Reducing the effects of metal artefact using high keV monoenergetic reconstruction of dual energy CT (DECT) in hip replacements

Abstract

The aim of this study was to determine whether high keV monoenergetic reconstruction of dual energy computed tomography (DECT) could be used to overcome the effects of beam hardening artefact that arise from preferential deflection of low energy photons. Two phantoms were used: a Charnley total hip replacement set in gelatine and a Catphan 500. DECT datasets were acquired at 100, 200 and 400 mA (Siemens Definition Flash, 100 and 140 kVp) and reconstructed using a standard combined algorithm (1:1) and then as monoenergetic reconstructions at 10 keV intervals from 40 to 190 keV. Semi-automated segmentation with threshold inpainting was used to obtain the attenuation values and standard deviation (SD) of the streak artefact. High contrast line pair resolution and background noise were assessed using the Catphan 500. Streak artefact is progressively reduced with increasing keV monoenergetic reconstructions. Reconstruction of a 400 mA acquisition at 150 keV results in reduction in the volume of streak artefact from 65 cm(3) to 17 cm(3) (74 %). There was a decrease in the contrast to noise ratio (CNR) at higher tube voltages, with the peak CNR seen at 70-80 keV. High contrast spatial resolution was maintained at high keV values. Monoenergetic reconstruction of dual energy CT at increasing theoretical kilovoltages reduces the streak artefact produced by beam hardening from orthopaedic prostheses, accompanied by a modest increase in heterogeneity of background image attenuation, and decrease in contrast to noise ratio, but no deterioration in high contrast line pair resolution.