Slice Encoding For Metal Artifact Correction Research Articles

Advanced Imaging of Total Knee Arthroplasty.

The prevalence of total knee arthroplasty (TKA) is increasing with the aging population. Although long-term results are satisfactory, suspected postoperative complications often require imaging with the implant in place. Advancements in computed tomography (CT), such as tin prefiltration, metal artifact reduction algorithms, dual-energy CT with virtual monoenergetic imaging postprocessing, and the application of cone-beam CT and photon-counting detector CT, allow a better depiction of the tissues adjacent to the metal. For magnetic resonance imaging (MRI), high bandwidth (BW) optimization, the combination of view angle tilting and high BW, as well as multispectral imaging techniques with multiacquisition variable-resonance image combination or slice encoding metal artifact correction, have significantly improved imaging around metal implants, turning MRI into a useful clinical tool for patients with suspected TKA complications.

Managing hardware-related metal artifacts in MRI: current and evolving techniques.

Magnetic resonance imaging (MRI) around metal implants has been challenging due to magnetic susceptibility differences between metal implants and adjacent tissues, resulting in image signal loss, geometric distortion, and loss of fat suppression. These artifacts can compromise the diagnostic accuracy and the evaluation of surrounding anatomical structures. As the prevalence of total joint replacements continues to increase in our aging society, there is a need for proper radiological assessment of tissues around metal implants to aid clinical decision-making in the management of post-operative complaints and complications. Various techniques for reducing metal artifacts in musculoskeletal imaging have been explored in recent years. One approach focuses on improving hardware components. High-density multi-channel radiofrequency (RF) coils, parallel imaging techniques, and gradient warping correction enable signal enhancement, image acquisition acceleration, and geometric distortion minimization. In addition, the use of susceptibility-matched implants and low-field MRI helps to reduce magnetic susceptibility differences. The second approach focuses on metal artifact reduction sequences such as view-angle tilting (VAT) and slice-encoding for metal artifact correction (SEMAC). Iterative reconstruction algorithms, deep learning approaches, and post-processing techniques are used to estimate and correct artifact-related errors in reconstructed images. This article reviews recent developments in clinically applicable metal artifact reduction techniques as well as advances in MR hardware. The review provides a better understanding of the basic principles and techniques, as well as an awareness of their limitations, allowing for a more reasoned application of these methods in clinical settings.

Artifact Reduction Proton Density Magnetic Resonance Imaging Can Better Visualize Unicompartmental Knee Arthroplasty Components but Does Not Improve Measurement Accuracy at 3T: An In Vitro Phantom Study.

Background There are no studies of the efficacy of slice encoding for metal artifact correction (SEMAC) magnetic resonance imaging (MRI) at 3T for patients following unicompartmental knee arthroplasty (UKA), although the artifact is expected to increase compared with 1.5T. Purpose To clarify whether SEMAC MRI can better visualize UKA components and improve measurement accuracy at 3T MRI. Materials and methods The phantom consisted of femoral and tibial standard UKA components embedded in agarose gel. The MR images were scanned on a 3T MR system including proton density (PD) MR images. Six orthopedic surgeons blinded to the size and details of the components independently scored the diagnostic value for measurement and measured the lengths of the femoral posterior condyle, femoral peg, anterior-posterior (AP) tibial component, medial-lateral (ML) tibial component, and tibial keel, with and without SEMAC. Visualization scores were stratified as 0 = definitely nondiagnostic, 1 = probably nondiagnostic, 2 = possibly diagnostic, 3 = probably diagnostic, and 4 = definitely diagnostic. In addition, the differences between actual length and 95% confidence intervals of five measurement points were analyzed. Results The diagnostic values of the posterior condyle (2.0; 1.5 vs. 0; 0) and femoral peg (1.5; 1.0 vs. 0; 0) were significantly better in SEMAC-PD MRI than in non-SEMAC-PD MRI (P<0.05). On the other hand, there were no significant differences in the visualizations of AP, ML, and keel of the tibial components. Measurements of the femoral posterior condyle and tibial keel approached the actual length, but were not involved within the 95% confidence interval(actual length, 19.4 mm vs. 95% CI, 15.7-19.1 mm). Conclusion A significant reduction of metal artifacts was observed only around the femoral component in SEMAC-PD MRI. Despite artifact reduction, this sequence did not result in better visualization for measurement.

