Abstract
Metal hardware serves as a common artifact source in spine CT imaging in the form of beam-hardening, photon starvation, and streaking. Postprocessing metal artifact reduction techniques have been developed to decrease these artifacts, which has been proved to improve visualization of soft-tissue structures and increase diagnostic confidence. However, metal artifact reduction reconstruction introduces its own novel artifacts that can mimic pathology.
Highlights
Metal artifacts are an obstacle to obtaining high-fidelity CT images in postoperative spine imaging, which is increasingly problematic as the number of instrumented spinal fusions grows
Perihardware lucency (Fig 2A, white arrow) is concerning because it usually signifies loosening of the hardware; this is not visualized in the non-Metal artifact reduction (MAR) images
While MAR techniques of different vendors may have overlap in method, each vendor has its own proprietary algorithm.[17]
Summary
Metal artifacts are an obstacle to obtaining high-fidelity CT images in postoperative spine imaging, which is increasingly problematic as the number of instrumented spinal fusions grows. The main artifacts introduced by metallic spinal implants include beam-hardening, photon starvation, and streaking,[8] which diminish overall image quality and impair the identification of pathology.[9,10] Metal artifact reduction (MAR; GE Healthcare, Milwaukee, Wisconsin) postprocessing techniques have been developed[11] to recover image quality and detail in affected areas and to diminish the artifacts themselves.[12] MAR introduces different artifacts that can mimic pathology, which radiologists need to recognize.[12,13] The purpose of this article was to review MARrelated artifacts seen on GE Healthcare scanners.
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