Clinical Feasibility Studies and Potential Applications of Cone-Beam Computed Tomography Integrated in Multimodality X-Ray System for Small Animals

Diagnostic imaging is essential in veterinary practice, and cone-beam computed tomography (CBCT) has emerged as a promising tool to complement radiography. This study aimed to optimize the image quality of a novel multimodality veterinary X-ray prototype integrating direct digital radiography, fluoroscopy and CBCT, and to assess its potential clinical applications, focusing on the CBCT component. 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.