The use of slice encoding for metal artifact correction (SEMAC) sequencing improves the diagnostic evaluation of graft integrity following anterior cruciate ligament reconstruction

ObjectivesTo determine whether magnetic resonance imaging (MRI) with metal artifact reduction sequencing is superior to conventional knee MRI in the evaluation of an injured anterior cruciate ligament (ACL) graft, where visualisation on conventional MRI can be limited by the metal artifact from fixation devices. MethodsEighteen patients underwent conventional MRI sequence (proton density fat saturated [PDFS]) and two types of metal artifact reduction sequencing MRI (WARP, slice encoding for metal artifact correction (SEMAC); Siemens) following a secondary injury to their ACL reconstructed knee. Six raters with experience in knee MRI evaluation reviewed sagittal PDFS, WARP, and SEMAC sequences, providing semi-quantitative grades for visualisation and diagnostic confidence assessing the ACL, posterior cruciate ligament , menisci, tibial and femoral tunnel margins, and articular cartilage. Intra-class correlation coefficients for inter-rater reliability were evaluated. The 6-rater mean scores for the visualisation and diagnostic confidence derived from each sequence were compared using the Friedman test for multiple paired samples. ResultsNo statistically significant difference in the ACL visualisation among the sequences was found (p ​= ​0.193). Further, a subgroup analysis was performed in cases evaluated as “moderately blurry” or “indistinct ACL visualisation” on PDFS (58% of cases). SEMAC significantly improved diagnostic confidence in ACL visualisation (p ​= ​0.041) and ACL graft rupture (p ​= ​0.044) compared to PDFS.There was no statistically significant difference in the inter-observer reliability between sequences. The WARP sequence added 2.84 ​± ​0.69 ​min, while SEMAC added 2.95 ​± ​0.40 ​min to the standard knee MRI scan time. Conclusionuse of the SEMAC metal reduction sequence significantly improved diagnostic accuracy and confidence in the detection of ACL graft rupture in cases where the ACL was moderately blurry or indistinct on the PDFS sequence. This sequence should be considered as an adjunct to conventional PDFS in cases where graft visualisation is limited by the metal artifact from fixation devices. Level of evidenceIII.

Image Quality and Artifact Reduction of a Cochlear Implant With Rotatable Magnets.

To determine if metal reduction magnetic resonance imaging sequences and changes in implant placement minimize artifact from cochlear implants and improve visualization of intracranial structures. Cadaveric study. Tertiary referral center. Five cadaveric heads. Specimens were implanted with Advanced Bionics HiRes Ultra3D devices at nasion-external auditory canal angles of 90, 120, and 160 degrees, and distances from the external auditory canal of 9 or 12 cm. Standard brain/internal auditory canal (IAC) sequences with metal artifact reducing technique were acquired in a 1.5T scanner. The primary outcome was visibility of 14 intracranial structures graded on a 4-point scale (1, structures <50% visible; 2, >50% visible with some areas nonvisible from artifact; 3, artifact present but adequate for diagnosis; and 4, high quality). Scores were determined by experienced head and neck radiologists and compared with one-way analysis of variance. Imaging sequences included axial 5-mm whole-brain turbo spin echo (TSE) T2 with right to left and anterior to posterior encoding, fluid-attenuation inversion recovery high bandwidth, axial 5-mm whole-brain slice-encoding metal artifact correction (SEMAC), axial IAC constructive interference in steady state, and axial 3-mm T1 IAC with and without fat saturation. T1 IACs in axial and coronal planes were best for ipsilateral structures overall (mean [standard deviation {SD}], 3.8 [0.6] and 3.8 [0.5]). SEMAC (mean [SD], 3.5 [0.8]) was superior to TSE with anterior to posterior encoding (mean [SD], 3.5 [0.9) for ipsilateral cortex, cerebellopontine angle, and brainstem/cerebellum, and equivalent for the inner ear. Constructive interference in steady state and T1 with fat saturation were poor for all ipsilateral structures (mean, 2.8 [ p < 0.01]; mean, 3.1 [ p < 0.01]). The 120 degrees/12 cm position was overall best, although the 120 degrees/9 cm position still afforded visualization of ipsilateral structures; other angles and distances conferred slight advantages for specific structures of interest. SEMAC and T2 TSE with anterior to posterior encoding sequences provide artifact suppression while retaining excellent image quality. Different placement angles did not confer improvement in visualization, although placement distances provided slight advantages for some structures.

