title: Potential of 80-kV high-resolution cone-beam CT imaging combined with an optimized protocol for neurological surgery.
abstract: BACKGROUND
  With the development of computed tomography (CT) and magnetic resonance imaging (MRI), the use of conventional X-ray angiography including digital subtraction angiography (DSA) for diagnosis has decreased, as it is an invasive technique with a risk of neurological complications. However, X-ray angiography imaging technologies have progressed markedly, along with the development of endovascular treatments. A newly developed angiography technique using cone-beam CT (CBCT) technology provides higher spatial resolution than conventional CT. Herein, we describe the potential of this technology for neurosurgical operations with reference to clinical cases.
  
  
  METHODS
  Two hundred twenty-five patients who received 80-kV high-resolution CBCT from July 2011 to June 2014 for preoperative examinations were included in this study. For pathognomonical cases, images were taken with suitable reconstruction modes and contrast protocols. Cases were compared with intraoperative findings or images from other modalities.
  
  
  RESULTS
  We observed the following pathognomonical types: (1) imaging of the distal dural ring (DDR) and the surrounding structure for paraclinoid aneurysms, (2) imaging of thin blood vessels, and (3) imaging of both brain tumors and their surrounding anatomy. Our devised 80-kV high-resolution CBCT imaging system provided clear visualization of detailed anatomy when compared with other modalities in almost all cases. Only two cases provided poor visualization due to movement artifact.
  
  
  CONCLUSIONS
  Eighty-kilovolt high-resolution CBCT has the potential to provide detailed anatomy for neurosurgical operations when utilizing suitable modes and contrast protocols.
authors.affiliation: Department of Neurosurgery, Toranomon Hospital, 2-2-2 Minatoku Toranomon, Tokyo, 105-8470, Japan, skanayama-nsu@umin.ac.jp.
authors.forename: Seisaku
authors.initials: S
authors.lastname: Kanayama
authors.forename: Takayuki
authors.initials: T
authors.lastname: Hara
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Hamada
authors.forename: Yuji
authors.initials: Y
authors.lastname: Matsumaru
mesh_terms: D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D054893:Cone-Beam Computed Tomography / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D012189:Retrospective Studies; D025321:Surgery, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult