Clinical assessment of metal artifact reduction methods in dual-energy CT examinations of instrumented spines

Zaiyang Long, David R De Lone, Amy L. Kotsenas, Vance T Lehman, Alex A. Nagelschneider, Gregory J. Michalak, Joel Garland Fletcher, Cynthia H McCollough, Lifeng Yu

Research output: Contribution to journalArticle

Abstract

OBJECTIVE. The purpose of this study was to evaluate the performance of three metal artifact reduction methods in dual-energy CT (DECT) examinations of instrumented spines. MATERIALS AND METHODS. Twenty patients with instrumented spines who underwent spine DECT were retrospectively identified. All scans were obtained on a dual-source 128-MDCT scanner. In addition to the original DE mixed images, DECT images were reconstructed using an iterative metal artifact reconstruction algorithm (DE iMAR), virtual monochromatic imaging (VMI) algorithm (DE Mono+), and a combination of the two algorithms DE iMAR and DE Mono+, which we refer to here as "DE iMAR Mono+." The four image series were anonymized and randomized for a reader study. Four experienced neuroradiologists rated the images in terms of artifact scores of four anatomic regions and overall image quality scores in both bone and soft-tissue display window settings. In addition, a quantitative analysis was performed to assess the performance of the three metal artifact reduction methods. RESULTS. There were statistically significant differences in the artifact scores and overall image quality scores among the four methods (both, p < 0.001). DE iMAR Mono+ showed the best artifact scores and quality scores (all, p < 0.001). The intraclass correlation coefficient for the overall image quality score was 0.779 using the bone display window and 0.892 using the soft-tissue display window (both, p < 0.001). In addition, DE iMAR Mono+ reduced the artifacts by the greatest amount in the quantitative analysis. CONCLUSION. The method that used DE iMAR Mono+ showed the best performance of spine metal artifact reduction using DECT data. These results may be specific to this CT vendor and implant type.

Original languageEnglish (US)
Pages (from-to)395-401
Number of pages7
JournalAmerican Journal of Roentgenology
Volume212
Issue number2
DOIs
StatePublished - Feb 1 2019

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Artifacts
Spine
Metals
Bone and Bones

Keywords

  • Dual-energy CT
  • iMAR
  • Metal artifact
  • Spine
  • Virtual monochromatic imaging

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Clinical assessment of metal artifact reduction methods in dual-energy CT examinations of instrumented spines. / Long, Zaiyang; De Lone, David R; Kotsenas, Amy L.; Lehman, Vance T; Nagelschneider, Alex A.; Michalak, Gregory J.; Fletcher, Joel Garland; McCollough, Cynthia H; Yu, Lifeng.

In: American Journal of Roentgenology, Vol. 212, No. 2, 01.02.2019, p. 395-401.

Research output: Contribution to journalArticle

Long, Zaiyang ; De Lone, David R ; Kotsenas, Amy L. ; Lehman, Vance T ; Nagelschneider, Alex A. ; Michalak, Gregory J. ; Fletcher, Joel Garland ; McCollough, Cynthia H ; Yu, Lifeng. / Clinical assessment of metal artifact reduction methods in dual-energy CT examinations of instrumented spines. In: American Journal of Roentgenology. 2019 ; Vol. 212, No. 2. pp. 395-401.
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AU - Long, Zaiyang

AU - De Lone, David R

AU - Kotsenas, Amy L.

AU - Lehman, Vance T

AU - Nagelschneider, Alex A.

AU - Michalak, Gregory J.

AU - Fletcher, Joel Garland

AU - McCollough, Cynthia H

AU - Yu, Lifeng

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N2 - OBJECTIVE. The purpose of this study was to evaluate the performance of three metal artifact reduction methods in dual-energy CT (DECT) examinations of instrumented spines. MATERIALS AND METHODS. Twenty patients with instrumented spines who underwent spine DECT were retrospectively identified. All scans were obtained on a dual-source 128-MDCT scanner. In addition to the original DE mixed images, DECT images were reconstructed using an iterative metal artifact reconstruction algorithm (DE iMAR), virtual monochromatic imaging (VMI) algorithm (DE Mono+), and a combination of the two algorithms DE iMAR and DE Mono+, which we refer to here as "DE iMAR Mono+." The four image series were anonymized and randomized for a reader study. Four experienced neuroradiologists rated the images in terms of artifact scores of four anatomic regions and overall image quality scores in both bone and soft-tissue display window settings. In addition, a quantitative analysis was performed to assess the performance of the three metal artifact reduction methods. RESULTS. There were statistically significant differences in the artifact scores and overall image quality scores among the four methods (both, p < 0.001). DE iMAR Mono+ showed the best artifact scores and quality scores (all, p < 0.001). The intraclass correlation coefficient for the overall image quality score was 0.779 using the bone display window and 0.892 using the soft-tissue display window (both, p < 0.001). In addition, DE iMAR Mono+ reduced the artifacts by the greatest amount in the quantitative analysis. CONCLUSION. The method that used DE iMAR Mono+ showed the best performance of spine metal artifact reduction using DECT data. These results may be specific to this CT vendor and implant type.

AB - OBJECTIVE. The purpose of this study was to evaluate the performance of three metal artifact reduction methods in dual-energy CT (DECT) examinations of instrumented spines. MATERIALS AND METHODS. Twenty patients with instrumented spines who underwent spine DECT were retrospectively identified. All scans were obtained on a dual-source 128-MDCT scanner. In addition to the original DE mixed images, DECT images were reconstructed using an iterative metal artifact reconstruction algorithm (DE iMAR), virtual monochromatic imaging (VMI) algorithm (DE Mono+), and a combination of the two algorithms DE iMAR and DE Mono+, which we refer to here as "DE iMAR Mono+." The four image series were anonymized and randomized for a reader study. Four experienced neuroradiologists rated the images in terms of artifact scores of four anatomic regions and overall image quality scores in both bone and soft-tissue display window settings. In addition, a quantitative analysis was performed to assess the performance of the three metal artifact reduction methods. RESULTS. There were statistically significant differences in the artifact scores and overall image quality scores among the four methods (both, p < 0.001). DE iMAR Mono+ showed the best artifact scores and quality scores (all, p < 0.001). The intraclass correlation coefficient for the overall image quality score was 0.779 using the bone display window and 0.892 using the soft-tissue display window (both, p < 0.001). In addition, DE iMAR Mono+ reduced the artifacts by the greatest amount in the quantitative analysis. CONCLUSION. The method that used DE iMAR Mono+ showed the best performance of spine metal artifact reduction using DECT data. These results may be specific to this CT vendor and implant type.

KW - Dual-energy CT

KW - iMAR

KW - Metal artifact

KW - Spine

KW - Virtual monochromatic imaging

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