The Impact of View- Angle Tilting and Slice Encoding for Metal Artifact Correction Methods on the Metal Artifact Reduction in Magnetic Resonance Imaging of the Knee Prosthesis

Purpose: At Magnetic Resonance Imaging (MRI), artifacts arising from metal implants are an obstacle to obtaining optimal images. This study aimed to evaluate the impact of View-Angle Tilting (VAT) and Slice Encoding for Metal Artifact Correction (SEMAC) techniques for the artifact reduction of patients during knee MRI with metal implants.&#x0D; Materials and Methods: The MR images without any intervention of the knee from 20 patients with knee prostheses were used. The VAT and SEMAC metal artifact reduction techniques were applied to all the MR images. Volume and mass of the metal prosthesis were quantified using the MATLAB program and compared with the real measurements using nonparametric Wilcoxon tests in SPSS software. The qualitative analysis was performed by two blinded observers regarding the score of artifact size, distortions, image quality, and visualization of bone marrow and soft tissues adjacent to metal implants. In addition, Cohen’s kappa values were used for inter-observer agreement.&#x0D; Results: The average volume of the platinum based on the conventional, VAT, and SEMAC methods was estimated at 14.22 ± 0.43, 14.05 ± 0.4, and 13.3 ± 0.45 cm3, respectively. The statistical analysis showed no significant difference (P &gt; 0.05) between the mean value of the platinum volume for the SEMAC method and the real measurement (13.6 ± 0.33 cm3). Furthermore, regarding the conventional, VAT, and SEMAC sequences, the mean mass of the platinum was obtained at 305.02 ± 9.22, 301.37 ± 8.58, and 285.28 ± 9.65 g, respectively, with the P-Value of 0.005, 0.009, and 0.268, compared to the real measurements (286.81±8.75 g). Notably, the blinded readers demonstrated that the SEMAC method was remarkably superior quality compared with VAT and conventional acquisitions (P-Value&lt; 0.05).&#x0D; Conclusion: The knee prosthesis metal artifact was reduced using the VAT and SEMAC techniques, in a way that, the reduction was significant by the SEMAC method. In addition, concerning the qualitative observer analysis, the application of the SEMAC technique provides improved visualization of tissue structures adjacent to metal implants.

New-Generation Low-Field Magnetic Resonance Imaging of Hip Arthroplasty Implants Using Slice Encoding for Metal Artifact Correction: First In Vitro Experience at 0.55 T and Comparison With 1.5 T.

Despite significant progress, artifact-free visualization of the bone and soft tissues around hip arthroplasty implants remains an unmet clinical need. New-generation low-field magnetic resonance imaging (MRI) systems now include slice encoding for metal artifact correction (SEMAC), which may result in smaller metallic artifacts and better image quality than standard-of-care 1.5 T MRI. This study aims to assess the feasibility of SEMAC on a new-generation 0.55 T system, optimize the pulse protocol parameters, and compare the results with those of a standard-of-care 1.5 T MRI. Titanium (Ti) and cobalt-chromium total hip arthroplasty implants embedded in a tissue-mimicking American Society for Testing and Materials gel phantom were evaluated using turbo spin echo, view angle tilting (VAT), and combined VAT and SEMAC (VAT + SEMAC) pulse sequences. To refine an MRI protocol at 0.55 T, the type of metal artifact reduction techniques and the effect of various pulse sequence parameters on metal artifacts were assessed through qualitative ranking of the images by 3 expert readers while taking measured spatial resolution, signal-to-noise ratios, and acquisition times into consideration. Signal-to-noise ratio efficiency and artifact size of the optimized 0.55 T protocols were compared with the 1.5 T standard and compressed-sensing SEMAC sequences. Overall, the VAT + SEMAC sequence with at least 6 SEMAC encoding steps for Ti and 9 for cobalt-chromium implants was ranked higher than other sequences for metal reduction ( P < 0.05). Additional SEMAC encoding partitions did not result in further metal artifact reductions. Permitting minimal residual artifacts, low magnetic susceptibility Ti constructs may be sufficiently imaged with optimized turbo spin echo sequences obviating the need for SEMAC. In cross-platform comparison, 0.55 T acquisitions using the optimized protocols are associated with 45% to 64% smaller artifacts than 1.5 T VAT + SEMAC and VAT + compressed-sensing/SEMAC protocols at the expense of a 17% to 28% reduction in signal-to-noise ratio efficiency. B 1 -related artifacts are invariably smaller at 0.55 T than 1.5 T; however, artifacts related to B 0 distortion, although frequently smaller, may appear as signal pileups at 0.55 T. Our results suggest that new-generation low-field SEMAC MRI reduces metal artifacts around hip arthroplasty implants to better advantage than current 1.5 T MRI standard of care. While the appearance of B 0 -related artifacts changes, reduction in B 1 -related artifacts plays a major role in the overall benefit of 0.55 T.

