Abstract
ObjectiveTo quantify metal artifact reduction using 130 keV virtual monochromatic imaging (VMI) with and without orthopedic metal artifact reduction (O-MAR) in total hip arthroplasty.MethodsConventional polychromatic images and 130 keV VMI of a phantom with pellets representing bone with unilateral or bilateral prostheses were reconstructed with and without O-MAR on a dual-layer CT. Pellets were categorized as unaffected, mildly affected and severely affected.ResultsWhen 130 keV VMI with O-MAR was compared to conventional imaging with O-MAR, a relative metal artifact reduction in CT values, contrast-to-noise (CNR), signal-to-noise (SNR) and noise in mildly affected pellets (67%, 74%, 48%, 68%, respectively; p < 0.05) was observed but no significant relative metal artifact reduction in severely affected pellets. Comparison between 130 keV VMI without O-MAR and conventional imaging with O-MAR showed relative metal artifact reduction in CT values, CNR, SNR and noise in mildly affected pellets (92%, 72%, 38%, 51%, respectively; p < 0.05) but negative relative metal artifact reduction in CT values and noise in severely affected pellets (− 331% and -223%, respectively; p < 0.05), indicating aggravation of metal artifacts.ConclusionOverall, VMI of 130 keV with O-MAR provided the strongest metal artifact reduction.
Highlights
Computed tomography (CT) is commonly used as imaging modality during postoperative follow-up after total hip arthroplasties (THA) [1]
Reconstructions with O-metal artifact reduction (MAR) resulted in the exact same values for these parameters as orthopedic metal artifact reduction (O-MAR) does not change CT values when no metal is present
Conventional imaging with O-MAR resulted in a decrease of streak artifacts for both unilateral and bilateral images
Summary
Computed tomography (CT) is commonly used as imaging modality during postoperative follow-up after total hip arthroplasties (THA) [1]. More advanced methods include the use of model-based image reconstruction, iterative image reconstruction and metal artifact reduction (MAR) software [2, 3]. The artifact reduction ability of such software in conventional CT imaging of THA can be further increased by the addition of iterative model-based reconstruction (IMR) [1]. Another option to reduce artifacts is the use of dual-energy CT (DECT) with reconstruction of virtual monochromatic images at high energy levels. Several patient studies showed that the combination of MAR software and virtual monochromatic dual-energy CT imaging reduces metal artifacts even more effectively than one technique alone [5,6,7]
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