Mobile C-arm cone-beam computed tomography (CBCT) has been widely used for real-time intraoperative 3D imaging. However, current practice often mechanically applies the fan-beam CT criterion of "180° plus fan angle" in pursuit of "data completeness" in reconstruction. This review argues that, under the single circular trajectory of three-dimensional cone-beam geometry, complete data are mathematically unattainable; moreover, blindly increasing sampling may exacerbate the trade-off among intraoperative image quality (Q), imaging time (T), and radiation dose (D). Against this background, this review reframes the evaluation of intraoperative CBCT around "data sufficiency" rather than "data completeness." This perspective moves beyond the excessive pursuit of absolute mathematical and analytic accuracy, and instead emphasizes task-specific minimum image-quality thresholds required for clinical decision-making. By synthesizing evidence from multiple clinical scenarios, this review suggests that approximation errors can be acceptable when clinical decision-making requirements are satisfied, thereby achieving a Q-T-D balance.

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