Metal Artifact Reduction in CT: Where Are We After Four Decades?

Methods to overcome metal artifacts in computed tomography (CT) images have been researched and developed for nearly 40 years. When X-rays pass through a metal object, depending on its size and density, different physical effects will negatively affect the measurements, most notably beam hardening, scatter, noise, and the non-linear partial volume effect. These phenomena severely degrade image quality and hinder the diagnostic power and treatment outcomes in many clinical applications. In this paper, we first review the fundamental causes of metal artifacts, categorize metal object types, and present recent trends in the CT metal artifact reduction (MAR) literature. To improve image quality and recover information about underlying structures, many methods and correction algorithms have been proposed and tested. We comprehensively review and categorize these methods into six different classes of MAR: metal implant optimization, improvements to the data acquisition process, data correction based on physics models, modifications to the reconstruction algorithm (projection completion and iterative reconstruction), and image-based post-processing. The primary goals of this paper are to identify the strengths and limitations of individual MAR methods and overall classes, and establish a relationship between types of metal objects and the classes that most effectively overcome their artifacts. The main challenges for the field of MAR continue to be cases with large, dense metal implants, as well as cases with multiple metal objects in the field of view. Severe photon starvation is difficult to compensate for with only software corrections. Hence, the future of MAR seems to be headed toward a combined approach of improving the acquisition process with dual-energy CT, higher energy X-rays, or photon-counting detectors, along with advanced reconstruction approaches. Additional outlooks are addressed, including the need for a standardized evaluation system to compare MAR methods.

[1]  Hanbean Youn,et al.  Generation of hybrid sinograms for the recovery of kV-CT images with metal artifacts for helical tomotherapy. , 2015, Medical physics.

[2]  Thorsten M Buzug,et al.  A fully 3D approach for metal artifact reduction in computed tomography. , 2012, Medical physics.

[3]  Patrick Dupont,et al.  An iterative maximum-likelihood polychromatic algorithm for CT , 2001, IEEE Transactions on Medical Imaging.

[4]  David Faul,et al.  Suppression of Metal Artifacts in CT Using a Reconstruction Procedure That Combines MAP and Projection Completion , 2009, IEEE Transactions on Medical Imaging.

[5]  Rainer Raupach,et al.  A new algorithm for metal artifact reduction in computed tomography: in vitro and in vivo evaluation after total hip replacement. , 2003, Investigative radiology.

[6]  A. Feydy,et al.  Virtual monochromatic spectral imaging with fast kilovoltage switching: reduction of metal artifacts at CT. , 2013, Radiographics : a review publication of the Radiological Society of North America, Inc.

[7]  S Tohnak,et al.  Dental CT metal artefact reduction based on sequential substitution. , 2011, Dento maxillo facial radiology.

[8]  Vladimir Pekar,et al.  Segmentation-aided adaptive filtering for metal artifact reduction in radio-therapeutic CT images , 2004, SPIE Medical Imaging.

[9]  Yong-Min Huh,et al.  Overcoming artifacts from metallic orthopedic implants at high-field-strength MR imaging and multi-detector CT. , 2007, Radiographics : a review publication of the Radiological Society of North America, Inc.

[10]  P. Rüegsegger,et al.  Anchorage of femoral implants visualized by modified computed tomography , 2004, Archives of orthopaedic and traumatic surgery.

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

[12]  S M Smith,et al.  A description for computed tomography based on sinusoidal curves. , 2003, Journal of X-ray science and technology.

[13]  Thorsten Heußer,et al.  Prior-based artifact correction (PBAC) in computed tomography. , 2014, Medical physics.

[14]  James L Bedford,et al.  Tolerance levels for quality assurance of electron density values generated from CT in radiotherapy treatment planning , 2016 .

[15]  Denis Laurendeau,et al.  An algorithm for efficient metal artifact reductions in permanent seed. , 2010, Medical physics.

[16]  G Delso,et al.  MR-driven metal artifact reduction in PET/CT , 2013, Physics in medicine and biology.

[17]  Ke Li,et al.  Prior Image Constrained Compressed Sensing Metal Artifact Reduction (PICCS-MAR): 2D and 3D Image Quality Improvement with Hip Prostheses at CT Colonography , 2016, European Radiology.

[18]  Demis Hassabis,et al.  Mastering the game of Go with deep neural networks and tree search , 2016, Nature.

