ArticleJournal of neurointerventional surgery2023
The butterfly effect: improving brain cone-beam CT image artifacts for stroke assessment using a novel dual-axis trajectory.
Article in Journal of neurointerventional surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 13 citations in OpenAlex.
- CBCT Dose Is Reduced with Angular Tube Current Modulation While Maintaining Image Quality and Reducing Photon Starvation Artifacts.Annals of biomedical engineering · 2026Article
- Diagnostic Accuracy of Ischemia and Hemorrhage on Cone-Beam CT Immediately After Endovascular Thrombectomy.Stroke (Hoboken, N.J.) · 2026Article
- A Comparability Study Between Intravenous Contrast-Enhanced Cone-Beam Computed Tomography (CBCT) and Magnetic Resonance Angiography (MRA) on the Post-Treatment Follow-Up of Intracranial Aneurysms: A Single-Center Prospective Cohort Study.Diagnostics (Basel, Switzerland) · 2025Article
- Image Quality Evaluation for Brain Soft Tissue in Neuroendovascular Treatment by Dose-Reduction Mode of Dual-Axis "Butterfly" Scan.AJNR. American journal of neuroradiology · 2025Article
- Current trends in antiplatelet strategies for emergent carotid stenting in acute tandem occlusions: a web-based, nationwide survey in the Italian neurovascular community.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Article
- Review
- Image Quality and Radiation Dose of Conventional and Wide-Field High-Resolution Cone-Beam Computed Tomography for Cerebral Angiography: A Phantom Study.Tomography (Ann Arbor, Mich.) · 2023Article
- Dual-Layer Detector Cone-Beam CT Angiography for Stroke Assessment: First-in-Human Results (the Next Generation X-ray Imaging System Trial).AJNR. American journal of neuroradiology · 2023Article
Corrections and comments
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Authors and funding
10 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCone-beam computed tomography (CBCT) imaging of the brain can be performed in the angiography suite to support various neurovascular procedures. Relying on CBCT brain imaging solely, however, still lacks full diagnostic confidence due to the inferior image quality compared with CT and various imaging artifacts that persist even with modern CBCT.
objectiveTo perform a detailed evaluation of image artifact improvement using a new CBCT protocol which implements a novel dual-axis 'butterfly' trajectory.
methodsOur study included 94 scans from 47 patients who received CBCT imaging for assessment of either ischemia or hemorrhage during a neurovascular procedure. Both a traditional uni-axis 'circular' and novel dual-axis 'butterfly' protocol were performed on each patient (same-patient control). Each brain scan was divided into six regions and scored out of 3 based on six artifacts originating from various physics-based and patient-based sources.
resultsThe dual-axis trajectory produces CBCT images with significantly fewer image artifacts than the traditional circular scan (whole brain average artifact score, AS: 0.20 vs 0.33), with the greatest improvement in bone beam hardening (AS: 0.13 vs 0.78) and cone-beam artifacts (AS: 0.04 vs 0.55).
conclusionsRecent developments in CBCT imaging protocols have significantly improved image artifacts, which has improved diagnostic confidence for stroke and supports a direct-to-angiography suite transfer approach for patients with acute ischemic stroke.
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