title: Dose reduction in cone-beam CT scanning for intracranial stent deployment before coil embolization of intracranial wide-neck aneurysms.
abstract: OBJECTIVE
  Flat panel detector (FD)-equipped angiography machines are increasingly used for neuro-angiographic imaging. During intracranial stent-assisted coil embolization procedures, it is very important to clearly and quickly visualize stent shape after deployment in the vessel. It is necessary to quickly visualize stents by cone-beam computed tomography (CBCT). The aim of this study was to compare CBCTs at 10 and 20 s, and to confirm that this method is useful for neuro-endovascular treatment procedures.
  
  
  METHODS
  We treated 30 patients with wide-necked intracranial aneurysms with a flexible, self-expanding neurovascular stent and subsequent aneurysm embolization with platinum micro-coils. We performed the CBCT after stent deployment. We compared the 10 s and 20 s CBCTs, using the full width one-half maximum (FWHM) visualization.
  
  
  RESULTS
  Accurate stent placement with subsequent coil occlusion of the aneurysms was feasible in all patients. Stent struts were clearly visualized on both 10 s and 20 s CBCTs. Importantly, 10 s CBCT can reduce the radiation dose by about 42%, compared with 20 s CBCT. Performing 10 s CBCT with a 14% dilution of the contrast medium may significantly improve image acquisition during stent-assisted coil embolization.
  
  
  CONCLUSIONS
  Reduced-dose, 10 s CBCT can visualize stents in clinical cases, while significantly reducing radiation exposure.
authors.affiliation: Division of Radiological Technology, Institute of Biomedical Research and Innovation, Kobe, Japan kuriyama@fbri.org.
authors.forename: Takumi
authors.initials: T
authors.lastname: Kuriyama
authors.affiliation: Division of Neuroendovascular Therapy, Institute of Biomedical Research and Innovation, Kobe, Japan Division of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Sakai
authors.affiliation: CA/IR Department, Division of Advanced Therapies, Siemens Japan, Tokyo, Japan.
authors.forename: Norimitsu
authors.initials: N
authors.lastname: Niida
authors.affiliation: Division of Radiological Technology, Institute of Biomedical Research and Innovation, Kobe, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Sueoka
authors.affiliation: Division of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan.
authors.forename: Mikiya
authors.initials: M
authors.lastname: Beppu
authors.affiliation: Research and Collaboration Department, Siemens Japan, Tokyo, Japan.
authors.forename: Chihebeddine
authors.initials: C
authors.lastname: Dahmani
authors.affiliation: Research and Collaboration Department, Siemens Japan, Tokyo, Japan.
authors.forename: Iwao
authors.initials: I
authors.lastname: Kojima
authors.affiliation: Division of Neuroendovascular Therapy, Institute of Biomedical Research and Innovation, Kobe, Japan.
authors.forename: Chiaki
authors.initials: C
authors.lastname: Sakai
authors.affiliation: Division of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan.
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Imamura
authors.affiliation: Division of Integrated Oncology, Institute of Biomedical Research and Innovation, Kobe, Japan.
authors.forename: Katsuhiro
authors.initials: K
authors.lastname: Masago
authors.affiliation: Division of Integrated Oncology, Institute of Biomedical Research and Innovation, Kobe, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Katakami
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002533:Cerebral Angiography; D054893:Cone-Beam Computed Tomography / Q000379:methods*; D003287:Contrast Media; D004621:Embolization, Therapeutic / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000628:therapy*; D007479:Iopamidol; D008297:Male; D008875:Middle Aged; D011829:Radiation Dosage; D011835:Radiation Protection; D011857:Radiographic Image Interpretation, Computer-Assisted; D015641:Radiography, Interventional / Q000379:methods*; D015607:Stents; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D007479:Iopamidol
keywords: Aneurysm; brain; coil embolization; cone-beam computed tomography; embolization; flat panel detector; radiation dose; radiation exposure; stent