[19]  Patrick Dupont,et al.  Reduction of metal streak artifacts in X-ray computed tomography using a transmission maximum a posteriori algorithm , 1999 .

[20]  Willi A Kalender,et al.  A novel forward projection-based metal artifact reduction method for flat-detector computed tomography , 2009, Physics in medicine and biology.

[21]  P. Suetens,et al.  Metal streak artifacts in X-ray computed tomography: a simulation study , 1998, 1998 IEEE Nuclear Science Symposium Conference Record. 1998 IEEE Nuclear Science Symposium and Medical Imaging Conference (Cat. No.98CH36255).

[22]  Francesco C Stingo,et al.  An evaluation of three commercially available metal artifact reduction methods for CT imaging , 2015, Physics in medicine and biology.

[23]  Jong Beom Ra,et al.  Metal artifact reduction based on sinogram correction in CT , 2009, 2009 IEEE Nuclear Science Symposium Conference Record (NSS/MIC).

[24]  Norbert J. Pelc,et al.  High Speed Reprojection And Its Applications , 1988, Medical Imaging.

[25]  Ge Wang,et al.  High-kVp Assisted Metal Artifact Reduction for X-Ray Computed Tomography , 2016, IEEE Access.

[26]  Victor J. Sank,et al.  IMAGE RECONSTRUCTION FROM PROJECTIONS: ***I , 1978 .

[27]  N J Pelc,et al.  Nonlinear partial volume artifacts in x-ray computed tomography. , 1980, Medical physics.

[28]  Jacob Geleijns,et al.  Development and validation of segmentation and interpolation techniques in sinograms for metal artifact suppression in CT. , 2010, Medical physics.

[29]  D E Raeside,et al.  A pattern recognition method for the removal of streaking artifact in computed tomography. , 1981, Radiology.

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

[31]  L. Xing,et al.  Metal artifact reduction in x-ray computed tomography (CT) by constrained optimization. , 2011, Medical physics.

[32]  W. Kalender,et al.  A pragmatic approach to metal artifact reduction in CT: merging of metal artifact reduced images , 2004, European Radiology.

[33]  Predrag Sukovic,et al.  Penalized weighted least-squares image reconstruction for dual energy X-ray transmission tomography , 2000, IEEE Transactions on Medical Imaging.

[34]  Lothar Spies,et al.  Metal artifact reduction in CT using tissue-class modeling and adaptive prefiltering. , 2006, Medical physics.

[35]  Rainer Raupach,et al.  Adaptive normalized metal artifact reduction (ANMAR) in computed tomography , 2011, 2011 IEEE Nuclear Science Symposium Conference Record.

[36]  P. Rüegsegger,et al.  CT BONE DENSITOMETRY OF THE ANCHORAGE OF ARTIFICIAL KNEE JOINTS , 1985 .

[37]  K Harada,et al.  Reduction of dental metallic artefacts in CT: value of a newly developed algorithm for metal artefact reduction (O-MAR). , 2014, Clinical radiology.

[38]  Steve B. Jiang,et al.  A hybrid metal artifact reduction algorithm for x-ray CT. , 2013, Medical physics.

[39]  M W Vannier,et al.  Fast iterative algorithm for metal artifact reduction in X-ray CT. , 2000, Academic radiology.

[40]  Yiannis Kyriakou,et al.  Reducing Metal Artifacts in Computed Tomography Caused by Hip Endoprostheses Using a Physics-Based Approach , 2010, Investigative radiology.

[41]  W. Kalender,et al.  Generalized multi-dimensional adaptive filtering for conventional and spiral single-slice, multi-slice, and cone-beam CT. , 2001, Medical physics.

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

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

[44]  Wang,et al.  Iterative X-ray Cone-Beam Tomography for Metal Artifact Reduction and Local Region Reconstruction , 1999, Microscopy and Microanalysis.

[45]  Seemeen Karimi,et al.  Metal artifact reduction for CT-based luggage screening , 2014, 2014 IEEE International Conference on Acoustics, Speech and Signal Processing (ICASSP).

[46]  Ryan J. Murphy,et al.  Deblurring subject to nonnegativity constraints when known functions are present with application to object-constrained computerized tomography , 2001, IEEE Transactions on Medical Imaging.

[47]  Peter Michael Edic,et al.  Complementary contrast media for metal artifact reduction in dual-energy CT , 2015, Medical Imaging.

