 5 cm will help reduce the cost: currently, each CdTe PCD module is usually no more than 2.5 cm wide along any directions, therefore building a PCD wider than 5 cm will require the more expensive 4-side buttable technology rather than 3-side buttable technology, not to mention the higher cost of a larger sensor.…”

Section: Discussionmentioning

confidence: 99%

A C-arm photon counting CT prototype with volumetric coverage using multi-sweep step-and-shoot acquisitions

Treb¹,

Ji²,

Feng³

et al. 2022

Phys. Med. Biol.

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Objective: Existing clinical C-arm interventional systems use scintillator-based energy-integrating flat panel detectors (FPDs) to generate cone-beam CT (CBCT) images. Despite its volumetric coverage, FPD-CBCT does not provide sufficient low-contrast detectability desired for certain interventional procedures. The purpose of this work was to develop a C-arm photon counting detector (PCD) CT system with a step-and-shoot data acquisition method to further improve the tomographic imaging performance of interventional systems. Approach: As a proof-of-concept, a cadmium telluride-based 51 cm × 0.6 cm PCD was mounted in front of a FPD in an Artis Zee biplane system. A total of 10 C-arm sweeps (5 forward and 5 backward) were prescribed. A motorized patient table prototype was synchronized with the C-arm system such that it translates the object by a designated distance during the sub-second rest time in between gantry sweeps. To evaluate whether this multi-sweep step-and-shoot acquisition strategy can generate high-quality and volumetric PCD-CT images without geometric distortion artifacts, experiments were performed using physical phantoms, a human cadaver head, and an in vivo swine subject. Comparison with FPD-CT was made under matched narrow beam collimation and radiation dose conditions. Main Results: Compared with FPD-CT images, PCD-CT images had lower noise and improved visualization of low-contrast lesion models, as well as improved visibility of small iodinated blood vessels. Fine structures were visualized more clearly by the PCD-CT than the highest-available resolution provided by FPD-CBCT and MDCT. No perceivable geometric distortion artifacts were observed in the multi-planar PCD-CT images. Significance: This work is the first demonstration of the feasibility of high-quality and multi-planar (volumetric) PCD-CT imaging with a rotating C-arm gantry.

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Section: Discussionmentioning

confidence: 99%

A C-arm photon counting CT prototype with volumetric coverage using multi-sweep step-and-shoot acquisitions

Treb¹,

Ji²,

Feng³

et al. 2022

Phys. Med. Biol.

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show abstract

“…At our institution, the protocol used for head CBCT acquisition is 20sDCT-Head, also known as high-resolution CBCT (HR-CBCT). This protocol has proved to be valuable for evaluating intracranial stent expansion in cases of stent-assisted coil embolization as well as for the timely detection of intracranial hemorrhage and early ischemic lesions during procedures [ 2 , 26 , 27 ]. Compared to 6sDCT-Body, the 20sDCT-Head scans had a higher radiation dose due to having a longer acquisition time (20 s vs. 6 s), more projection images (496 f vs. 397 f), and a higher detector dose (1.200 μGy/fr vs. 0.360 μGy/fr).…”

Section: Discussionmentioning

confidence: 99%

“…Cone-beam computed tomography (CBCT) is a valuable three-dimensional (3D) volumetric imaging technique widely utilized in neuroradiology and interventional oncology [ 1 , 2 ]. It offers significant advantages in terms of visualizing complex anatomical structures, guiding percutaneous punctures and catheterizations, verifying intracranial stent placement in real time, and promptly monitoring intracranial hemorrhages or infractions [ 3 , 4 , 5 , 6 , 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Radiation Exposure and Influential Factors in Cone-Beam Computed Tomography (CBCT) of the Head and Abdomen during Interventional Procedures

Li,

Qu,

Zhang

et al. 2024

Tomography

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Cone-beam computed tomography (CBCT) is a widely used imaging technique in interventional radiology. Although CBCT offers great advantages in terms of improving comprehension of complex angioarchitectures and guiding therapeutic decisions, its additional degree of radiation exposure has also aroused considerable concern. In this study, we aimed to assess radiation exposure and its influential factors in patients undergoing CBCT scans of the head and abdomen during interventional procedures. A total of 752 patients were included in this retrospective study. Dose area product (DAP) and reference air kerma (RAK) were used as measures of patient dose. The results showed that the median values of DAP were 53.8 (50.5–64.4) Gy⋅cm2 for head CBCT and 47.4 (39.6–54.3) Gy⋅cm2 for that of the abdomen. Male gender and body mass index (BMI) were characterized by increased DAP and RAK values in both head and abdominal CBCT scans. Larger FOV size was associated with a higher DAP but a lower RAK value, especially in head CBCT scans. Exposure parameters under automatic exposure control (AEC) also varied according to patient BMI and gender. In conclusion, the patients received slightly higher radiation doses from head CBCT scans than from those applied to the abdomen. BMI, gender, and FOV size were the key factors that influenced the radiation dose administered to the patients during CBCT scans. Our results may help to define and minimize patients’ exposure to radiation.

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“…High resolution cone beam CT (HR-CBcT) angiography provides not only volumetric datasets by which three-dimensional images and adjacent bony structures can be seen, but has an increasing role in understanding the angioarchitecture of disease and guiding therapies. The authors provided a practical review of the principles of image acquisition, injection protocols, and reformatting paradigms (small volume of interest, maximum intensity projection, and volume rendering) 13. Applications to the diagnosis and treatment of aneurysms, brain arteriovenous malformations, cranial dural arteriovenous fistula, and stroke are reviewed.…”

Section: Principles Techniques and Applications Of High Resolution Co...mentioning

confidence: 99%

JNISspotlight: commissioned reviews

Chen

2023

J NeuroIntervent Surg

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Principles, techniques and applications of high resolution cone beam CT angiography in the neuroangio suite

Cited by 18 publications

References 34 publications

A C-arm photon counting CT prototype with volumetric coverage using multi-sweep step-and-shoot acquisitions

A C-arm photon counting CT prototype with volumetric coverage using multi-sweep step-and-shoot acquisitions

Evaluation of Radiation Exposure and Influential Factors in Cone-Beam Computed Tomography (CBCT) of the Head and Abdomen during Interventional Procedures

JNISspotlight: commissioned reviews

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