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Metal artifact reduction using virtual monochromatic images for patients with pedicle screws implants on CT

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Abstract

Purpose

To evaluate the effect of spectral CT for metal artifact reduction in patients with pedicle screw.

Methods

45 patients with 119 pairs of pedicle screws underwent spectral CT examination. One set of conventional (140 kVp) polychromatic image and nine sets of virtual monochromatic images (60–140 keV) were obtained. The standard deviation (SD) of CT number in 12 locations around the implant and 1 on homogenous fat was measured to generate artifact index (AI). Objective assessment including AI, CT number and SD value was performed with independent t test and paired sample t test. Two radiologists independently reviewed the image quality, and Wilcoxon signed-rank test and kappa analysis were used for the subjective scores of image quality.

Results

The artifact index (AI) of all the regions decreased as keV increased. AIs of 100–140 keV were lower than that of 140 kVp images. At 120 keV there was no significant difference in CT numbers of psoas major muscle and vertebral canal between pedicle screw level and pedicle level, but a significant difference in SD value was determined between the two levels. The subjective scores at 100–140 keV were higher than the images at 140 kVp, and the highest subjective score of two observers and excellent interobserver agreement were found at 120 keV (κ = 0.889).

Conclusions

Virtual monochromatic images at high-energy levels have a well-concordant effect of removing metal artifacts, and 120 keV monochromatic images provided an accurate CT number and good subjective score.

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Abbreviations

AI:

Artifact index

GSI:

Gemstone spectral imaging

MARs:

Metal artifacts reduction software

MSCT:

Multi-slice computed tomography

ROI:

Region of interest

SD:

Standard deviation

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Conflict of interest

We declared that we have no financial and personal relationships with other people or organizations that can inappropriately influence our work; there is no professional or other personal interest of any nature or kind in any product, service and/or company that could be construed as influencing the position presented in the manuscript entitled.

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Authors and Affiliations

  1. Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, 116011, Liaoning, China

    Yue Dong, Ai Jun Shi, Ru Xin Wang, Li Fei Sun, Ai Lian Liu & Yi Jun Liu

  2. Department of Radiology, LiaoNing Cancer Hospital, DaLian Medical University Clinical Oncology College, Shenyang, 110042, Liaoning, China

    Yue Dong

  3. Department of Radiology, Affiliated ZhongShan Hospital of Dalian University, Dalian, 116001, Liaoning, China

    Jian Lin Wu

Authors
  1. Yue Dong
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  2. Ai Jun Shi
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  4. Ru Xin Wang
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  5. Li Fei Sun
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Correspondence to Yue Dong.

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Dong, Y., Shi, A.J., Wu, J.L. et al. Metal artifact reduction using virtual monochromatic images for patients with pedicle screws implants on CT. Eur Spine J 25, 1754–1763 (2016). https://doi.org/10.1007/s00586-015-4053-4

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  • DOI: https://doi.org/10.1007/s00586-015-4053-4

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