RT Journal Article
SR Electronic
T1 The butterfly effect: improving brain cone-beam CT image artifacts for stroke assessment using a novel dual-axis trajectory
JF Journal of NeuroInterventional Surgery
JO J NeuroIntervent Surg
FD BMJ Publishing Group Ltd.
SP 283
OP 287
DO 10.1136/neurintsurg-2021-018553
VO 15
IS 3
A1 Cancelliere, Nicole Mariantonia
A1 Hummel, Eric
A1 van Nijnatten, Fred
A1 van de Haar, Peter
A1 Withagen, Paul
A1 van Vlimmeren, Marijke
A1 Hallacoglu, Bertan
A1 Agid, Ronit
A1 Nicholson, Patrick
A1 Mendes Pereira, Vitor
YR 2023
UL http://jnis.bmj.com/content/15/3/283.abstract
AB Background Cone-beam computed tomography (CBCT) imaging of the brain can be performed in the angiography suite to support various neurovascular procedures. Relying on CBCT brain imaging solely, however, still lacks full diagnostic confidence due to the inferior image quality compared with CT and various imaging artifacts that persist even with modern CBCT.Objective To perform a detailed evaluation of image artifact improvement using a new CBCT protocol which implements a novel dual-axis ‘butterfly’ trajectory.Methods Our study included 94 scans from 47 patients who received CBCT imaging for assessment of either ischemia or hemorrhage during a neurovascular procedure. Both a traditional uni-axis ‘circular’ and novel dual-axis ‘butterfly’ protocol were performed on each patient (same-patient control). Each brain scan was divided into six regions and scored out of 3 based on six artifacts originating from various physics-based and patient-based sources.Results The dual-axis trajectory produces CBCT images with significantly fewer image artifacts than the traditional circular scan (whole brain average artifact score, AS: 0.20 vs 0.33), with the greatest improvement in bone beam hardening (AS: 0.13 vs 0.78) and cone-beam artifacts (AS: 0.04 vs 0.55).Conclusions Recent developments in CBCT imaging protocols have significantly improved image artifacts, which has improved diagnostic confidence for stroke and supports a direct-to-angiography suite transfer approach for patients with acute ischemic stroke.All data relevant to the study are included in the article or uploaded as supplementary information. Not applicable.