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

Hakvoort, E.T.; Wellenberg, R.H.H.; Streekstra, Geert J.

doi:10.1016/j.ejmp.2019.11.006

Cited by 15 publications

(7 citation statements)

References 26 publications

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“…in the peripheral ROIs, MAR could reduce the CT number accuracy. This has previously been reported by others ( 22 , 23 ) . MAR techniques have been developed to correct for visible metal artefacts to improve diagnostic radiology, supposedly at the cost of additional artefacts.…”

Section: Discussionsupporting

confidence: 90%

Comparison of Metal Artefacts for Different Dual Energy Ct Techniques

Pettersson

Bäck

Thilander-Klang

2021

Radiation Protection Dosimetry

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This study compares dual-energy computed tomography (DECT) images of a phantom including different material inserts and with additional lateral titanium or stainless steel inserts, simulating bilateral hip prostheses. Dual-source (DS) and fast kV-switching (FKS) DECT with/without metal artefact reduction (MAR) were compared with regards to virtually monoenergetic CT number accuracy and the depiction of different materials. Streak artefacts were observed between the metal inserts that were more severe with steel compared to titanium inserts. The artefact severity and CT number accuracy depended on the photon energy (keV) for both DECT techniques. While MAR generally increased the CT number accuracy and material depiction within the streak artefacts, it sometimes decreased the accuracy outside the streak artefacts for both DS and FKS. FKS depicted the metal inserts more accurately than DS with regards to both CT numbers and external diameter.

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Section: Discussionsupporting

confidence: 90%

Comparison of Metal Artefacts for Different Dual Energy Ct Techniques

Pettersson

Bäck

Thilander-Klang

2021

Radiation Protection Dosimetry

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“…Previous hip studies have concentrated on artifact reduction, 16 CT number consistency in pelvic soft tissues, 17 high contrast phantoms, 18 or noise 19 but cancellous bone consists of a network of interconnected trabecular struts 100–150 μm thick. This study has shown that heavily weighting the high energy tube in dual‐energy algorithms (and to a lesser extent at higher monoenergetic levels) reduces clinically important bone density and trabecular contrast around a simulated acetabular bone defect.…”

Section: Discussionmentioning

confidence: 99%

Impact of computed tomography metal artifact reduction protocol on periprosthetic tissue characterization after total hip arthroplasty: A cadaveric study

Dwyer

Korlaet

Callary

et al. 2022

Journal Orthopaedic Research

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Metal artifact reduction (MAR) has improved computed tomography (CT) imaging of total hip arthroplasty (THA) but the assessment of osteolysis and implant to bone contact relies on the accurate depiction of bone defects, cancellous bone, and cement. This study evaluates the impact of available single and dual-energy protocols on periprosthetic tissue characterization in a cadaveric phantom. Bilateral THA was performed on a fresh frozen cadaveric pelvis with simulated osteolytic cavities. CT acquisitions with projection-based MAR and noise equivalence were performed using single energy 140 kVp, single energy 150 kVp with 0.6 mm tin filtration, and dual-energy at 100/150 kVp with 0.6 mm tin filtration, from which simulated energies were extracted. Image subtraction, segmentation, region of interest histograms, and line profiles were used to characterize tissue density and separation. Tissue densities were heavily dependent on the energy profile of the protocol. Cancellous bone ranged from 182 to 45 HU and cement from 1012 to 131 HU using 140 kVp compared to dual-energy with weighted high energy tube, respectively. Spectral separation between cancellous bone, osteolytic defect, and cement was reduced for all protocols compared with 140 kVp. Spectral overlap was most severe using dual-energy with heavily weighted high-energy tubes. Dualenergy algorithms reduced trabecular contrast within the cancellous bone and cortical edge response. Although the dual-energy acquisition has been proposed as an additive to projection-based MAR techniques in THA, reduced density and contrast in clinically relevant periprosthetic tissue compared to 140 kVp single energy may limit its use in characterizing periprosthetic tissues.

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“…The use of MAR in addition to MBIR was previously reported to reduce the radiation dose by up to 80% from that with conventional FBP [ 31 ]. Previous studies demonstrated the effectiveness of MAR at reducing metal artifacts following total hip arthroplasty (THA) [ 36 , 37 , 38 , 39 ], total knee arthroplasty (TKA) [ 30 ], and different metal fixation implants [ 40 , 41 , 42 ]. Bolstad et al concluded that MAR reduced metal artifacts, particularly on implants made of steel and cobalt-chrome [ 42 ].…”

Section: Metal Artifact Reduction Strategiesmentioning

confidence: 99%

“…Previous studies reported that DECT reduced metal artifacts on spine implants, implants for fractures, and hip and knee prostheses [ 40 , 41 , 42 , 50 , 51 , 52 ]. However, there is no generalized optimal kV for metal implants, which may be attributed to differences in metal alloys, the size, shape, and geometry of the implant, the body region, and the acquisition parameters used [ 31 ].…”

Section: Metal Artifact Reduction Strategiesmentioning

confidence: 99%

Advances in Bone Joint Imaging-Metal Artifact Reduction

et al. 2022

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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.

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

Cited by 15 publications

References 26 publications

Comparison of Metal Artefacts for Different Dual Energy Ct Techniques

Comparison of Metal Artefacts for Different Dual Energy Ct Techniques

Impact of computed tomography metal artifact reduction protocol on periprosthetic tissue characterization after total hip arthroplasty: A cadaveric study

Advances in Bone Joint Imaging-Metal Artifact Reduction

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