[48]  Rangaraj M. Rangayyan,et al.  Streak Preventive Image Reconstruction with ART and Adaptive Filtering , 1982, IEEE Transactions on Medical Imaging.

[49]  Mehran Yazdi,et al.  An opposite view data replacement approach for reducing artifacts due to metallic dental objects. , 2011, Medical physics.

[50]  C. Bartneck,et al.  Reducing beam hardening effects and metal artefacts in spectral CT using Medipix3RX , 2014 .

[51]  B. Kratz,et al.  Metal artifact reduction in computed tomography using nonequispaced fourier transform , 2009, 2009 IEEE Nuclear Science Symposium Conference Record (NSS/MIC).

[52]  Jeffrey H. Siewerdsen,et al.  High-contrast object localization and removal in cone-beam CT , 2005, SPIE Medical Imaging.

[53]  Kai Mei,et al.  Reduction of Metal Artifact in Single Photon-Counting Computed Tomography by Spectral-Driven Iterative Reconstruction Technique , 2015, PloS one.

[54]  William R. Brody,et al.  Iterative convolution backprojection algorithms for image reconstruction from limited data , 1983 .

[55]  Marc Kachelrieß,et al.  Segmentation-free empirical beam hardening correction for CT. , 2015, Medical physics.

[56]  Lu Liu,et al.  Model-based Iterative Reconstruction: A Promising Algorithm for Today's Computed Tomography Imaging. , 2014, Journal of medical imaging and radiation sciences.

[57]  Joseph A. O'Sullivan,et al.  Alternating Minimization Algorithms for Transmission Tomography , 2007, IEEE Transactions on Medical Imaging.

[58]  J L Weese,et al.  Avoidance of artifacts on computerized tomograms by selection of appropriate surgical clips. , 1984, American journal of surgery.

[59]  J Sau,et al.  Streak artifact reduction in filtered backprojection using a level line-based interpolation method. , 2000, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[60]  Seemeen Karimi,et al.  Segmentation of artifacts and anatomy in CT metal artifact reduction. , 2012, Medical physics.

[61]  Mehran Yazdi,et al.  An adaptive approach to metal artifact reduction in helical computed tomography for radiation therapy treatment planning: experimental and clinical studies. , 2005, International journal of radiation oncology, biology, physics.

[62]  J. H. Brown,et al.  Reduction of aneurysm clip artifacts on CT angiograms: a technical note. , 1999, AJNR. American journal of neuroradiology.

[63]  Bruno De Man,et al.  Iterative reconstruction for reduction of metal artifacts in computed tomography , 2001 .

[64]  Takeo Kanade,et al.  Fast Streaking Artifact Reduction in CT Using Constrained Optimization in Metal Masks , 2004, MICCAI.

[65]  Johan Nuyts,et al.  Metal artifact reduction in computed tomography using local models in an image block-iterative scheme. , 2012, Medical physics.

[66]  In Sook Lee,et al.  A Pragmatic Protocol for Reduction in the Metal Artifact and Radiation Dose in Multislice Computed Tomography of the Spine: Cadaveric Evaluation after Cervical Pedicle Screw Placement , 2007, Journal of computer assisted tomography.

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

[68]  Sorapong Aootaphao,et al.  Penalized-likelihood reconstruction for metal artifact reduction in cone-beam CT , 2008, 2008 30th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[69]  G Henrich,et al.  A simple computational method for reducing streak artifacts in CT images. , 1980, Computerized tomography.

[70]  May Oehler,et al.  Statistical image reconstruction for inconsistent CT projection data. , 2007, Methods of information in medicine.

[71]  Hengyong Yu,et al.  A segmentation-based method for metal artifact reduction. , 2007, Academic radiology.

[72]  L. John Schreiner,et al.  Metal artifact suppression in megavoltage computed tomography , 2005, SPIE Medical Imaging.

[73]  Peter Maass,et al.  The interior Radon transform , 1992 .

[74]  Song Luo,et al.  Monoenergetic imaging of dual-energy CT reduces artifacts from implanted metal orthopedic devices in patients with factures. , 2011, Academic radiology.

[75]  Rebecca Fahrig,et al.  Metal artifact correction for x-ray computed tomography using kV and selective MV imaging. , 2014, Medical physics.

[76]  Jiang Hsieh,et al.  Computed Tomography: Principles, Design, Artifacts, and Recent Advances, Fourth Edition , 2022 .

