Single-energy Metal Artifact Reduction Algorithm Research Articles

Reduction of metal artifacts from knee tumor prostheses on CT images: value of the single energy metal artifact reduction (SEMAR) algorithm

BackgroundTo evaluate the effect of the single energy metal artifact reduction (SEMAR) algorithm with a multidetector CT (MDCT) for knee tumor prostheses.MethodsFirst, a phantom of knee tumor prosthesis underwent a MDCT scan. The raw data was reconstructed by iterative reconstruction (IR) alone and IR plus SEMAR. The mean value of the CT number and the image noise were measured around the prosthesis at the stem level and articular level. Second, 95 consecutive patients with knee tumor prostheses underwent MDCT scans. The raw data were also reconstructed by the two methods. Periprosthetic structures were selected at the similar two levels. Four radiologists visually graded the image quality on a scale from 0 to 5. Additionally, the readers also assessed the presence of prosthetic complication and tumor recurrence on a same scale.ResultsIn the phantom, when the SEMAR was used, the CT numbers were closer to normal value and the noise of images using soft and sharper kernel were respectively reduced by up to 77.1% and 43.4% at the stem level, and by up to 82.2% and 64.5% at the articular level. The subjective scores increased 1 ~ 3 points and 1 ~ 4 points at the two levels, respectively. Prosthetic complications and tumor recurrence were diagnosed in 66 patients. And the SEMAR increased the diagnostic confidence of prosthetic complications and tumor recurrence (4 ~ 5 vs. 1 ~ 1.5).ConclusionsThe SEMAR algorithm can significantly reduce the metal artifacts and increase diagnostic confidence of prosthetic complications and tumor recurrence in patients with knee tumor prostheses.

SleepTrip as a Tool to Create Analysis Pipelines for Investigations of Polysomnography in Clinical Populations

To investigate whether a newly-developed single-energy metal artifact reduction (SEMAR) algorithm applied to images acquired on a 320-MDCT volume scanner reduces image artifacts from dental metal.We inserted the lower right teeth covered with a dental metal alloy and crown in a skull phantom and performed single-volume scanning on a second-generation 320-MDCT scanner. A 12-mm diameter spherical lesion was placed either close to or far from the dental metal. The tube voltage and current were 120 kVp and 80 or 155 mA, respectively. Images were reconstructed with filtered back projection (FBP) or iterative reconstruction (IR), with or without SEMAR. We calculated the signal-to-artifact ratios (SAR) to quantify the visibility of the lesion. Two radiologists inspected 96 images (48 with lesion and 48 without) for the presence or absence of the lesion using a 5-point ordinal scale (1 = definitely absent to 5 = definitely present).On images reconstructed with FPB and IR with SEMAR, streak artifacts from the dental metal were reduced substantially compared to images without SEMAR. At 155 mA with the lesion near the dental metal, the SARs were better on FBP and IR images (FBP: 1.7 and 0.5 with and without SEMAR, respectively; IR: 1.6 and 0.9 with and without SEMAR, respectively). The observer visual scores improved with SEMAR (FBP: 4.2 and 3.2 with and without SEMAR, respectively; IR: 4.2 and 3.0).The SEMAR algorithm reduces dental metal artifacts and improves lesion detectability and image quality in patients with oral cavity lesions.

Lateral Position With Gantry Tilt Further Improves Computed Tomography Image Quality Reconstructed Using Single-Energy Metal Artifact Reduction Algorithm in the Oral Cavity.

To assess the limitations of single-energy metal artifact reduction algorithm in the oral cavity and evaluate the availability of a solution by setting the patient in a lateral position (LP) with the use of a gantry tilt (GT). We analyzed 88 patients with dental metals retrospectively in study 1, and 74 patients prospectively in study 2. Patients were classified: metal I with dental metals in 1 region, metal II in 2 regions, and metal III in 3 regions. Patients underwent neck computed tomography examinations in a supine position (SP) in study 1, and 2 positions, an LP with a GT and an SP, in study 2. All images were reconstructed with this algorithm. Image quality was scored using a 4-point scale: 1 = severe artifact, 2 = moderate artifact, 3 = slight artifact, 4 = no artifact. The scores were compared between metal I, metal II, and metal III using the Mann-Whitney U test in study 1, and between an LP with a GT and an SP using the Wilcoxon signed ranks test in study 2. The scores outside the dental arch were significantly higher in metal I than in metal II and metal III (3.0 ± 0.6 vs 2.3 ± 0.5 vs 2.2 ± 0.4; P < 0.0001 for metal I vs metal II and for metal I vs metal III) and significantly higher in an LP with a GT than an SP (3.2 ± 0.4 vs 2.3 ± 0.4; P < 0.0001). Single-energy metal artifact reduction algorithm could reduce metal artifacts adequately in patients with dental metals in 1 region, but not in 2 or more regions. However, even for the latter, combination of this algorithm and an LP with a GT could further improve the image quality.

