Image quality improvements for brain soft tissue in neuro-endovascular treatments: A novel dual-axis "butterfly"
Hisayuki Hosoo1, Yoshiro Ito1, Aiki Marushima1
1Division of Stroke Prevention and Treatment, Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan; Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.
Purpose:
Cone-beam computed tomography (CBCT) is useful in the diagnosis of complications after neuro-endovascular treatment. However, the image quality of conventional CBCT is inferior to that of conventional CT. To solve this problem, a dual-axis butterfly CBCT available with an angiography suite has been developed. This study aimed to evaluate the image quality of this dual-axis butterfly CBCT compared to the conventional CBCT in the same patient.
Method:
We prospectively included patients who underwent scheduled neuro-endovascular treatment and performed conventional CBCT and novel dual-axis butterfly CBCT as a postoperative examination. We evaluated artifacts, brain contrast, and cortico-medullary junctions on a scoring system using a 5-point scale in which lower scores indicate better image quality. In addition, the white matter/gray matter ratio was calculated in selected brain lobe regions.
Results:
Forty-seven cases (94 paired images) were enrolled. The novel dual-axis butterfly CBCT had significantly fewer supratentorial and infratentorial artifacts in the artifact evaluation. Similarly, contrast and cortico-medullary junction discrimination in the cerebral hemispheres scored significantly better in the butterfly scan in all regions. The white matter/gray matter ROI ratio was significantly higher in the novel dual-axis butterfly CBCT in the frontal and occipital lobes but not in the temporal lobe.
Conclusions:
Compared to conventional CBCT, the novel dual-axis butterfly CBCT showed supratentorial and infratentorial artifact reduction as well as improved contrast with the brain parenchyma and cerebrospinal fluid space and white matter/gray matter discrimination ability.
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