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Metal Artifact Reduction Software Used With Abdominopelvic Dual-Energy CT of Patients With Metal Hip Prostheses: Assessment of Image Quality and Clinical Feasibility

 Seung Chol Han  ;  Yong Eun Chung  ;  Young Han Lee  ;  Kwan Kyu Park  ;  Myeong Jin Kim  ;  Ki Whang Kim 
 AMERICAN JOURNAL OF ROENTGENOLOGY, Vol.203(4) : 788-795, 2014 
Journal Title
Issue Date
Algorithms ; Artifacts* ; Feasibility Studies ; Female ; Hip Prosthesis* ; Humans ; Metals* ; Middle Aged ; Observer Variation ; Pelvis/diagnostic imaging ; Radiographic Image Enhancement/methods* ; Radiographic Image Interpretation, Computer-Assisted/methods ; Radiography, Abdominal/methods* ; Radiography, Dual-Energy Scanned Projection/methods ; Reproducibility of Results ; Sensitivity and Specificity ; Software* ; Tomography, X-Ray Computed/methods*
Metal Artifact Reduction software ; abdominal dual-energy CT ; metal hip prosthesis ; pelvic cavity ; phantom
OBJECTIVE: The objective of our study was to determine the feasibility of using Metal Artifact Reduction (MAR) software for abdominopelvic dual-energy CT in patients with metal hip prostheses. MATERIALS AND METHODS: This retrospective study included 33 patients (male-female ratio, 19:14; mean age, 63.7 years) who received total hip replacements and 20 patients who did not have metal prostheses as the control group. All of the patients underwent dual-energy CT. The quality of the images reconstructed using the MAR algorithm and of those reconstructed using the standard reconstruction was evaluated in terms of the visibility of the bladder wall, pelvic sidewall, rectal shelf, and bone-prosthesis interface and the overall diagnostic image quality with a 4-point scale. The mean and SD attenuation values in Hounsfield units were measured in the bladder, pelvic sidewall, and rectal shelf. For validation of the MAR interpolation algorithm, pelvis phantoms with small bladder "lesions" and metal hip prostheses were made, and images of the phantoms both with and without MAR reconstruction were evaluated. RESULTS: Image quality was significantly better with MAR reconstruction than without at all sites except the rectal shelf, where the image quality either had not changed or had worsened after MAR reconstruction. The mean attenuation value was changed after MAR reconstruction to its original expected value at the pelvic sidewall (p < 0.001) and inside the bladder (p < 0.001). The SD attenuation value was significantly decreased after MAR reconstruction at the pelvic sidewall (p = 0.019) but did not show significant differences at the bladder (p = 0.173) or rectal shelf (p = 0.478). In the phantom study, all lesions obscured by metal artifacts on the standard reconstruction images were visualized after MAR reconstruction; however, new artifacts had developed in other parts of the MAR reconstruction images. CONCLUSION: The use of MAR software with dual-energy CT decreases metal artifacts and increases diagnostic confidence in the assessment of the pelvic cavity but also introduces new artifacts that can obscure pelvic structures.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Ki Whang(김기황)
Kim, Myeong Jin(김명진) ORCID logo https://orcid.org/0000-0001-7949-5402
Park, Kwan Kyu(박관규) ORCID logo https://orcid.org/0000-0003-0514-3257
Lee, Young Han(이영한) ORCID logo https://orcid.org/0000-0002-5602-391X
Chung, Yong Eun(정용은) ORCID logo https://orcid.org/0000-0003-0811-9578
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