[77]  Joel G Fletcher,et al.  Metal artifact suppression from reformatted projections in multislice helical CT using dual-front active contours. , 2010, Medical physics.

[78]  P. Rüegsegger,et al.  Computed Tomography Reconstruction from Hollow Projections: An Application to In Vivo Evaluation of Artificial Hip Joints , 1979, Journal of computer assisted tomography.

[79]  Joel G Fletcher,et al.  Metal Artifact Reduction From Reformatted Projections for Hip Prostheses in Multislice Helical Computed Tomography: Techniques and Initial Clinical Results , 2009, Investigative radiology.

[80]  Li Zhang,et al.  X-ray CT metal artifacts reduction through curvature based sinogram inpainting , 2006 .

[81]  Liang Li,et al.  A novel metal artifact reducing method for cone-beam CT based on three approximately orthogonal projections , 2013, Physics in medicine and biology.

[82]  K Engelke,et al.  CT of metal implants: reduction of artifacts using an extended CT scale technique. , 2000, Journal of computer assisted tomography.

[83]  Rainer Raupach,et al.  Empirical scatter correction (esc): A new CT scatter correction method and its application to metal artifact reduction , 2010, IEEE Nuclear Science Symposuim & Medical Imaging Conference.

[84]  Najla Megherbi Bouallagu,et al.  A novel intensity limiting approach to Metal Artefact Reduction in 3D CT baggage imagery , 2012, 2012 19th IEEE International Conference on Image Processing.

[85]  Gary H. Glover,et al.  An algorithm for the reduction of metal clip artifacts in CT reconstructions. , 1981 .

[86]  Andreas Rieder,et al.  Incomplete data problems in X-ray computerized tomography , 1989 .

[87]  Benoit Hamelin,et al.  Iterative CT reconstruction of real data with metal artifact reduction , 2008, 2008 5th IEEE International Symposium on Biomedical Imaging: From Nano to Macro.

[88]  J. Hsieh.  Adaptive streak artifact reduction in computed tomography resulting from excessive x-ray photon noise. , 1998, Medical physics.

[89]  Thorsten M. Buzug,et al.  Spurious structures created by interpolation-based CT metal artifact reduction , 2009, Medical Imaging.

[90]  R Nowotny,et al.  Helical and conventional CT in the imaging of metallic foreign bodies in the orbit. , 2000, Acta ophthalmologica Scandinavica.

[91]  Krishna Subramanyan,et al.  A radial adaptive filter for metal artifact reduction , 2005, SPIE Medical Imaging.

[92]  D Giantsoudi,et al.  MO-FG-CAMPUS-IeP2-05: Feasibility Demonstration of High-Voltage Clinical CT and Impact On X-Ray Penetration Through Metal Objects. , 2016, Medical physics.

[93]  Marcus Brehm,et al.  Moving metal artifact reduction in cone-beam CT scans with implanted cylindrical gold markers. , 2014, Medical physics.

[94]  Ibm Tj.  Using scout images to reduce metal artifacts in CT with application to revision total hip surgery , 2017 .

[95]  Claus Belka,et al.  Post-processing sets of tilted CT volumes as a method for metal artifact reduction , 2014, Radiation Oncology.

[96]  P. Knott,et al.  A comparison of magnetic and radiographic imaging artifact after using three types of metal rods: stainless steel, titanium, and vitallium. , 2010, The spine journal : official journal of the North American Spine Society.

[97]  W A Kalender,et al.  Metal Artifact Reduction for Clipping and Coiling in Interventional C-Arm CT , 2010, American Journal of Neuroradiology.

[98]  Zhiqiang Chen,et al.  Metal artifact reduction in dual energy CT by sinogram segmentation based on active contour model and TV inpainting , 2009, 2009 IEEE Nuclear Science Symposium Conference Record (NSS/MIC).

[99]  Ming Li,et al.  A prior-based metal artifact reduction algorithm for x-ray CT. , 2015, Journal of X-ray science and technology.

[100]  G. Hounsfield.  Computerized transverse axial scanning (tomography): Part I. Description of system. 1973. , 1973, The British journal of radiology.

[101]  Hamid Soltanian-Zadeh,et al.  CT artifact correction: an image-processing approach , 1996, Medical Imaging.

