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Potential of 80-kV high-resolution cone-beam CT imaging combined with an optimized protocol for neurological surgery

  • Diagnostic Neuroradiology
  • Published:
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Abstract

Introduction

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.

Conclusion

Eighty-kilovolt high-resolution CBCT has the potential to provide detailed anatomy for neurosurgical operations when utilizing suitable modes and contrast protocols.

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Abbreviations

CT:

Computerized tomography

CTA:

Computed tomography angiography

MRI:

Magnetic resonance imaging

MRA:

Magnetic resonance angiography

DSA:

Digital subtraction angiography

CBCT:

Cone-beam CT

DDR:

Distal dural ring

References

  1. Vertinsky AT, Schwartz NE, Fischbein NJ, Rosenberg J, Albers GW, Zaharchuk G (2008) Comparison of multidetector CT angiography and MR imaging of cervical artery dissection. AJNR Am J Neuroradiol 29:1753–1760. doi:10.3174/ajnr.A1189

    Article  CAS  PubMed  Google Scholar 

  2. Tomandl BF, Klotz E, Handschu R, Stemper B, Reinhardt F, Huk WJ, Eberhardt KE, Fateh-Moghadam S (2003) Comprehensive imaging of ischemic stroke with multisection CT. Radiographics 23:565–592. doi:10.1148/rg.233025036

    Article  PubMed  Google Scholar 

  3. Mnyusiwalla A, Aviv RI, Symons SP (2009) Radiation dose from multidetector row CT imaging for acute stroke. Neuroradiology 51:635–640. doi:10.1007/s00234-009-0543-6

    Article  PubMed  Google Scholar 

  4. Miley JT, Taylor RA, Janardhan V, Tummala R, Lanzino G, Qureshi AI (2008) The value of computed tomography angiography in determining treatment allocation for aneurysmal subarachnoid hemorrhage. Neurocrit Care 9:300–306. doi:10.1007/s12028-008-9109-4

    Article  PubMed  Google Scholar 

  5. Akpek S, Brunner T, Benndorf G, Strother C (2005) Three-dimensional imaging and cone beam volume CT in C-arm angiography with flat panel detector. Diagn Interv Radiol 11:10–13

    PubMed  Google Scholar 

  6. Mordasini P, Al-Senani F, Gralla J, Do D-D, Brekenfeld C, Schroth G (2009) The use of flat panel angioCT (DynaCT) for navigation through a deformed and fractured carotid stent. Neuroradiology 52:629–632. doi:10.1007/s00234-009-0556-1

    Article  PubMed  Google Scholar 

  7. Soderman M, Babic D, Holmin S, Andersson T (2008) Brain imaging with a flat detector C-arm: technique and clinical interest of XperCT. Neuroradiology 50:863–868. doi:10.1007/s00234-008-0419-1

    Article  CAS  PubMed  Google Scholar 

  8. Patel NV, Gounis MJ, Wakhloo AK, Noordhoek N, Blijd J, Babic D, Takhtani D, Lee SK, Norbash A (2011) Contrast-enhanced angiographic cone-beam CT of cerebrovascular stents: experimental optimization and clinical application. AJNR Am J Neuroradiol 32:137–144. doi:10.3174/ajnr.A2239

    CAS  PubMed  Google Scholar 

  9. Blanc R, Pistocchi S, Babic D, Bartolini B, Obadia M, Alamowitch S, Piotin M (2012) Intravenous flat-detector CT angiography in acute ischemic stroke management. Neuroradiology 54:383–391. doi:10.1007/s00234-011-0893-8

    Article  PubMed  Google Scholar 

  10. Caroff J, Mihalea C, Neki H, Ruijters D, Ikka L, Benachour N, Moret J, Spelle L (2014) Role of C-Arm VasoCT in the Use of endovascular WEB flow disruption in intracranial aneurysm treatment. AJNR Am J Neuroradiol. doi:10.3174/ajnr.A3860

    PubMed  Google Scholar 

  11. Kizilkilic O, Kocer N, Metaxas GE, Babic D, Homan R, Islak C (2012) Utility of VasoCT in the treatment of intracranial aneurysm with flow-diverter stents. J Neurosurg 117:45–49. doi:10.3171/2012.4.jns111660

    Article  PubMed  Google Scholar 

  12. Oikawa S, Kyoshima K, Kobayashi S (1998) Surgical anatomy of the juxta-dural ring area. J Neurosurg 89:250–254. doi:10.3171/jns.1998.89.2.0250

    Article  CAS  PubMed  Google Scholar 

  13. Matsumura Y, Nagashima M (1999) Anatomical variations in the origin of the human ophthalmic artery with special reference to the cavernous sinus and surrounding meninges. Cells Tissues Organs 164:112–121

