Metal artifact reduction techniques in musculoskeletal CT-imaging

Wellenberg, R.H.H.; Hakvoort, E.T.; Slump, Cornelis H.; Boomsma, Martijn F.; Maas, Mario; Streekstra, Geert J.

doi:10.1016/j.ejrad.2018.08.010

Cited by 125 publications

(92 citation statements)

References 75 publications

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“…It was striking that stainless steel 2 produced more intense artifacts than the thicker stainless steel 3 while this was not the case for titanium. This result was caused by the sharp edges between the high attenuating second steel implant and low attenuating background, which amplify metal artifacts due to so called edge effects [26]. Although the image contrast in 120 kVp and 70 keV images is comparable, this was not the case for the artifact intensities determined by Fourier analysis where 70 keV images were more distorted than 120 kVp images.…”

Section: Fourier Analysismentioning

confidence: 98%

Quantifying near metal visibility using dual energy computed tomography and iterative metal artifact reduction in a fracture phantom

2020

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Section: Fourier Analysismentioning

confidence: 98%

Quantifying near metal visibility using dual energy computed tomography and iterative metal artifact reduction in a fracture phantom

2020

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“…For several implants either VMI and MAR as standalone approaches have been successfully used to reduce artifacts, e.g. total hip replacements, spinal fixation hardware, contrast media, and dental implants 12,13,[22][23][24]27,28 . This aspect is highly relevant as combination of both approaches is only available in dual-energy CT systems which allow for row data-based reconstruction of virtual monoenergetic images (VMI), but clinically used are mainly conventional single-energy CT systems, thereby MAR as a standalone post processing approach has the advantage of a higher availability also in conventional CT systems 12,13 .…”

Section: Discussionmentioning

confidence: 99%

“…Altering tube current and voltage and/or applying narrow collimation can reduce metal artifacts, but mostly also increases radiation exposure 11 . Recently, postprocessing iterative metal artifact reduction algorithms (MAR) became available and showed reliable artifact reduction without impact on total applied radiation dose 12,13 . MAR have been reported to yield effective artifact reduction in patients with larger orthopaedic implants [12][13][14] , and smaller implants, such as dental or intracranial implants [15][16][17] .…”

mentioning

confidence: 99%

“…Recently, postprocessing iterative metal artifact reduction algorithms (MAR) became available and showed reliable artifact reduction without impact on total applied radiation dose 12,13 . MAR have been reported to yield effective artifact reduction in patients with larger orthopaedic implants [12][13][14] , and smaller implants, such as dental or intracranial implants [15][16][17] . Further, MAR have shown artifact reduction in phantom models with coils and clips 10,16,[18][19][20] .…”

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confidence: 99%

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Virtual monoenergetic images and post-processing algorithms effectively reduce CT artifacts from intracranial aneurysm treatment

