Metal artifacts in intraoperative O-arm CBCT scans

Juha I Peltonen,Touko Kaasalainen,Mika Kortesniemi

doi:10.1186/s12880-020-00538-4

Juha I Peltonen, Touko Kaasalainen + Show 1 more

Open Access

https://doi.org/10.1186/s12880-020-00538-4

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Abstract

BackgroundCone-beam computed tomography (CBCT) has become an increasingly important medical imaging modality in orthopedic operating rooms. Metal implants and related image artifacts create challenges for image quality optimization in CBCT. The purpose of this study was to develop a robust and quantitative method for the comprehensive determination of metal artifacts in novel CBCT applications.MethodsThe image quality of an O-arm CBCT device was assessed with an anthropomorphic pelvis phantom in the presence of metal implants. Three different kilovoltage and two different exposure settings were used to scan the phantom both with and without the presence of metal rods.ResultsThe amount of metal artifact was related to the applied CBCT imaging protocol parameters. The size of the artifact was moderate with all imaging settings. The highest applied kilovoltage and exposure level distinctly increased artifact severity.ConclusionsThe developed method offers a practical and robust way to quantify metal artifacts in CBCT. Changes in imaging parameters may have nonlinear effects on image quality which are not anticipated based on physics.

Highlights

Cone-beam computed tomography (CBCT) has become an increasingly important medical imaging modality in orthopedic operating rooms
Fig. 3. 25% artifact isolevels of the maximum artifact intensity with respect to the used tube voltage measured as millimeters versus the angle from the artifact center
This study aimed to develop a robust method to quantify metal artifacts in CBCT and to apply this method to O-arm scans of an anthropomorphic phantom with metal inserts

Summary

Introduction

Cone-beam computed tomography (CBCT) has become an increasingly important medical imaging modality in orthopedic operating rooms. The purpose of this study was to develop a robust and quantitative method for the comprehensive determination of metal artifacts in novel CBCT applications. An evolving three-dimensional (3D) imaging technique, called cone-beam computed tomography (CBCT), has gained increasing interest and usage in medical imaging. This versatile imaging method is used for diagnosis and treatment planning purposes for example in dentistry, orthopedics, neurosurgery, and interventional radiology. The application of CBCT systems is increasing in operating rooms where it is used for intraoperative 3D imaging. CBCT-based image guidance has the potential to reduce complication rates and improve cost-effectiveness [7].

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