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Performances of low-dose dual-energy CT in reducing artifacts from implanted metallic orthopedic devices


Filograna, Laura; Magarelli, Nicola; Leone, Antonio; de Waure, Chiara; Calabrò, Giovanna Elisa; Finkenstaedt, Tim; Thali, Michael J; Bonomo, Lorenzo (2016). Performances of low-dose dual-energy CT in reducing artifacts from implanted metallic orthopedic devices. Skeletal Radiology, 45(7):937-947.

Abstract

OBJECTIVES: The objective was to evaluate the performances of dose-reduced dual-energy computed tomography (DECT) in decreasing metallic artifacts from orthopedic devices compared with dose-neutral DECT, dose-neutral single-energy computed tomography (SECT), and dose-reduced SECT.
MATERIALS AND METHODS: Thirty implants in 20 consecutive cadavers underwent both SECT and DECT at three fixed CT dose indexes (CTDI): 20.0, 10.0, and 5.0 mGy. Extrapolated monoenergetic DECT images at 64, 69, 88, 105, 120, and 130 keV, and individually adjusted monoenergy for optimized image quality (OPTkeV) were generated. In each group, the image quality of the seven monoenergetic images and of the SECT image was assessed qualitatively and quantitatively by visually rating and by measuring the maximum streak artifact respectively.
RESULTS: The comparison between SECT and OPTkeV evaluated overall within all groups showed a significant difference (p <0.001), with OPTkeV images providing better images. Comparing OPTkeV with the other DECT images, a significant difference was shown (p <0.001), with OPTkeV and 130-keV images providing the qualitatively best results. The OPTkeV images of 5.0-mGy acquisitions provided percentages of images with scores 1 and 2 of 36 % and 30 % respectively, compared with 0 % and 33.3 % of the corresponding SECT images of 10- and 20-mGy acquisitions. Moreover, DECT reconstructions at the OPTkeV of the low-dose group showed higher CT numbers than the SECT images of dose groups 1 and 2.
CONCLUSIONS: This study demonstrates that low-dose DECT permits a reduction of artifacts due to metallic implants to be obtained in a similar manner to neutral-dose DECT and better than reduced or neutral-dose SECT.

Abstract

OBJECTIVES: The objective was to evaluate the performances of dose-reduced dual-energy computed tomography (DECT) in decreasing metallic artifacts from orthopedic devices compared with dose-neutral DECT, dose-neutral single-energy computed tomography (SECT), and dose-reduced SECT.
MATERIALS AND METHODS: Thirty implants in 20 consecutive cadavers underwent both SECT and DECT at three fixed CT dose indexes (CTDI): 20.0, 10.0, and 5.0 mGy. Extrapolated monoenergetic DECT images at 64, 69, 88, 105, 120, and 130 keV, and individually adjusted monoenergy for optimized image quality (OPTkeV) were generated. In each group, the image quality of the seven monoenergetic images and of the SECT image was assessed qualitatively and quantitatively by visually rating and by measuring the maximum streak artifact respectively.
RESULTS: The comparison between SECT and OPTkeV evaluated overall within all groups showed a significant difference (p <0.001), with OPTkeV images providing better images. Comparing OPTkeV with the other DECT images, a significant difference was shown (p <0.001), with OPTkeV and 130-keV images providing the qualitatively best results. The OPTkeV images of 5.0-mGy acquisitions provided percentages of images with scores 1 and 2 of 36 % and 30 % respectively, compared with 0 % and 33.3 % of the corresponding SECT images of 10- and 20-mGy acquisitions. Moreover, DECT reconstructions at the OPTkeV of the low-dose group showed higher CT numbers than the SECT images of dose groups 1 and 2.
CONCLUSIONS: This study demonstrates that low-dose DECT permits a reduction of artifacts due to metallic implants to be obtained in a similar manner to neutral-dose DECT and better than reduced or neutral-dose SECT.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Diagnostic and Interventional Radiology
04 Faculty of Medicine > Institute of Legal Medicine
Dewey Decimal Classification:340 Law
610 Medicine & health
Uncontrolled Keywords:Low-dose dual-energy computed tomography; Metallic artifact reduction; Monoenergetic extrapolation
Language:English
Date:2016
Deposited On:03 May 2016 15:40
Last Modified:08 Dec 2017 19:27
Publisher:Springer
ISSN:0364-2348
Publisher DOI:https://doi.org/10.1007/s00256-016-2377-8
PubMed ID:27033858

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