Reliability of slice-encoding for metal artefact correction (SEMAC) MRI to identify prosthesis loosening in patients with painful total hip arthroplasty - a single centre, prospective, surgical validation study.

Objectives:To validate reliability of slice-encoding for metal artefact correction (SEMAC)-MRI findings in prosthesis loosening detection by comparing them to surgical outcomes (gold standard) in symptomatic patients following hip arthroplasties. To evaluate periprosthetic anatomical structures in symptomatic patients to identify an alternative cause of hip symptoms.Methods:We prospectively followed 47 symptomatic patients (55 hips, 39 painful hips – group P and 16 control hips – group C) at our institution from 2011 to 2016. We acquired 1.5 T MRI conventional and SEMAC-MRI images for all patients. Two consultants scored MRI for osteolysis and marrow oedema zone-wise using predefined signal characteristics and settled scoring variations by consensus. We used Spearman Rank-Order Correlation for correlation analysis and used OMERACT (Outcome Measures in Rheumatology) filter pillars to validate SEMAC-MRI findings.Results:Eleven patients needed revision surgery, all from group P. None from group C required revision surgery. Remaining 28 hips in the group P were managed conservatively pain completely resolved in 21 hips, eight hips had trochanteric bursitis, eight had extraarticular cause and the remaining five hips had spontaneous pain resolution. We found moderate-to-weak correlation between SEMAC-MRI findings for prosthesis loosening and revision surgery outcomes. Sensitivity, Specificity, PPV and NPV in Group P were (72.7, 64.3, 44.4, 85.7%) in T1W-SEMAC, (90.9, 46.4, 40.0, 92.9%) in STIR-SEMAC and (36.3, 78.5, 40.0, 75.8%) in PDW-SEMAC.Conclusion:Negative SEMAC-MRI results can effectively exclude prosthesis loosening confirmed on revision surgery and SEMAC-MRI can detect alternative cause of hip pain accurately.Advances in knowledge:Negative SEMAC-MRI in painful THA patients can effectively exclude prosthesis loosening as a cause.

Comparison of artefact reduction possibilities with the new active transcutaneous bone conduction implant (Bonebridge).

This study aimed to evaluate the possibilities of artefact reduction using different anatomical implant positions with the Bonebridge bone-conduction hearing implant 602 for a patient with an acoustic neuroma requiring regular diagnostic magnetic resonance imaging of the tumour position. Three implant positions and magnetic resonance imaging examinations with and without customised sequences for metal artefact suppression were investigated. The diagnostic usefulness was rated by a radiologist (qualitative evaluation), and the relation between the area of artefact and the total head area was calculated (quantitative evaluation). Following the qualitative analysis, the radiologist rated the superior to middle fossa implant placement significantly better for diagnostic purposes, which is in agreement with the calculated artefact ratio (p < 0.0001). The customised slice-encoding metal artifact correction view-angle tilting metal artifact reduction technique sequences significantly decreased the relative artefact area between 5.13 per cent and 25.02 per cent. The smallest mean artefact diameter was found for the superior to middle fossa position with 6.80 ± 1.30 cm (range: 5.42-9.74 cm; reduction of 18.65 per cent). The application of artefact reduction sequencing and special anatomical implant positioning allows regular magnetic resonance imaging in patients with the bone-conduction hearing implant 602 without sacrificing diagnostic imaging quality for tumour diagnosis.

Comparison of metal artifact reduction techniques in magnetic resonance imaging of carbon-reinforced PEEK and titanium spinal implants.

Carbon-reinforced PEEK (C-FRP) implants are non-magnetic and have increasingly been used for the fixation of spinal instabilities. To compare the effect of different metal artifact reduction (MAR) techniques in magnetic resonance imaging (MRI) on titanium and C-FRP spinal implants. Rod-pedicle screw constructs were mounted on ovine cadaver spine specimens and instrumented with either eight titanium pedicle screws or pedicle screws made of C-FRP and marked with an ultrathin titanium shell. MR scans were performed of each configuration on a 3-T scanner. MR sequences included transaxial conventional T1-weighted turbo spin echo (TSE) sequences, T2-weighted TSE, and short-tau inversion recovery (STIR) sequences and two different MAR-techniques: high-bandwidth (HB) and view-angle-tilting (VAT) with slice encoding for metal artifact correction (SEMAC). Metal artifact degree was assessed by qualitative and quantitative measures. There was a much stronger effect on artifact reduction with using C-FRP implants compared to using specific MRI MAR-techniques (screw shank: P < 0.001; screw tulip: P < 0.001; rod: P < 0.001). VAT-SEMAC sequences were able to reduce screw-related signal loss artifacts in constructs with titanium screws to a certain degree. Constructs with C-FRP screws showed less artifact-related implant diameter amplification when compared to constructs with titanium screws (P < 0.001). Constructs with C-FRP screws are associated with significantly less artifacts compared to constructs with titanium screws including dedicated MAR techniques. Artifact-reducing sequences are able to reduce implant-related artifacts. This effect is stronger in constructs with titanium screws than in constructs with C-FRP screws.