[102]  D. Fleischmann,et al.  Evaluation of two iterative techniques for reducing metal artifacts in computed tomography. , 2011, Radiology.

[103]  Lei Dong,et al.  Reducing metal artifacts in cone-beam CT images by preprocessing projection data. , 2007, International journal of radiation oncology, biology, physics.

[104]  A. Mamourian,et al.  Nonhelical Acquisition CT Angiogram after Aneurysmal Clipping: In Vitro Testing Shows Diminished Artifact , 2008, American Journal of Neuroradiology.

[105]  Jun Wang,et al.  Metal artifact reduction in CT using fusion based prior image. , 2013, Medical physics.

[106]  J. Verburg,et al.  CT metal artifact reduction method correcting for beam hardening and missing projections , 2012, Physics in medicine and biology.

[107]  W. Kalender,et al.  Reduction of CT artifacts caused by metallic implants. , 1987 .

[108]  S. Zhao,et al.  X-ray CT metal artifact reduction using wavelets: an application for imaging total hip prostheses , 2000, IEEE Transactions on Medical Imaging.

[109]  Jikun Wei,et al.  X-ray CT high-density artefact suppression in the presence of bones , 2004, Physics in medicine and biology.

[110]  H. Tuy.  A post-processing algorithm to reduce metallic clip artifacts in CT images , 1993, European Radiology.

[111]  John H. Healey,et al.  Carbon fiber intramedullary nails reduce artifact in postoperative advanced imaging , 2015, Skeletal Radiology.

[112]  Guang-Hong Chen,et al.  Prior image constrained compressed sensing (PICCS) , 2008, SPIE BiOS.

[113]  Andoni P. Toms,et al.  Reducing the effects of metal artefact using high keV monoenergetic reconstruction of dual energy CT (DECT) in hip replacements , 2013, Skeletal Radiology.

[114]  Yi-Fei Pu,et al.  A new CT metal artifacts reduction algorithm based on fractional-order sinogram inpainting. , 2011, Journal of X-ray science and technology.

[115]  Guang-Hong Chen,et al.  Reduction of metal artifacts using subtracted CT projection data , 2004, SPIE Optics + Photonics.

[116]  N. Ebraheim,et al.  Reduction of postoperative CT artifacts of pelvic fractures by use of titanium implants. , 1990, Orthopedics.

[117]  Sana Boudabbous,et al.  Model-Based Iterative Reconstruction (MBIR) for the Reduction of Metal Artifacts on CT. , 2015, AJR. American journal of roentgenology.

[118]  Jerry L. Prince,et al.  Model-Based Tomographic Reconstruction of Objects Containing Known Components , 2012, IEEE Transactions on Medical Imaging.

[119]  Ja-Young Choi,et al.  Metal Artifact Reduction by the Alteration of Technical Factors in Multidetector Computed Tomography: A 3-Dimensional Quantitative Assessment , 2008, Journal of computer assisted tomography.

[120]  Habib Zaidi,et al.  X-ray CT Metal Artifact Reduction Using Wavelet Domain $L_{0}$ Sparse Regularization , 2013, IEEE Transactions on Medical Imaging.

[121]  Jacob Geleijns,et al.  Metal artifact reduction for CT: development, implementation, and clinical comparison of a generic and a scanner-specific technique. , 2012, Medical physics.

[122]  E. Fishman,et al.  Evaluation of CT techniques for reducing artifacts in the presence of metallic orthopedic implants. , 1988, Journal of computer assisted tomography.

[123]  Joseph A. O'Sullivan,et al.  Pose estimation of known objects during transmission tomographic image reconstruction , 2006, IEEE Transactions on Medical Imaging.

[124]  Andoni P Toms,et al.  CT metal artefact reduction of total knee prostheses using angled gantry multiplanar reformation. , 2010, The Knee.

[125]  Joseph A. O'Sullivan,et al.  Iterative deblurring for CT metal artifact reduction , 1996, IEEE Trans. Medical Imaging.

[126]  Stephen M. Smith,et al.  Metal artifact reduction for CT based on sinusoidal description , 2005 .

[127]  K Freeman,et al.  CT scans through metal scanning technique versus hardware composition. , 1994, Computerized medical imaging and graphics : the official journal of the Computerized Medical Imaging Society.

[128]  Konstantin Nikolaou,et al.  Metal artifact reduction by dual energy computed tomography using monoenergetic extrapolation , 2011, European Radiology.