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CT metal artifacts in patients with total hip replacements: for artifact reduction monoenergetic reconstructions and post-processing algorithms are both efficient but not similar

  • Computed Tomography
  • Published:
European Radiology Aims and scope Submit manuscript

A Correction to this article was published on 10 July 2018

This article has been updated

Abstract

Objectives

This study compares metal artifact (MA) reduction in imaging of total hip replacements (THR) using virtual monoenergetic images (VMI), for MA-reduction-specialized reconstructions (MAR) and conventional CT images (CI) from detector-based dual-energy computed tomography (SDCT).

Methods

Twenty-seven SDCT-datasets of patients carrying THR were included. CI, MAR and VMI with different energy-levels (60–200 keV) were reconstructed from the same scans. MA width was measured. Attenuation (HU), noise (SD) and contrast-to-noise ratio (CNR) were determined in: extinction artifact, adjacent bone, muscle and bladder. Two radiologists assessed MA-reduction and image quality visually.

Results

In comparison to CI, VMI (200 keV) and MAR showed a strong artifact reduction (MA width: CI 29.9±6.8 mm, VMI 17.6±13.6 mm, p<0.001; MAR 16.5±14.9 mm, p<0.001; MA density: CI -412.1±204.5 HU, VMI -279.7±283.7 HU; p<0.01; MAR -116.74±105.6 HU, p<0.001). In strong artifacts reduction was superior by MAR. In moderate artifacts VMI was more effective. MAR showed best noise reduction and CNR in bladder and muscle (p<0.05), whereas VMI were superior for depiction of bone (p<0.05). Visual assessment confirmed that VMI and MAR improve artifact reduction and image quality (p<0.001).

Conclusions

MAR and VMI (200 keV) yielded significant MA reduction. Each showed distinct advantages both regarding effectiveness of artifact reduction, MAR regarding assessment of soft tissue and VMI regarding assessment of bone.

Key Points

• Spectral-detector computed tomography improves assessment of total hip replacements and surrounding tissue.

• Virtual monoenergetic images and MAR reduce metal artifacts and enhance image quality.

• Evaluation of bone, muscle and pelvic organs can be improved by SDCT.

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Change history

  • 10 July 2018

    The original version of this article, published on 03 May 2018, unfortunately contained a mistake. The following correction has therefore been made in the original.

Abbreviations

CI:

Conventional CT imaging/images

CNR:

Contrast-to-noise ratio

MA:

Metal artifact

MAR:

Metal artifact reduction algorithm

SDCT:

Spectral-detector CT

THR:

Total hip replacement

VMI:

Virtual monoenergetic images

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Funding

The authors state that this work has not received any funding.

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Author notes

  1. Kai Roman Laukamp and Simon Lennartz Contributed equally to this work

Authors and Affiliations

  1. Department of Radiology, University of Cologne, Kerpener Straße 62, 50937, Cologne, Germany

    Kai Roman Laukamp, Simon Lennartz, Victor-Frederic Neuhaus, Nils Große Hokamp, Robert Rau, Markus Le Blanc, Nuran Abdullayev, Anastasios Mpotsaris, David Maintz & Jan Borggrefe

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  1. Kai Roman Laukamp
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Correspondence to Jan Borggrefe.

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Guarantor

The scientific guarantor of this publication is Jan Borggrefe.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

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Written informed consent was waived by the Institutional Review Board.

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Institutional Review Board approval was obtained.

Methodology

• retrospective

• diagnostic or prognostic study

• performed at one institution

Additional information

The original version of this article was revised: The names of Nuran Abdullayev and Anastasios Mpotsaris were presented incorrectly.

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Laukamp, K.R., Lennartz, S., Neuhaus, VF. et al. CT metal artifacts in patients with total hip replacements: for artifact reduction monoenergetic reconstructions and post-processing algorithms are both efficient but not similar. Eur Radiol 28, 4524–4533 (2018). https://doi.org/10.1007/s00330-018-5414-2

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  • DOI: https://doi.org/10.1007/s00330-018-5414-2

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