Heating of Hip Arthroplasty Implants During Metal Artifact Reduction MRI at 1.5- and 3.0-T Field Strengths.

The aim of this study was to quantify the spatial temperature rises that occur during 1.5- and 3.0-T magnetic resonance imaging (MRI) of different types of hip arthroplasty implants using different metal artifact reduction techniques. Using a prospective in vitro study design, we evaluated the spatial temperature rises of 4 different total hip arthroplasty constructs using clinical metal artifact reduction techniques including high-bandwidth turbo spin echo (HBW-TSE), slice encoding for metal artifact correction (SEMAC), and compressed sensing SEMAC at 1.5 and 3.0 T. Each MRI protocol included 6 pulse sequences, with imaging planes, parameters, and coverage identical to those in patients. Implants were immersed in standard American Society for Testing and Materials phantoms, and fiber optic sensors were used for temperature measurement. Effects of field strength, radiofrequency pulse polarization at 3.0 T, pulse protocol, and gradient coil switching on heating were assessed using nonparametric Friedman and Wilcoxon signed-rank tests. Across all implant constructs and MRI protocols, the maximum heating at any single point reached 13.1°C at 1.5 T and 1.9°C at 3.0 T. The temperature rises at 3.0 T were similar to that of background in the absence of implants (P = 1). Higher temperature rises occurred at 1.5 T compared with 3.0 T (P < 0.0001), and circular compared with elliptical radiofrequency pulse polarization (P < 0.0001). Compressed sensing SEMAC generated equal or lower degrees of heating compared with HBW-TSE at both field strengths (P < 0.0001). Magnetic resonance imaging of commonly used total hip arthroplasty implants is associated with variable degrees of periprosthetic tissue heating. In the absence of any perfusion effects, the maximum temperature rises fall within the physiological range at 3.0 T and within the supraphysiologic range at 1.5 T. However, with the simulation of tissue perfusion effects, the heating at 1.5 T also reduces to the upper physiologic range. Compressed sensing SEMAC metal artifact reduction MRI is not associated with higher degrees of heating than the HBW-TSE technique.

Metal artifacts of hip arthroplasty implants at 1.5-T and 3.0-T: a closer look into the B1 effects.

To evaluate the effect of circular polarization (CP) and elliptical polarization (EP) of the B1 field on metal implant-induced artifacts of titanium (Ti) and cobalt-chromium (CoCr) hip arthroplasty implants at 1.5-T and 3.0-T field strengths. In vitro Ti and CoCr total hip arthroplasty implants were evaluated using high transmit and receive bandwidth turbo spin echo (HBW-TSE) and slice encoding for metal artifact correction (SEMAC) metal artifact reduction techniques. Each technique was implemented at 1.5-T, which only allows for CP of B1 field as the system default, as well as 3.0-T, which permitted CP and EP. Manual segmentation quantified the size of the metal artifacts at the level of the acetabular cup, femoralneck, and femoral shaft. In the acetabular cup and femoral neck, 1.5-T CP achieved smaller artifact sizes than 3.0-T CP (28-29% on HBW-TSE, p = 0.002-0.005; 17-34% on SEMAC, p = 0.019-0.102) and 3.0-T EP (25-28% on HBW-TSE, p = 0.010-0.011; 14-36% on SEMAC, p = 0.058-0.135) techniques. In the femoral stem region, 3.0-T EP achieved more efficient artifact suppression than 3.0-T CP (HBW-TSE 44-45%, p < 0.001-0.022; SEMAC 76-104%, p < 0.001-0.022) and 1.5-T CP (HBW-TSE 76-96%, p < 0.001-0.003; SEMAC 138-173%, p = 0.003-0.005) techniques. Despite slightly superior metal reduction ability of the 1.5-T in the region of the acetabular cup and prosthesis neck, 3.0-T MRI of hip arthroplasty implants using elliptically polarized RF pulses may overall be more effective in reducing metal artifacts than the current standard 1.5-T MRI techniques, which by default implements circularly polarized RF pulses.