Metal Artifact Reduction in Head CT Performed for Patients with Deep Brain Stimulation Devices: Effectiveness of a Single-Energy Metal Artifact Reduction Algorithm.

Deep brain stimulation electrodes induce massive artifacts on CT images, deteriorating the diagnostic value of examinations. We aimed to investigate the usefulness and potential limitations of a single-energy metal artifact reduction algorithm in head CT performed in patients with implanted deep brain stimulation devices. Thirty-four patients with deep brain stimulation (bilateral, n = 28) who underwent head CT on a 320-detector row scanner and whose images were reconstructed with and without single-energy metal artifact reduction at the examinations were retrospectively included. The severity of artifacts around electrodes was assessed objectively using SDs and an artifact index. Two radiologists subjectively evaluated the severity of artifacts from electrodes, the visibility of electrode localization and surrounding structures, and overall diagnostic confidence on 4-point scales. Background image quality (GM-WM contrast and image noise) was subjectively and objectively assessed. The presence and location of artifacts newly produced by single-energy metal artifact reduction were analyzed. Single-energy metal artifact reduction provided lower objective and subjective metal artifacts and improved visualization of electrode localization and surrounding structures and diagnostic confidence compared with non-single-energy metal artifact reduction images, with statistical significance (all, P < .01). No significant differences were observed in GM-WM contrast and image noise (all, P ≥ .11). The new artifacts from single-energy metal artifact reduction were prominently observed in patients with bilateral deep brain stimulation at high convexity, possibly induced by deep brain stimulation leads placed under the parietal scalp. Single-energy metal artifact reduction substantially reduces the metal artifacts from deep brain stimulation electrodes and improves the visibility of intracranial structures without affecting background image quality. However, non-single-energy metal artifact reduction images should be simultaneously reviewed to accurately assess the entire intracranial area, particularly in patients with bilateral deep brain stimulation.

Dosimetric assessment of a single-energy metal artifact reduction algorithm for computed tomography images in radiation therapy.

This study aimed to evaluate the performance of a single-energy metal artifact reduction (SEMAR) algorithm for radiation therapy treatment using phantom cases with metal inserts, assess improvements in computed tomography (CT) number accuracy, and investigate its effects on treatment planning dosimetry. A standard electron density phantom was scanned with and without metal inserts. The numbers of tissue-equivalent materials on both uncorrected and SEMAR-corrected CT images were compared. Treatment planning accuracy was evaluated by comparing dose distributions computed using true density images (without metal inserts), uncorrected images (with metal inserts), and SEMAR-corrected images (with metal inserts) using three-dimensional gamma analysis. The numbers of the true density and uncorrected and SEMAR-corrected CT images in a muscle plug with unilateral inserts were 25.9HU, - 281.8HU, and 26.1HU, respectively. A similar tendency was obtained for other tissue-equivalent materials, and the numbers on CT images were improved with the SEMAR algorithm. In cases involving 1 portal irradiation, 10-MV X-ray, and the Acuros XB algorithm, the pass ratio between the true density and uncorrected images was 89.89%, while that between the true density and SEMAR-corrected images was 95.03%. Improvements in dose distribution were evident using the SEMAR algorithm. Similar trends were found for different irradiation methods and dose calculation algorithms. The SEMAR algorithm can significantly reduce metal artifacts on CT images used for radiation treatment planning. This aspect influenced dosimetry in the region of the artifact and dose distribution was significantly improved with use of the SEMAR-corrected images.

Subtraction CTA: An Alternative Imaging Option for the Follow-Up of Flow-Diverter-Treated Aneurysms?

This was a pilot study to explore the diagnostic accuracy and safety of subtraction CTA combined with a single-energy metal artifact reduction algorithm (SEMAR) compared to DSA for the evaluation of intracranial aneurysm occlusion after flow diverter treatment. We included patients treated with a flow diverter for an unruptured intracranial aneurysm between November 2015 and November 2016. The patient cohort comprised 2 groups: those who underwent follow-up imaging 1 month after flow-diverter treatment and those with a known residual intracranial aneurysm after flow diverter treatment who underwent imaging at regular follow-ups. Full-brain subtraction CTA was performed on a 320-detector row CT system. A low-dose non-enhanced volume acquisition was followed by a contrast-enhanced volume CTA. Iterative and noise-reduction filters, SEMAR, and SURESubtraction algorithms were applied. DSA was performed on a flat panel C-arm angiography system. Standard posteroanterior, lateral, 3D, and detailed 2D acquisitions were performed. Imaging was independently scored by 2 clinicians. Aneurysm occlusion (Raymond scale) was our primary outcome parameter. Thirteen intracranial aneurysms were evaluated with subtraction CTA and DSA. Nine aneurysm remnants were demonstrated by both subtraction CTA and DSA. The sensitivity and specificity of subtraction CTA for the detection of aneurysm occlusion were 100% (95% CI, 82.41%-100%) and 100% (95% CI, 67.55%-100%), respectively. Agreement between readers was perfect (κ = 1.0). The smallest neck remnant detected on subtraction CTA was 1.2 mm. No complications occurred. Subtraction CTA with single-electron metal artifact reduction is effective in the reduction of metal artifacts of flow diverters and might therefore be a viable alternative in the assessment of intracranial aneurysm occlusion after flow diverter treatment.

