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

  • Diagnostic Neuroradiology
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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.


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.


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.


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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Computerized tomography


Computed tomography angiography


Magnetic resonance imaging


Magnetic resonance angiography


Digital subtraction angiography


Cone-beam CT


Distal dural ring


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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.

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We declare that we have no conflict of interest.

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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).

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