Sequence application of Brain mri with orthodontic bracket

Magnetic Resonance Imaging (MRI) examination of the brain at high resolution will be able to detect abnormalities in the brain that are not detected before. The MRI machine is equipped with a very strong magnetic force, therefore metal objects can interfere with the workings of the machine . Some patients, there may be a magnet in the body unnoticed, for example: orthodontic bracket. The purpose of this study was to analyze the effectiveness of sequences to reduce metal artifacts due to the installation of the Orthodontic Bracket. This type of research is a quantitative analytic with a quasi-experimental research design. The research design used was a one group pretest-posttest design to determine the optimization of the application of the Slice Encoding Metal Artifact Correction (SEMAC) and View Angle Tilting (VAT) sequences on Brain MRI with Orthodontic Bracket. The results showed that the SEMAC sequence combined with T2 TSE was able to reduce metal artifacts well. VAT sequences combined with T2 TSE were able to reduce metal artifacts quite well. A more optimal sequence to reduce metal artifacts is T2 TSE SEMAC, where the sequence is able to reveal thin structures that are not visible in the T2 TSE or T2 TSE VAT sequences.

Artificial neural network for Slice Encoding for Metal Artifact Correction (SEMAC) MRI.

To develop new artificial neural networks (ANNs) to accelerate slice encoding for metal artifact correction (SEMAC) MRI. Eight titanium phantoms and 77 patients after brain tumor surgery involving metallic neuro-plating instruments were scanned using SEMAC at a 3T Skyra scanner. For the phantoms, proton-density, T1-, and T2-weighted images were acquired for developing both multilayer perceptron (MLP) and convolutional neural network (CNN). For the patients, T2-weighted images were acquired for developing CNN. All networks were trained with the SEMAC factor 4 or 6 as input and the factor 12 as label, yielding an acceleration factor of 3 or 2. Performance of the CNN model was compared against parallel imaging and compressed sensing on the phantom datasets. Two extra T1-weighted in vivo sets were acquired to investigate generalizability of the models to different contrasts. Both multilayer perceptron and CNN provided artifact-suppressed images better than the input images and comparable to the label images visually and quantitatively, a trend observable regardless of input SEMAC factor and image type (P < .01). CNN suppressed the artifacts better than multilayer perceptron, parallel imaging, and compressed sensing (P < .01). Tests on the patient datasets demonstrated clear metal artifact suppression visually and quantitatively (P < .01). Tests on T1 datasets also demonstrated clear visual metal artifact suppression. Our study introduced a new effective way of artificial neural networks to accelerate SEMAC MRI while maintaining the comparable quality of metal artifact suppression. Application on the preliminary patient datasets proved the feasibility in clinical usage, which warrants further investigation.

Metal About the Hip and Artifact Reduction Techniques: From Basic Concepts to Advanced Imaging.

Promising outcomes of hip replacement interventions in this era of aging populations have led to higher demands for hip arthroplasty procedures. These require effective methods and techniques for the detection of postoperative outcomes and complications. Based on the presence or absence of radiographic findings, magnetic resonance imaging (MRI) and computed tomography (CT) may be required to detect and further characterize different causes of failing implants. Yet metal-related artifacts degrade image quality and pose significant challenges for adequate image quality. To mitigate such artifacts in MRI, a set of techniques, collectively known as metal artifact reduction sequence (MARS) MRI, were developed that optimize the framework of the conventional pulse sequences and exploit novel multispectral and multispatial imaging methods such as Slice Encoding for Metal Artifact Correction (SEMAC) and Multi-Acquisition Variable-Resonance Image Combination (MAVRIC). Metal-induced artifacts on CT can be effectively reduced with virtual monochromatic reconstruction of dual-energy CT data sets, metal artifact reduction reconstruction algorithms, and postprocessing image visualization techniques.

Assessing image artifacts from radiotherapy electromagnetic transponders with metal-artifact reduction imaging

Image artifacts due to 14 gauge radiotherapy electromagnetic (EM) transponders were assessed on conventional spin echo images, and corrected using metal artifact reduction techniques: high bandwidth, view angle tilting (VAT), and slice encoding for metal artifact correction (SEMAC). Large areas of signal loss and/or pile-up were produced in an area extending up to 15.3 mm in radius for 14G transponders in standard imaging. Using high bandwidth imaging with VAT, in-plane artifact sizes were reduced by up to 35%. SEMAC did not significantly reduce in-plane or through plane artifact size for axially oriented images, but was effective in reducing through-plane artifacts for sagittal images. Using the experimental data, magnetic field maps were simulated so that the magnetic susceptibility of the transponder could be estimated and slice profiles could be visualized. Due to the large susceptibilities involved, current correction techniques are unable to fully correct artifacts due to EM transponders and significant areas of signal loss and distortion remain. Care should be taken when planning MRI following EM transponder implantation.

