Cone-beam CT (CBCT) technique has been used by orthopedists to monitor bone graft growth after orthopedic surgery. In order to correct severe metal artifacts in reconstructed images caused by metal implants used in bone grafting, a three-dimensional metal artifact correction method has been previously proposed. The implants' mathematic boundaries were generated to help to segment metal from reconstructed images. The segmented metal implants were forward-projected onto the detector to create metal-only projections to compensate for beam-hardening effect. This method was proved effective with the metal implants of regular shape which can be simulated by simple 3D primitives, such as cuboid, cylinder and cone. But for metal implants of arbitrary shape, their boundaries are difficult to define mathematically. To solve this problem, this paper proposed a method by setting up an implant image library and using the implants' a priori shape information from the library during the artifact correction. The implants were acquired and scanned before the surgery and their a priori information were stored in a library. During the artifact correction, the library was called to provide the shape information of the implants to help to do the implant segmentation. The segmented implants were forward-projected onto the detector to generate implant-only projections by a cone-beam forward-projection technique. Beam-hardening effect in the original projections was then compensated by high polynomial orders of implant projections. Finally, the corrected projections were back-projected to produce artifacts-reduced images. Both phantom studies and patient studies were conducted to test this correction method. Results from both studies show the artifacts have been greatly reduced and the accuracy of bone volume measurement has been increased.
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