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Reliability and benefits of single-energy projection-based metallic artifact reduction (SEMAR) in the different orthopedic hardware for the hip

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Skeletal Radiology Aims and scope Submit manuscript

Abstract

Objective

To evaluate the performance and reliability of the single-energy metal artifact reduction (SEMAR) algorithm in patients with different orthopedic hardware at the hips.

Materials and methods

A total of 153 patients with hip instrumentation who had undergone CT with adaptive iterative dose reduction (AIDR) 3D and SEMAR algorithms between February 2015 and October 2019 were included retrospectively. Patients were divided into 5 groups by the hardware type. Two readers with 21 and 13 years of experience blindly reviewed all image sets and graded the extent of artifacts and imaging quality using 5-point scales. To evaluate reliability, the mean densities and image noises were measured at the urinary bladder, veins, and fat in images with artifacts and the reference images.

Results

No significant differences were found in the mean densities of the urinary bladder, veins, and fat between the SEMAR images with artifacts (7.57 ± 9.49, 40.29 ± 23.07, 86.78 ± 38.34) and the reference images (7.77 ± 6.2, 40.27 ± 8.66, 89.10 ± 20.70) (P = .860, .994, .392). Image noises of the urinary bladder in the SEMAR images with artifacts (14.25 ± 4.50) and the SEMAR reference images (9.69 ± 1.29) were significantly higher than those in the AIDR 3D reference images (9.11 ± 1.12) (P < .001; P < .001). All AIDR 3D images were non-diagnostic (overall quality ≤ 3) and less than a quarter of the SEMAR images were non-diagnostic (16.7–23.7%), mainly in patients with prostheses [reader 1: 91.7% (22/24); reader 2: 92.6% (25/27)].

Conclusion

The SEMAR algorithm significantly reduces metal artifacts in CT images, more in patients with internal fixations than in patients with prostheses, and provides reliable attenuation of soft tissues.

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Acknowledgements

The authors thank the Division of Medical Statistics and Bioinformatics, Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, for assistance with this study.

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Authors and Affiliations

  1. Department of Medical Imaging, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan

    Yu-Hua Chen & Chia-Hsin Lu

  2. Department of Medical Imaging, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan

    Chia-Hsin Lu, Yu-Jen Chen & Han-Sheng Chen

  3. Department of Radiology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

    Chia-Hsin Lu, Yu-Jen Chen, Han-Sheng Chen & Tsyh-Jyi Hsieh

  4. Department of Medical Imaging, Chi Mei Medical Center, No.901, Zhonghua Rd, Yongkang Dist, Tainan City 710, Taiwan

    Tsyh-Jyi Hsieh

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  1. Yu-Hua Chen
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Correspondence to Tsyh-Jyi Hsieh.

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Ethics approval

This study was approved by the Institutional Review Board of Kaohsiung Medical University Chung-Ho Memorial Hospital (IRB No: KMUHIRB-E(1)-20190447). Because of the retrospective nature, the requirement of informed consent was waived.

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The authors declare no competing interests.

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Chen, YH., Lu, CH., Chen, YJ. et al. Reliability and benefits of single-energy projection-based metallic artifact reduction (SEMAR) in the different orthopedic hardware for the hip. Skeletal Radiol 51, 1853–1863 (2022). https://doi.org/10.1007/s00256-022-04040-6

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  • DOI: https://doi.org/10.1007/s00256-022-04040-6

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