MSVAT-SPACE-STIR and SEMAC-STIR for Reduction of Metallic Artifacts in 3T Head and Neck MRI.

The incidence of metallic dental restorations and implants is increasing, and head and neck MR imaging is becoming challenging regarding artifacts. Our aim was to evaluate whether multiple-slab acquisition with view angle tilting gradient based on a sampling perfection with application-optimized contrasts by using different flip angle evolution (MSVAT-SPACE)-STIR and slice-encoding for metal artifact correction (SEMAC)-STIR are beneficial regarding artifact suppression compared with the SPACE-STIR and TSE-STIR in vitro and in vivo. At 3T, 3D artifacts of 2 dental implants, supporting different single crowns, were evaluated. Image quality was evaluated quantitatively (normalized signal-to-noise ratio) and qualitatively (2 reads by 2 blinded radiologists). Feasibility was tested in vivo in 5 volunteers and 5 patients, respectively. Maximum achievable resolution and the normalized signal-to-noise ratio of MSVAT-SPACE-STIR were higher compared with SEMAC-STIR. Performance in terms of artifact correction was dependent on the material composition. For highly paramagnetic materials, SEMAC-STIR was superior to MSVAT-SPACE-STIR (27.8% smaller artifact volume) and TSE-STIR (93.2% less slice distortion). However, MSVAT-SPACE-STIR reduced the artifact size compared with SPACE-STIR by 71.5%. For low-paramagnetic materials, MSVAT-SPACE-STIR performed as well as SEMAC-STIR. Furthermore, MSVAT-SPACE-STIR decreased artifact volume by 69.5% compared with SPACE-STIR. The image quality of all sequences did not differ systematically. In vivo results were comparable with in vitro results. Regarding susceptibility artifacts and acquisition time, MSVAT-SPACE-STIR might be advantageous over SPACE-STIR for high-resolution and isotropic head and neck imaging. Only for materials with high-susceptibility differences to soft tissue, the use of SEMAC-STIR might be beneficial. Within limited acquisition times, SEMAC-STIR cannot exploit its full advantage over TSE-STIR regarding artifact suppression.

Comparisons of slice-encoding metal artifact correction and view-angle tilting magnetic resonance imaging and traditional digital radiography in evaluating chronic hip pain after total hip arthroplasty

PurposeThe aims of this study were (1) to compare the areas of metal-induced artifacts and definition of periprosthetic structures between patients scanned with the slice-encoding metal artifact correction and view-angle tilting (SEMAC-VAT) turbo-spin-echo (TSE) prototype and those scanned with the standard TSE magnetic resonance (MR) sequences and (2) to further clarify the superiority of the SEMAC-VAT MR imaging technique at detecting lesions in patients after total hip arthroplasty (THA), compared with digital radiography (DR). Materials and methodsA total of 38 consecutive patients who underwent THA were referred to MR imaging at our institution. All patients suffered from chronic hip pain postoperatively. Twenty-three patients of the 38 were examined with a 1.5-T MR scanner using a SEMAC-VAT TSE prototype and standard TSE sequence, and the remaining 15 patients were examined with the same 1.5-T MR scanner, but using the SEMAC-VAT TSE prototype only. The traditional DR imaging was also performed for all patients. Two radiologists then independently measured the area of metal-induced artifacts and evaluated the definition of both the acetabular and femoral zones based on a three-point scale. Finally, the positive findings of chronic hip pain after THA based on SEMAC-VAT TSE MR imaging and traditional DR imaging were compared and analysed. ResultsThe areas of metal-induced artifacts were significantly smaller in the SEMAC-VAT TSE sequences than those in the standard TSE sequences for both the T1-weighted (p < 0.001) and T2-weighted (p < 0.001) turbo inversion recovery magnitude images. In addition, 28 patients showed a series of positive signs in the SEMAC-VAT images that were not observed in the traditional DR images. ConclusionCompared with the standard TSE MR imaging, SEMAC-VAT MR imaging significantly reduces metal-induced artifacts and might successfully detect most positive signs missed in the traditional DR images. Translational potential of this articleThe main objective of this research was to show that MR sequences from the SEMAC-VAT TSE prototype provide a significant advantage at detecting lesions in patients after THA because of the excellent soft-tissue resolution of the MR imaging. SEMAC-VAT MR can evaluate chronic hip pain after THA and determine the cause, which can help the clinician decide on whether a surgical revision is needed.

