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

<b>Background:</b> MRA is used in our center for monitoring post-treatment residual aneurysmal neck and stent patency. IV CBCT offers better spatial resolution and may provide significant advantages. <b>Objective:</b> This study investigates the image quality of IV CBCT compa...

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Main Authors: Man Cho Lee, King Him Fung, Shing Him Liu, Koel Wei Sum Ko, Nok Lun Chan, Neeraj Ramesh Mahboobani, Ka Wai Shek, Tak Lap Poon, Wai Lun Poon
Format: Article
Language:English
Published: MDPI AG 2025-07-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/15/14/1774
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author Man Cho Lee
King Him Fung
Shing Him Liu
Koel Wei Sum Ko
Nok Lun Chan
Neeraj Ramesh Mahboobani
Ka Wai Shek
Tak Lap Poon
Wai Lun Poon
author_facet Man Cho Lee
King Him Fung
Shing Him Liu
Koel Wei Sum Ko
Nok Lun Chan
Neeraj Ramesh Mahboobani
Ka Wai Shek
Tak Lap Poon
Wai Lun Poon
author_sort Man Cho Lee
collection DOAJ
description <b>Background:</b> MRA is used in our center for monitoring post-treatment residual aneurysmal neck and stent patency. IV CBCT offers better spatial resolution and may provide significant advantages. <b>Objective:</b> This study investigates the image quality of IV CBCT compared to that of MRA for the follow-up of intracranial aneurysms. <b>Materials and Methods:</b> In this prospective cohort study, 97 patients (mean age: 63.1 ± 11.7; 75 women and 22 men) with 114 treated cerebral aneurysms were included from July 2023 to April 2024. All patients underwent IV CBCT and MRA on the same day. Two neurointerventional radiologists assessed image quality using a five-point Likert scale on two separate occasions six weeks apart. Diagnostic values were evaluated across six parameters. Intra-observer and inter-observer agreements were calculated. Subgroup analyses were performed. <b>Results:</b> Overall, IV CBCT and MRA are comparable in terms of their ability to assess parent vessel status and the degree of artifacts (<i>p</i> > 0.05) though MRA shows a slight advantage in evaluating residual aneurysmal neck (<i>p</i> = 0.05). For clipped aneurysms, IV CBCT is superior in assessing residual aneurysmal neck (OR = 16.0, <i>p</i> < 0.001) and parent vessel status (OR = 15.1, <i>p</i> < 0.001) with significantly fewer artifacts (OR > 100, <i>p</i> < 0.001). For aneurysms solely treated with stents, IV CBCT is superior in assessing residual aneurysmal neck (OR > 20, <i>p</i> = 0.002) and parent vessel status (OR > 20, <i>p</i> = 0.002) with significantly fewer artifacts (OR > 20, <i>p</i> = 0.002). IV CBCT outperforms MRA in evaluating stent struts and the vessel wall status of a stented segment when MRA is non-diagnostic. <b>Conclusions:</b> IV CBCT and MRA have their own strengths and roles in the follow-up of post-treatment intracranial aneurysms. Overall, IV CBCT is superior in terms of its assessment of intracranial aneurysms treated solely with stents or surgical clips.
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spelling doaj-art-96b81383a18e413bb0659bc21704a4bb2025-08-20T03:08:01ZengMDPI AGDiagnostics2075-44182025-07-011514177410.3390/diagnostics15141774A 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 StudyMan Cho Lee0King Him Fung1Shing Him Liu2Koel Wei Sum Ko3Nok Lun Chan4Neeraj Ramesh Mahboobani5Ka Wai Shek6Tak Lap Poon7Wai Lun Poon8Queen Elizabeth Hospital, Hong KongQueen Elizabeth Hospital, Hong KongQueen Elizabeth Hospital, Hong KongQueen Elizabeth Hospital, Hong KongQueen Elizabeth Hospital, Hong KongPrince of Wales Hospital, Hong KongQueen Elizabeth Hospital, Hong KongQueen Elizabeth Hospital, Hong KongQueen Elizabeth Hospital, Hong Kong<b>Background:</b> MRA is used in our center for monitoring post-treatment residual aneurysmal neck and stent patency. IV CBCT offers better spatial resolution and may provide significant advantages. <b>Objective:</b> This study investigates the image quality of IV CBCT compared to that of MRA for the follow-up of intracranial aneurysms. <b>Materials and Methods:</b> In this prospective cohort study, 97 patients (mean age: 63.1 ± 11.7; 75 women and 22 men) with 114 treated cerebral aneurysms were included from July 2023 to April 2024. All patients underwent IV CBCT and MRA on the same day. Two neurointerventional radiologists assessed image quality using a five-point Likert scale on two separate occasions six weeks apart. Diagnostic values were evaluated across six parameters. Intra-observer and inter-observer agreements were calculated. Subgroup analyses were performed. <b>Results:</b> Overall, IV CBCT and MRA are comparable in terms of their ability to assess parent vessel status and the degree of artifacts (<i>p</i> > 0.05) though MRA shows a slight advantage in evaluating residual aneurysmal neck (<i>p</i> = 0.05). For clipped aneurysms, IV CBCT is superior in assessing residual aneurysmal neck (OR = 16.0, <i>p</i> < 0.001) and parent vessel status (OR = 15.1, <i>p</i> < 0.001) with significantly fewer artifacts (OR > 100, <i>p</i> < 0.001). For aneurysms solely treated with stents, IV CBCT is superior in assessing residual aneurysmal neck (OR > 20, <i>p</i> = 0.002) and parent vessel status (OR > 20, <i>p</i> = 0.002) with significantly fewer artifacts (OR > 20, <i>p</i> = 0.002). IV CBCT outperforms MRA in evaluating stent struts and the vessel wall status of a stented segment when MRA is non-diagnostic. <b>Conclusions:</b> IV CBCT and MRA have their own strengths and roles in the follow-up of post-treatment intracranial aneurysms. Overall, IV CBCT is superior in terms of its assessment of intracranial aneurysms treated solely with stents or surgical clips.https://www.mdpi.com/2075-4418/15/14/1774cone-beam computed tomographymagnetic resonance angiographyintracranial aneurysm
spellingShingle Man Cho Lee
King Him Fung
Shing Him Liu
Koel Wei Sum Ko
Nok Lun Chan
Neeraj Ramesh Mahboobani
Ka Wai Shek
Tak Lap Poon
Wai Lun Poon
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
cone-beam computed tomography
magnetic resonance angiography
intracranial aneurysm
title 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_short 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
title_sort 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
topic cone-beam computed tomography
magnetic resonance angiography
intracranial aneurysm
url https://www.mdpi.com/2075-4418/15/14/1774
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