Artifact reduction of different metallic implants in flat detector C-arm CT

Flat detector CT has been increasingly used as a follow-up examination after endovascular intervention. Metal artifact reduction has been successfully demonstrated in coil mass cases, but only in a small series. We attempted to objectively and subjectively evaluate the feasibility of metal artifact...

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Bibliographic Details
Published in:American journal of neuroradiology : AJNR 2014-07, Vol.35 (7), p.1288-1292
Main Authors: Hung, S-C, Wu, C-C, Lin, C-J, Guo, W-Y, Luo, C-B, Chang, F-C, Chang, C-Y
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Algorithms
Cerebral Angiography - methods
Feasibility Studies
Female
Humans
Male
Metals
Middle Aged
Patient Safety
Prostheses and Implants
Radiographic Image Enhancement - methods
Radiography, Interventional - methods
Reproducibility of Results
Sensitivity and Specificity
Tomography, X-Ray Computed - instrumentation
Tomography, X-Ray Computed - methods
X-Ray Intensifying Screens
Young Adult
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Summary:Flat detector CT has been increasingly used as a follow-up examination after endovascular intervention. Metal artifact reduction has been successfully demonstrated in coil mass cases, but only in a small series. We attempted to objectively and subjectively evaluate the feasibility of metal artifact reduction with various metallic objects and coil lengths. We retrospectively reprocessed the flat detector CT data of 28 patients (15 men, 13 women; mean age, 55.6 years) after they underwent endovascular treatment (20 coiling ± stent placement, 6 liquid embolizers) or shunt drainage (n = 2) between January 2009 and November 2011 by using a metal artifact reduction correction algorithm. We measured CT value ranges and noise by using region-of-interest methods, and 2 experienced neuroradiologists rated the degrees of improved imaging quality and artifact reduction by comparing uncorrected and corrected images. After we applied the metal artifact reduction algorithm, the CT value ranges and the noise were substantially reduced (1815.3 ± 793.7 versus 231.7 ± 95.9 and 319.9 ± 136.6 versus 45.9 ± 14.0; both P < .001) regardless of the types of metallic objects and various sizes of coil masses. The rater study achieved an overall improvement of imaging quality and artifact reduction (85.7% and 78.6% of cases by 2 raters, respectively), with the greatest improvement in the coiling group, moderate improvement in the liquid embolizers, and the smallest improvement in ventricular shunting (overall agreement, 0.857). The metal artifact reduction algorithm substantially reduced artifacts and improved the objective image quality in every studied case. It also allowed improved diagnostic confidence in most cases.
ISSN:0195-6108
1936-959X
DOI:10.3174/ajnr.a3851