Instrument visualization using conventional and compressed sensing SEMAC for interventional MRI at 3T.

Interventional magnetic resonance imaging (MRI) at 3T benefits from higher spatial and temporal resolution, but artifacts of metallic instruments are often larger and may obscure target structures. To test that compressed sensing (CS) slice-encoding metal artifact correction (SEMAC) is feasible for 3T interventional MRI and affords more accurate instrument visualization than turbo spin echo (TSE) and gradient echo (GRE) techniques, and facilitates faster data acquisition than conventional SEMAC. Prospective. Cadaveric animal and 20 human subjects. TSE (acquisition time 31 sec), GRE (28-33 sec), SEMAC (128 sec), and CS-SEMAC (57 sec) pulse sequences were evaluated at 3T. Artifact width and length, signal-to-noise (SNR), and contrast-to-noise (CNR) ratios of 14-22G MR-conditional needles were measured in a phantom. Subsequently, high-bandwidth TSE and CS-SEMAC sequences were assessed in vivo with 20 patient procedures for the size of the metal artifact, image sharpness, image noise, motion artifacts, image contrast, and target, instrument, and structural visibility. Repeated-measures-analysis-of-variances and Mann-Whitney U-tests were applied. P ≤ 0.05 was considered statistically significant. CS-SEMAC and SEMAC created the smallest needle artifact widths (3.2-3.3 ± 0.4 mm, P = 1.0), whereas GRE showed the largest needle artifact widths (8.5-8.6 ± 0.4 mm) (P < 0.001). The artifact width difference between high-bandwidth TSE and CS-SEMAC was 0.8 ± 0.6 mm (P < 0.01). SEMAC and CS-SEMAC created the lowest average needle tip errors (0.3-0.4 ± 0.1 mm, P = 1.0). The average tip error difference between high-bandwidth TSE and SEMAC/CS-SEMAC was 2.0 ± 1.7 mm (P < 0.01). SNR and CNR were similar on TSE, SEMAC, and CS-SEMAC, and lowest on GRE. CS-SEMAC yielded smaller artifacts, less noise, less motion, and better instrument visibility (P < 0.001); high-bandwidth TSE showed better sharpness (P < 0.001) and targets visibility (P = 0.007); whereas image contrast (P = 0.273) and structural visibility (P = 0.1) were similar. CS-SEMAC is feasible for interventional MRI at 3T, visualizes instruments with higher accuracy than high-bandwidth TSE and GRE, and can be acquired 55% faster than conventional SEMAC. 2 Technical Efficacy: Stage 6 J. Magn. Reson. Imaging 2018;47:1306-1315.

PETRA, MSVAT-SPACE and SEMAC sequences for metal artefact reduction in dental MR imaging.

Dental MRI is often impaired by artefacts due to metallic dental materials. Several sequences were developed to reduce susceptibility artefacts. Here, we evaluated a set of sequences for artefact reduction for dental MRI for the first time. Artefact volume, signal-to-noise ratio (SNR) and image quality were assessed on a 3-T MRI for pointwise encoding time reduction with radial acquisition (PETRA), multiple-slab acquisition with view angle tilting gradient, based on a sampling perfection with application-optimised contrasts using different flip angle evolution (SPACE) sequence (MSVAT-SPACE), slice-encoding for metal-artefact correction (SEMAC) and compared to a standard SPACE and a standard turbo-spin-echo (TSE) sequence. Field-of-view and acquisition times were chosen to enable in vivo application. Two implant-supported prostheses were tested (porcelain fused to metal non-precious alloy and monolithic zirconia). Smallest artefact was measured for TSE sequences with no difference between the standard TSE and the SEMAC. MSVAT-SPACE reduced artefacts about 56% compared to the standard SPACE. Effect of the PETRA was dependent on sample used. Image quality and SNR were comparable for all sequences except PETRA, which yielded poor results. There is no benefit in terms of artefact reduction for SEMAC compared to standard TSE. Usage of MSVAT-SPACE is advantageous since artefacts are reduced and higher resolution is achieved. • SEMAC is not superior to TSE in terms of artefact reduction. • MSVAT-SPACE reduces susceptibility artefacts while maintaining comparable image quality. • PETRA reduces susceptibility artefacts depending on material but offers poor image quality.