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The study was conducted in three phases: optimization of CBCT image quality using postmortem samples, comparison of CBCT and 16-slice multidetector CT (MDCT) images of four cadavers (two dogs and two cats), and potential clinical applications in 24 live patients. Comparative evaluation in postmortem scans revealed that CBCT achieved equal quality in 65% of bone compared to MDCT and a slightly inferior quality in 90% of soft-tissue structures using the bone reconstruction protocol, with beam hardening as the main limiting factor. Clinical validation showed that CBCT was particularly useful for identifying small fractures and mineralized structures, providing diagnostic information not clearly visible on radiographs. Integration of radiography, fluoroscopy, and CBCT in a single device facilitated workflow and allowed a more precise diagnosis in most of the patients examined with the prototype, which demonstrated promising diagnostic performance in small-animal and exotic veterinary practice.<\/jats:p>","DOI":"10.3390\/ani16050763","type":"journal-article","created":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T16:18:45Z","timestamp":1772554725000},"page":"763","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Clinical Feasibility Studies and Potential Applications of Cone-Beam Computed Tomography Integrated in Multimodality X-Ray System for Small Animals"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-4628-5038","authenticated-orcid":false,"given":"Elena","family":"M\u00ednguez-Pereira","sequence":"first","affiliation":[{"name":"Department of Small Animal Medicine and Surgery, Veterinary Faculty, Complutense University of Madrid, 28040 Madrid, Spain"},{"name":"Veterinary Teaching Hospital, Complutense University, 28040 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Sanderson","sequence":"additional","affiliation":[{"name":"Department of Bioengineering, Carlos III University of Madrid, 28911 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4847-7233","authenticated-orcid":false,"given":"M\u00f3nica","family":"Abella","sequence":"additional","affiliation":[{"name":"Department of Bioengineering, Carlos III University of Madrid, 28911 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaolin","family":"Ye","sequence":"additional","affiliation":[{"name":"Sedecal Molecular Imaging, 28119 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nerea","family":"Le\u00f3n","sequence":"additional","affiliation":[{"name":"Sedecal Molecular Imaging, 28119 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2030-2711","authenticated-orcid":false,"given":"Alejandro","family":"Sisniega","sequence":"additional","affiliation":[{"name":"Sedecal Molecular Imaging, 28119 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Manuel","family":"Arco","sequence":"additional","affiliation":[{"name":"Sedecal Molecular Imaging, 28119 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Isabel","family":"Garc\u00eda-Real","sequence":"additional","affiliation":[{"name":"Department of Small Animal Medicine and Surgery, Veterinary Faculty, Complutense University of Madrid, 28040 Madrid, Spain"},{"name":"Veterinary Teaching Hospital, Complutense University, 28040 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"100382","DOI":"10.1016\/j.ejro.2021.100382","article-title":"Imaging Techniques in Veterinary Medicine. 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