{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T06:42:05Z","timestamp":1792392125808,"version":"4.4.0"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"9","license":[{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Neuroradiology"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and purpose<\/jats:title>\n                    <jats:p>Preservation of perforator arteries during cerebrovascular interventions remains challenging due to their submillimeter caliber and variable anatomy. High-resolution cone-beam computed tomography (HR-CBCT) offers improved resolution compared with conventional CT angiography (CTA), yet its utility for perforator assessment has not been systematically evaluated. This study assessed HR-CBCT for visualization of intracranial perforators in both preoperative and intraoperative contexts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Imaging from 20 patients who underwent aneurysm clipping, arteriovenous malformation resection, or dural arteriovenous fistula treatment between July 2022 and November 2024 was reviewed. Three imaging modalities were evaluated: preoperative CTA, preoperative HR-CBCT, and intraoperative HR-CBCT. Five perforator arteries\u2014the recurrent artery of Heubner, anterior choroidal artery, lateral lenticulostriate arteries, basilar artery perforators, and posterior cerebral artery perforators\u2014were independently scored by four neuroradiologists using a three-point visibility scale (3\u2009=\u2009visible, 2\u2009=\u2009not visible due to limited field of view, 1\u2009=\u2009not visible due to resolution). Reader confidence was recorded, and statistical analysis was performed using R.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Perforator visualization was significantly higher with both preoperative and intraoperative HR-CBCT compared with CTA. On preoperative imaging, confidence was significantly higher for anterior choroidal and lateral lenticulostriate arteries (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), but not for the recurrent artery of Heubner (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.102). Intraoperative scans showed no significant reduction in visibility. Effective dose did not differ between CTA and HR-CBCT (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.700).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Preoperative and intraoperative HR-CBCT provide superior perforator visualization compared with CTA, with intraoperative imaging closely matching preoperative performance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00234-026-04052-2","type":"journal-article","created":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T06:01:09Z","timestamp":1780466469000},"page":"3071-3081","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["High-resolution cone-beam CT (DynaCT Micro) enhances preoperative and intraoperative visualization of intracranial perforator arteries"],"prefix":"10.1007","volume":"68","author":[{"given":"Mikaeel A.","family":"Habib","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaeha","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William J.","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis O.","family":"Tierradentro-Garcia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Om H.","family":"Gandhi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Romano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suehyb G.","family":"Alkhatib","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Gewolb","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colbey","family":"Freeman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah A.","family":"Hamimi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mackenzie","family":"Castellanos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sami","family":"Almasri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda J.","family":"Bagley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar A.","family":"Choudhri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,3]]},"reference":[{"issue":"2","key":"4052_CR1","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1016\/j.nic.2024.01.005","volume":"34","author":"C Fritch","year":"2024","unstructured":"Fritch C, Church E, Wilkinson DA (2024) Advances in Intraoperative Imaging for Vascular Neurosurgery. 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The requirement for informed consent was waived due to the retrospective nature of the analysis and use of de-identified data.","order":1,"name":"Ethics","label":"Ethics approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable due to waiver of consent.","order":2,"name":"Ethics","label":"Consent to participate and consent to publish","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Omar Choudhri is a consultant for Siemens Healthineers, the biplane angiography system used during this study.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"During the preparation of this work the authors used ChatGPT (GPT-5.1, OpenAI) for grammar, wording clarity, and editorial suggestions. After using this tool, the authors reviewed and edited the content as needed and take full responsibility for the content of the published article.","order":4,"name":"Ethics","label":"Declaration of generative AI","group":{"name":"EthicsHeading","label":"Declarations"}}]}}