    Article  CAS  PubMed  Google Scholar 

  14. Hashimoto K, Nozaki K, Hashimoto N (2006) Optic strut as a radiographic landmark in evaluating neck location of a paraclinoid aneurysm. Neurosurgery 59:880–887. doi:10.1227/01.neu.0000232664.02190.e1

    Article  PubMed  Google Scholar 

  15. Murayama Y, Sakurama K, Satoh K, Nagahiro S (2001) Identification of the carotid artery dural ring by using three-dimensional computerized tomography angiography. Technical note. J Neurosurg 95:533–536. doi:10.3171/jns.2001.95.3.0533

    Article  CAS  PubMed  Google Scholar 

  16. Watanabe Y, Makidono A, Nakamura M, Saida Y (2011) 3D MR cisternography to identify distal dural rings: comparison of 3D-CISS and 3D-SPACE sequences. Magn Reson Med Sci 10:29–32

    Article  PubMed  Google Scholar 

  17. Watanabe Y, Nakazawa T, Yamada N, Higashi M, Hishikawa T, Miyamoto S, Naito H (2009) Identification of the distal dural ring with use of fusion images with 3D-MR cisternography and MR angiography: application to paraclinoid aneurysms. Am J Neuroradiol 30:845–850. doi:10.3174/ajnr.A1440

    Article  CAS  PubMed  Google Scholar 

  18. Tsuboi T, Tokunaga K, Shingo T, Itoh T, Mandai S, Kinugasa K, Date I (2007) Differentiation between intradural and extradural locations of juxta-dural ring aneurysms by using contrast-enhanced 3-dimensional time-of-flight magnetic resonance angiography. Surg Neurol 67:381–387. doi:10.1016/j.surneu.2006.08.006

    Article  PubMed  Google Scholar 

  19. Hirai T, Kai Y, Morioka M, Yano S, Kitajima M, Fukuoka H, Sasao A, Murakami R, Nakayama Y, Awai K, Toya R, Akter M, Korogi Y, Kuratsu J, Yamashita Y (2008) Differentiation between paraclinoid and cavernous sinus aneurysms with contrast-enhanced 3D constructive interference in steady- state MR imaging. Am J Neuroradiol 29:130–133. doi:10.3174/ajnr.A0756

    Article  CAS  PubMed  Google Scholar 

  20. Thines L, Lee SK, Dehdashti AR, Agid R, Willinsky RA, Wallace CM, Terbrugge KG (2009) Direct imaging of the distal dural ring and paraclinoid internal carotid artery aneurysms with high-resolution T2 turbo-spin echo technique at 3-T magnetic resonance imaging. Neurosurgery 64:1059–1064. doi:10.1227/01.neu.0000343523.67272.34

    Article  PubMed  Google Scholar 

  21. Tanriover N, Rhoton AL Jr, Kawashima M, Ulm AJ, Yasuda A (2004) Microsurgical anatomy of the insula and the sylvian fissure. J Neurosurg 100:891–922. doi:10.3171/jns.2004.100.5.0891

    Article  PubMed  Google Scholar 

  22. Suzuki Y, Matsumoto K (2000) Variations of the superficial middle cerebral vein: classification using three-dimensional CT angiography. AJNR Am J Neuroradiol 21:932–938

    CAS  PubMed  Google Scholar 

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Ethical standards and patient consent

We declare that all human studies have been approved by the local Ethics Committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. Patient consent was waived for this retrospective study; however, CBCT studies were performed with informed consent of the patient or the patient’s relatives.

Conflict of interest

We declare that we have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Toranomon Hospital, 2-2-2 Minatoku Toranomon, Tokyo, 105-8470, Japan

    Seisaku Kanayama & Takayuki Hara

  2. Department of Radiology, Toranomon Hospital, Tokyo, Japan

    Yusuke Hamada

  3. Department of Neuro-Endovascular Therapy, Toranomon Hospital, Tokyo, Japan

    Yuji Matsumaru

Authors
  1. Seisaku Kanayama
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  2. Takayuki Hara
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  3. Yusuke Hamada
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  4. Yuji Matsumaru
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Corresponding author

Correspondence to Seisaku Kanayama.

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Kanayama, S., Hara, T., Hamada, Y. et al. Potential of 80-kV high-resolution cone-beam CT imaging combined with an optimized protocol for neurological surgery. Neuroradiology 57, 155–162 (2015). https://doi.org/10.1007/s00234-014-1447-7

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  • DOI: https://doi.org/10.1007/s00234-014-1447-7

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