Abstract

ObjectivesTypical streak artifacts known as metal artifacts occur in the presence of strongly attenuating materials in computed tomography (CT). Recently, vendors have started offering metal artifact reduction (MAR) techniques. In addition, a MAR technique called the metal deletion technique (MDT) is freely available and able to reduce metal artifacts using reconstructed images. Although a comparison of the MDT to other MAR techniques exists, a comparison of commercially available MAR techniques is lacking. The aim of this study was therefore to quantify the difference in effectiveness of the currently available MAR techniques of different scanners and the MDT technique.Materials and MethodsThree vendors were asked to use their preferential CT scanner for applying their MAR techniques. The scans were performed on a Philips Brilliance ICT 256 (S1), a GE Discovery CT 750 HD (S2) and a Siemens Somatom Definition AS Open (S3). The scans were made using an anthropomorphic head and neck phantom (Kyoto Kagaku, Japan). Three amalgam dental implants were constructed and inserted between the phantom’s teeth. The average absolute error (AAE) was calculated for all reconstructions in the proximity of the amalgam implants.ResultsThe commercial techniques reduced the AAE by 22.0±1.6%, 16.2±2.6% and 3.3±0.7% for S1 to S3 respectively. After applying the MDT to uncorrected scans of each scanner the AAE was reduced by 26.1±2.3%, 27.9±1.0% and 28.8±0.5% respectively. The difference in efficiency between the commercial techniques and the MDT was statistically significant for S2 (p=0.004) and S3 (p<0.001), but not for S1 (p=0.63).ConclusionsThe effectiveness of MAR differs between vendors. S1 performed slightly better than S2 and both performed better than S3. Furthermore, for our phantom and outcome measure the MDT was more effective than the commercial MAR technique on all scanners.

Highlights

  • Metal implants like prostheses, plates and screws are routinely used in bone surgery

  • After applying the metal deletion technique (MDT) to uncorrected scans of each scanner the average absolute error (AAE) was reduced by 26.1±2.3%, 27.9±1.0% and 28.8±0.5% respectively

  • The effectiveness of metal artifact reduction (MAR) differs between vendors

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Summary

Introduction

Plates and screws are routinely used in bone surgery. Amalgam (a mercury alloy) is commonly present in tooth fillings. The presence of these metal objects causes reconstructed images from computed tomography (CT) to be suboptimal. Known as metal artifacts, occur in the presence of strongly attenuating objects and are caused by photon starvation, scattering, beam hardening and other effects [1]. Filtered back projection is the most commonly used CT reconstruction algorithm. Filtered back projection yields good results in ideal conditions but in the presence of metal implants metal artifacts can become so severe that the reconstructed images diagnostic accuracy is seriously hampered[2]. Accurate CT values are crucial for attenuation correction in PET-CT scanning[3,4], dose calculation in X-ray radiotherapy planning[5] and stopping power calculation in proton therapy planning[6,7]

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