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Metal implants on CT: comparison of iterative reconstruction algorithms for reduction of metal artifacts with single energy and spectral CT scanning in a phantom model

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Abstract

Purpose

To assess single energy metal artifact reduction (SEMAR) and spectral energy metal artifact reduction (MARS) algorithms in reducing artifacts generated by different metal implants.

Materials and method

Phantom was scanned with and without SEMAR (Aquilion One, Toshiba) and MARS (Discovery CT750 HD, GE), with various metal implants. Images were evaluated objectively by measuring standard deviation in regions of interests and subjectively by two independent reviewers grading on a scale of 0 (no artifact) to 4 (severe artifact). Reviewers also graded new artifacts introduced by metal artifact reduction algorithms.

Results

SEMAR and MARS significantly decreased variability of the density measurement adjacent to the metal implant, with median SD (standard deviation of density measurement) of 52.1 HU without SEMAR, vs. 12.3 HU with SEMAR, p < 0.001. Median SD without MARS of 63.1 HU decreased to 25.9 HU with MARS, p < 0.001. Median SD with SEMAR is significantly lower than median SD with MARS (p = 0.0011). SEMAR improved subjective image quality with reduction in overall artifacts grading from 3.2 ± 0.7 to 1.4 ± 0.9, p < 0.001. Improvement of overall image quality by MARS has not reached statistical significance (3.2 ± 0.6 to 2.6 ± 0.8, p = 0.088). There was a significant introduction of artifacts introduced by metal artifact reduction algorithm for MARS with 2.4 ± 1.0, but minimal with SEMAR 0.4 ± 0.7, p < 0.001.

Conclusion

CT iterative reconstruction algorithms with single and spectral energy are both effective in reduction of metal artifacts. Single energy-based algorithm provides better overall image quality than spectral CT-based algorithm. Spectral metal artifact reduction algorithm introduces mild to moderate artifacts in the far field.

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Authors and Affiliations

  1. Department of Radiology, Beth Israel Deaconess Medical Center, Rosenberg Building, Office 378, One Deaconess Drive, 330 Brookline Avenue, Boston, MA, 02215, USA

    Jieming Fang, Da Zhang, Carol Wilcox, Benedikt Heidinger, Vassilios Raptopoulos, Alexander Brook & Olga R. Brook

Authors
  1. Jieming Fang
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  2. Da Zhang
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  3. Carol Wilcox
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  4. Benedikt Heidinger
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  5. Vassilios Raptopoulos
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  6. Alexander Brook
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  7. Olga R. Brook
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Corresponding author

Correspondence to Olga R. Brook.

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No funding was received for this study.

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The authors declare that they have no conflict of interest.

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This article does not contain any studies with human participants or animals performed by any of the authors. For this type of study formal consent is not required.

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Statement of informed consent was not applicable since the manuscript does not contain any patient data.

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Fang, J., Zhang, D., Wilcox, C. et al. Metal implants on CT: comparison of iterative reconstruction algorithms for reduction of metal artifacts with single energy and spectral CT scanning in a phantom model. Abdom Radiol 42, 742–748 (2017). https://doi.org/10.1007/s00261-016-1023-1

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  • DOI: https://doi.org/10.1007/s00261-016-1023-1

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