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The fundamental performance of microangiography has been evaluated using the S-band linac-based inverse-Compton scattering X-ray (iCSX) method to determine how many photons would be required to apply iCSX to human microangiography. ICSX is characterized by its quasi-monochromatic nature and small focus size which are fundamental requirements for microangiography. However, the current iCSX source does not have sufficient flux for micro­angiography in clinical settings. It was determined whether S-band compact linac-based iCSX can visualize small vessels of excised animal organs, and the amount of X-ray photons required for real time microangiography in clinical settings was estimated. The iCSX coupled with a high-gain avalanche rushing amorphous photoconductor camera could visualize a resolution chart with only a single iCSX pulse of ∼3 ps duration; the resolution was estimated to be ∼500 µm. The iCSX coupled with an X-ray cooled charge-coupled device image sensor camera visualized seventh-order vascular branches (80 µm in diameter) of a rabbit ear by accumulating the images for 5 and 30 min, corresponding to irradiation of 3000 and 18000 iCSX pulses, respectively. The S-band linac-based iCSX visualized microvessels by accumulating the images. An iCSX source with a photon number of 3.6 × 103–5.4 × 104 times greater than that used in this study may enable visualizing microvessels of human fingertips even in clinical settings.

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