Clinical evaluation of the iterative metal artefact reduction algorithm for post-operative CT examination after maxillofacial surgery.

OBJECTIVES Metal artefacts present challenges to both radiologists and clinicians during post-operative imaging. Such artefacts reduce the diagnostic effectiveness of CT scans and mask findings that could be vital for patient management. Thus, a powerful artefact reduction tool is necessary when imaging patients with metal implants. Our aim was to test the recently introduced iterative metal artefact reduction (iMAR) algorithm in patients with maxillofacial implants. METHODS Images from 17 patients with diverse maxillofacial metal implants who had undergone CT scans were qualitatively and quantitatively analyzed before and after metal artefact reduction with iMAR. RESULTS After iMAR application, images exhibited decreased artefacts and improved image quality, leading to detection of lesions that were previously masked by artefacts. The application of iMAR did not affect image quality in regions distant from the metal implants. CONCLUSIONS The application of iMAR to CT examinations of patients with maxillofacial metal implants leads to artefact reduction, improvement of image quality and increased diagnostic utility. Routine implementation of iMAR during imaging of patients with metal hardware implants could add diagnostic value to their CT examinations.

[1]  W. Wuest,et al.  Improved Image Quality in Head and Neck CT Using a 3D Iterative Approach to Reduce Metal Artifact , 2015, American Journal of Neuroradiology.

[2]  R. Lanzman,et al.  Metal artifact reduction (MAR) based on two-compartment physical modeling: evaluation in patients with hip implants , 2017, Acta radiologica.

[3]  Rainer Raupach,et al.  Normalized Metal Artifact Reduction in Head and Neck Computed Tomography , 2012, Investigative radiology.

[4]  R. Raupach,et al.  Comparison and Combination of Dual-Energy- and Iterative-Based Metal Artefact Reduction on Hip Prosthesis and Dental Implants , 2015, PloS one.

[5]  Rainer Raupach,et al.  Normalized metal artifact reduction (NMAR) in computed tomography. , 2010, Medical physics.

[6]  P. Thunberg,et al.  Metal artefact reduction in CT imaging of hip prostheses—an evaluation of commercial techniques provided by four vendors. , 2015, The British journal of radiology.

[7]  Nancy A. Obuchowski,et al.  Iterative metal artifact reduction: Evaluation and optimization of technique , 2014, Skeletal Radiology.

[8]  Val M Runge,et al.  Metal Artifact Reduction in Pelvic Computed Tomography With Hip Prostheses: Comparison of Virtual Monoenergetic Extrapolations From Dual-Energy Computed Tomography and an Iterative Metal Artifact Reduction Algorithm in a Phantom Study , 2015, Investigative radiology.

[9]  Rainer Raupach,et al.  Frequency split metal artifact reduction (FSMAR) in computed tomography. , 2012, Medical physics.

[10]  F. Boas,et al.  CT artifacts: Causes and reduction techniques , 2012 .

[11]  Hatem Alkadhi,et al.  Metal artefact reduction from dental hardware in carotid CT angiography using iterative reconstructions , 2013, European Radiology.

[12]  J G Fletcher,et al.  CT Metal Artifact Reduction in the Spine: Can an Iterative Reconstruction Technique Improve Visualization? , 2015, American Journal of Neuroradiology.

[13]  Habib Zaidi,et al.  Assessment of metal artifact reduction methods in pelvic CT. , 2016, Medical physics.

[14]  Fabian Bamberg,et al.  Metal Artifact Reduction by Dual-Energy Computed Tomography Using Energetic Extrapolation: A Systematically Optimized Protocol , 2012, Investigative radiology.

[15]  Sebastian Bickelhaupt,et al.  Reduction of metal artifacts from hip prostheses on CT images of the pelvis: value of iterative reconstructions. , 2013, Radiology.

[16]  H. Alkadhi,et al.  CT metal artefact reduction for internal fixation of the proximal humerus: value of mono-energetic extrapolation from dual-energy and iterative reconstructions. , 2014, Clinical radiology.

[17]  Patrick Dupont,et al.  Metal streak artifacts in X-ray computed tomography: a simulation study , 1998 .

[18]  Nancy A Obuchowski,et al.  Imaging of Arthroplasties: Improved Image Quality and Lesion Detection With Iterative Metal Artifact Reduction, a New CT Metal Artifact Reduction Technique. , 2016, AJR. American journal of roentgenology.

[19]  Dimitre Hristov,et al.  Clinical evaluation of the iterative metal artifact reduction algorithm for CT simulation in radiotherapy. , 2015, Medical physics.