Advances in Bone Joint Imaging-Metal Artifact Reduction

Abstract

Numerous types of metal implants have been introduced in orthopedic surgery and are used in everyday practice. To precisely evaluate the postoperative condition of arthroplasty or trauma surgery, periprosthetic infection, and the loosening of implants, it is important to reduce artifacts induced by metal implants. In this review, we focused on technical advances in metal artifact reduction using digital tomosynthesis, computed tomography, and magnetic resonance imaging. We discussed new developments in diagnostic imaging methods and the continuous introduction of novel technologies to reduce metal artifacts; however, these innovations have not yet completely removed metal artifacts. Different algorithms need to be selected depending on the size, shape, material and implanted body parts of an implant. Future advances in metal artifact reduction algorithms and techniques and the development of new sequences may enable further reductions in metal artifacts even on original images taken previously. Moreover, the combination of different imaging modalities may contribute to further reductions in metal artifacts. Clinicians must constantly update their knowledge and work closely with radiologists to select the best diagnostic imaging method for each metal implant.

Comparison of Bone Evaluation and Metal Artifact between Photon-Counting CT and Five Energy-Integrating-Detector CT under Standardized Conditions Using Cadaveric Forearms

“…Increasing the keV setting in a VMI can effectively eliminate beam hardening due to metal implants [17,25]. Recently, the same phenomenon was observed using PCCT [24,26,27], with one study reporting that a 130 keV VMI of patients with spinal implants had significantly fewer metal artifacts than a 65 keV VMI [24].…”

A Pilot Study on the Reliability of Ultrasound-Based Assessment of Patella Diameter and Sulcus Angle

“…Reliability is one aspect of diagnostic test accuracy and is relevant for new technologies in orthopedic research, such as sensor-based assessments or modern approaches imaging technology [ 26 , 27 , 28 ]. Still, the next step in the validation of the measurement method would be to test its accuracy by comparing the values determined using ultrasonography with those determined using a former validated procedure as a reference test.…”

Secondary Rotator Cuff Insufficiency After Anatomic Total Shoulder Arthroplasty

“…Although advanced imaging such as magnetic resonance imaging (MRI) and computed tomography (CT) has value in detecting fatty infiltration of the rotator cuff, metal artifact interference can limit tendon assessment 2,4 . Multiple artifact reduction strategies have been introduced including the view angle tilting technique and slice encoding for metal artifact correction for MRI, and dual-energy application and standard acquisition and reconstruction modification for CT 18 . Ultrasound is more cost-effective but has varied utility based on the literature [19][20][21] .…”