Investigation of the need for an x-ray scatter-reduction grid during neurointerventional procedures.

X-ray guided neurointerventions are catheter-based treatments for cerebrovascular diseases such as strokes and aneurysms. During such procedures visualization of treatment devices is the primary imaging task. In this work we investigate the necessity of x-ray scatter-reduction grids in performing those tasks. Various endovascular treatment devices such as stents, coils and catheters along with a low contrast blood vessel phantom were placed on a head-equivalent phantom. Images of the objects were acquired with and without a grid (15:1 grid ratio, 80 lines/cm and Al interspace). The x-ray field was set to the full 8 x 8 inch FOV to allow for realistic scatter generation. The detector was positioned close to the phantom to investigate maximal scatter conditions. Contrast and Contrast to Noise (CNR) ratios of the catheter tip and the blood vessel phantom were measured and compared for images obtained with and without the grid. The x-ray technique parameters were kept constant for all acquisitions. For the catheter tip there was a 43% reduction in contrast with the removal of the grid due to increased scatter reaching the detector. However, due to increased primary there was a 18% increase in CNR. For the blood vessel phantom, there was a 33% reduction in contrast, whereas a 17% increase in CNR. All the devices and the blood vessels in the phantom were still visible even with the increased scatter without the grid. The results of the study indicate the use of grids during neurointervention procedures might not be necessary to perform the intervention.