Single-energy metal artifact reduction technique for reducing metallic coil artifacts on post-interventional cerebral CT and CT angiography.

To evaluate the effects of the single-energy metal artifact reduction (SEMAR) algorithm on image quality of cerebral CT and CT angiography (CTA) for patients who underwent intracranial aneurysm coiling. Twenty patients underwent cerebral CT and CTA using a 320-detector row CT after intracranial aneurysm coiling. Images with and without application of the SEMAR algorithm (SEMAR CT and standard CT images, respectively) were reconstructed for each patient. The images were qualitatively assessed by two independent radiologists in a blinded manner for the depiction of anatomical structures around the coil, delineation of the arteries around the coil, and the depiction of the status of coiled aneurysms. Artifact strength was quantitatively assessed by measuring the standard deviation of attenuation values around the coil. The strength of artifacts measured in SEMAR CT images was significantly lower than that in standard CT images (25.7 ± 10.2 H.U. vs. 80.4 ± 67.2 H.U., p < 0.01, Student's paired t test). SEMAR CT images were significantly improved compared with standard CT images in the depiction of anatomical structures around the coil (p < 0.01, the sign test), delineation of the arteries around the coil (p < 0.01), and the depiction of the status of coiled aneurysms (p < 0.01). The SEMAR algorithm significantly reduces metal artifacts from intracranial aneurysm coiling and improves visualization of anatomical structures and arteries around the coil, and depiction of the status of coiled aneurysms on post-interventional cerebral CT.

Single energy metal artifact reduction technique in the evaluation of postoperative tumor endoprostheses in the knee joint

Objective To evaluate the effect of the single energy metal artifact reduction (SEMAR) algorithm with a 320 multi-slice computed tomography (MSCT) volume scanner in patients with knee tumor prostheses. Methods From November 2015 to March 2016, 23 consecutive patients with knee tumor prostheses who underwent a 320-MSCT scan were collected. And the raw data were reconstructed using two different methods: conventional iterative reconstruction (IR) alone and IR associated with SEMAR. The ROI were objectively and subjectively assessed at osteotomy level and articular level, and the Wilcoxon signed rank test was used for them. Results Compared with IR, objectively, artifact index (AI) values of the osteotomy level decreased 44.8% to 74.1% and that of the articular level decreased 73.2% to 93.2%; subjectively, the scores of image quality of two levels were increased 0.5 to 2.0 scores and 1.0 to 4.0 scores by SEMAR respectively. The objective and subject image quality of periprosthetic structures were all significantly improved by the SEMAR algorithm (P<0.05). Conclusion The SEMAR algorithm significantly reduced the metal artifact of knee tumor prostheses, improved the image quality of periprosthetic structures and may increase diagnostic confidence of prosthetic complications in patients with modular knee tumor prostheses, especially at the osteotomy level. Key words: Knee prosthesis; Tomography,X-ray computed

A newly-developed metal artifact reduction algorithm improves the visibility of oral cavity lesions on 320-MDCT volume scans

PurposeTo investigate whether a newly-developed single-energy metal artifact reduction (SEMAR) algorithm applied to images acquired on a 320-MDCT volume scanner reduces image artifacts from dental metal. MethodsWe inserted the lower right teeth covered with a dental metal alloy and crown in a skull phantom and performed single-volume scanning on a second-generation 320-MDCT scanner. A 12-mm diameter spherical lesion was placed either close to or far from the dental metal. The tube voltage and current were 120 kVp and 80 or 155 mA, respectively. Images were reconstructed with filtered back projection (FBP) or iterative reconstruction (IR), with or without SEMAR. We calculated the signal-to-artifact ratios (SAR) to quantify the visibility of the lesion. Two radiologists inspected 96 images (48 with lesion and 48 without) for the presence or absence of the lesion using a 5-point ordinal scale (1 = definitely absent to 5 = definitely present). ResultsOn images reconstructed with FPB and IR with SEMAR, streak artifacts from the dental metal were reduced substantially compared to images without SEMAR. At 155 mA with the lesion near the dental metal, the SARs were better on FBP and IR images (FBP: 1.7 and 0.5 with and without SEMAR, respectively; IR: 1.6 and 0.9 with and without SEMAR, respectively). The observer visual scores improved with SEMAR (FBP: 4.2 and 3.2 with and without SEMAR, respectively; IR: 4.2 and 3.0). ConclusionThe SEMAR algorithm reduces dental metal artifacts and improves lesion detectability and image quality in patients with oral cavity lesions.