Zopfs

Lennartz

Pennig

et al. 2020

Sci Rep

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To evaluate artifact reduction by virtual monoenergetic images (VMI) and metal artifact reduction algorithms (MAR) as well as the combination of both approaches (VMI MAR) compared to conventional CT images (CI) as standard of reference. In this retrospective study, 35 patients were included who underwent spectral-detector CT (SDCT) with additional MAR-reconstructions due to artifacts from coils or clips. CI, VMI, MAR and VMI MAR (range: 100-200 keV, 10 keV-increment) were reconstructed. Region-of-interest based objective analysis was performed by assessing mean and standard deviation of attenuation (HU) in hypo-and hyperdense artifacts from coils and clips. Visually, extent of artifact reduction and diagnostic assessment were rated. Compared to CI, VMI ≥ 100 keV, MAR and VMI MAR between 100-200 keV increased attenuation in hypoattenuating artifacts (CI/VMI 200keV /MAR/VMI MAR200keV , HU: −77.6 ± 81.1/−65.1 ± 103.2/−36.9 ± 27.7/−21.1 ± 26.7) and decreased attenuation in hyperattenuating artifacts (HU: 47.4 ± 32.3/42.1 ± 50.2/29.5 ± 18.9/20.8 ± 25.8). However, differences were only significant for MAR in hypodense and VMI MAR in hypo-and hyperdense artifacts (p < 0.05). Visually, hypo-and hyperdense artifacts were significantly reduced compared to CI by VMI ≥140/100keV , MAR and VMI MAR≥100keV. Diagnostic assessment of surrounding brain tissue was significantly improved in VMI ≥100keV , MAR and VMI MAR≥100keV. The combination of VMI and MAR facilitates a significant reduction of artifacts adjacent to intracranial coils and clips. Hence, if available, these techniques should be combined for optimal reduction of artifacts following intracranial aneurysm treatment. Intracranial aneurysms are a common vascular disorder with a prevalence of approximately 4%, which can be expected to increase due to an ageing population 1,2. In case of rupture they are associated with a mortality risk of up to 50% [1]. Ruptured as well as unruptured aneurysms are commonly treated with surgical clipping or endovascular coiling 3,4. Postoperative imaging is pivotal to detect postoperative complications and ensure therapy success for which computed tomography (CT) is frequently applied besides digital subtraction angiography and magnetic resonance imaging 5. However, evaluation of brain parenchyma adjacent to clips and coils is often impaired by metal artifacts. Artifacts commonly appear as hypo-and hyperdense areas surrounding the metal material. These kind of artifacts result from a combination of beam-hardening caused by absorption of low energetic photons 6,7 , photon starvation resulting from complete absorption of all photons 7,8 , and scatter artifacts that can occur due to greater attenuation differences, e.g. soft tissue and dense metal material 9. Combined, these effects can result in strong interferences that may impair depiction and interpretation of surrounding brain tissue. Therefore, evaluation of post-interventional complications, such as tissue damage, haemorrhage, infarction and oedema may be limited 10. Further, any futur...

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“…Dual-energy computed tomography (DECT), however, can be used to decrease beam-hardening artifacts related to metal. 5,20,21 In the clinical setting, iMAR reconstructions can be obtained after image acquisition, whereas the decision to use DECT for metal artifact reduction must be made before image acquisition. 20 MRI allows for excellent evaluation of osseous, implant, and soft tissue structures, provided that metal artifact reduction techniques are used successfully.…”

Section: Imaging Modalitiesmentioning

confidence: 99%

Imaging of Hip Arthroplasties: Normal Findings and Hardware Complications

Deshmukh

Omar

2019

Semin Musculoskelet Radiol

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Hip arthroplasty is a common and largely successful surgical procedure, often used for the treatment of advanced osteoarthritis. Imaging plays a key role in routine postoperative imaging surveillance as well as the evaluation of post-arthroplasty pain. Radiographs are the first-line imaging modality and may be followed by computed tomography (CT), ultrasound, and/or magnetic resonance imaging (MRI). Recent advancements in imaging techniques allow for metal artifact reduction on CT and MRI. A variety of complications can arise in the setting of arthroplasty: mechanical loosening, component wear-induced synovitis and osteolysis, adverse local tissue reaction, infection, periprosthetic fracture, implant dislocation and/or component displacement, tendinopathy, and neurovascular injury. This article reviews normal and abnormal imaging findings of hip arthroplasty.

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Metal artifact reduction techniques in musculoskeletal CT-imaging

Cited by 125 publications

References 75 publications

Quantifying near metal visibility using dual energy computed tomography and iterative metal artifact reduction in a fracture phantom

Quantifying near metal visibility using dual energy computed tomography and iterative metal artifact reduction in a fracture phantom

Virtual monoenergetic images and post-processing algorithms effectively reduce CT artifacts from intracranial aneurysm treatment

Imaging of Hip Arthroplasties: Normal Findings and Hardware Complications

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