Evaluation of Orthopedic Metal Artifact Reduction Application in Three-Dimensional Computed Tomography Reconstruction of Spinal Instrumentation: A Single Saudi Center Experience

Ali, Amir Monir

doi:10.4103/jcis.jcis_92_17

Cited by 5 publications

(5 citation statements)

References 23 publications

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“…28 For CT, the metal artefact suppress algorithm “O-MAR” (metal artefact reduction algorithm for orthopaedic implants) provided by Philips was used. 29,30 Patients was stratified in 4 categories according to MRI findings (depending on maximal dimension of joint effusion and type of effusion or presence of ALTR) and similarly according to CT findings (depending on dimension and location of lytic lesions) (Tables 2 and 3). Joint affusion and ALTR were investigated with sonography and MRI, whilst lytic lesions were investigated by conventional plain radiographs, CT and MRI.…”

Section: Methodsmentioning

confidence: 99%

15-year follow-up of MoM 36-mm THA: clinical, laboratory, and radiological (CT and MRI) prospective assessment

et al. 2020

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Introduction: There is limited knowledge of the long-term results of metal-on-metal total hip arthroplasty (MoM THA), particularly concerning adverse local tissue reaction (ALTR), Co/Cr ions level and revision rate. Even if MoM bearing surfaces are no longer used, long-term data could help in defining the course and best management for these patients. The purpose of this study is to investigate the clinical outcomes, describe radiological findings including CT metal artefact reduction algorithm for orthopaedic implants (O-MAR) and MRI multi acquisition variable resonance image combination (MAVRIC) in 36-mm MoM THA. Methods: In this long-term prospective study, 46 consecutive patients with primary MoM THA (mono- or bilateral) were enrolled between 2004 and 2005. Pinnacle acetabular cup, Summit cementless stem with 36-mm metal head and Ultamet CoCr alloy liner (Depuy Inc.) were implanted, in the same centre by the same senior surgeon. Patients were reviewed at 5-, 10- and 15-years, including Co/Cr levels and standard radiographs at every follow-up, whilst the 15-year follow-up included hip sonography, MRI MAVRIC and CT O-MAR. Results: At 15 years, the overall survival rate of the implants (both stems and cups) was 83% (30/36). Revisions were performed in 9% (4/46) because of ALTR, 2% (1/46) septic loosening and 2% periprosthetic fracture. Both Cr and Co concentration increased over time, even though remaining at low level risk at 15 years: Co from 0.11 (+/– 0.18) to 4.29 (+/– 3.26) and Cr from 0.38 (+/– 0.32) to 1.37 (+/– 1.15). Functional scores in non-revised patients showed good to excellent results in more than 90%. Engh-score correlated with time from surgery ( p = 0.017) and with sonographic, CT and RM findings ( p < 0.05). Concordance has been found between CT and MRI findings (sign-rank test, p = 0.241; Intraclass Correlation Coefficients 0.987); however, no specific MRI or CT lesion patterns could be recognised among symptomatic and non-symptomatic patients. Discussion: The long-term rate of ALTR after 36-mm MoM THA was comparable with previous studies; a regular follow-up for those implants is mandatory. During follow-up Co-Cr levels increased over time and radiography was a suitable screening technique; the Engh score in particular, proved to be a reliable assessment tool. CT O-MAR and MRI with MAVRIC protocols may add valuable data in clinical practice, although MRI is significantly more efficient than CT in the identification of ALTR lesions, peri-articular effusion and in the evaluation of soft tissues.

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Section: Methodsmentioning

confidence: 99%

15-year follow-up of MoM 36-mm THA: clinical, laboratory, and radiological (CT and MRI) prospective assessment

et al. 2020

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Section: Introductionmentioning

confidence: 99%

“…The image artifacts created by high-density prostheses in the field of view of a CT scanner are due to four main factors, namely: beam hardening [4,5], scatter, noise [2,6] and photon starvation [4]. Beam hardening occurs because low-energy photons are attenuated to a greater degree than high-energy photons when passing through high-density scanned materials [4,5]. Poisson noise is caused by statistical errors of low photon counts which result in random, thin, bright, and dark streaks that appear in the direction of greatest attenuation [8].…”

Section: Introductionmentioning

confidence: 99%

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Comparing film measurements and Monte Carlo simulations of dose delivered in a pelvic phantom with titanium hip prosthesis

Dumela,

Oderinde,

Usman

2023

J. Phys.: Conf. Ser.

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An increasing number of elderly prostate cancer patients with high-density material hip prostheses are referred for external beam Radiotherapy (EBRT). Radiation treatment of pelvis cancer patients with high-density hip prostheses needs special attention due to the artifacts created in the computed tomography (CT) field of view and the radiotherapy dosimetry challenges. This study investigated the pelvic prostate point dose with and without titanium hip prosthesis using a 0.6 cc PTW Farmer ionization chamber, EBT3 Gafchromic films, compared with the EGSnrc Monte Carlo (MC) simulation dose distribution. The doses were measured and simulated in a locally made pelvic phantom. MC and measured doses were compared with the Treatment Planning System (TPS) calculated prostate point dose. The ionization chamber, EBT3 Gafchromic films, and MC doses have a maximum deviation of 6.3 %, 5.7 %, and 7.4 % for 6 MV and 4.2 %, 4.7 %, and 5.5 % for 15 MV photon beam, respectively, when compared with TPS calculated dose. There is a significant difference between the prostate point dose measured with ionization chamber, EBT3 Gafchromic film in comparison MC simulated doses. The MC simulation dose shows the highest deviation especially on the lateral field passing through the prosthesis.

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“…Several commercialized MAR techniques have been developed to overcome various types of metal artifacts. The techniques include single-energy metal artifact reduction (SEMAR) by Canon Medical Systems [6,7], metal artifact reduction software (MARS) and smart metal artifact reduction software (Smart-MAR) by GE Medical Systems [8][9][10], iterative metal artifact reduction (IMAR) by Siemens Healthcare [11][12][13], and metal artifact reduction for orthopedic implants (OMAR) by Philips [14,15]. It has been clinically verified that these techniques can effectively reduce metal artifacts in a CT scan, improve image quality and diagnostic value, and even improve treatment planning of radiation therapy [16].…”

Section: Introductionmentioning

confidence: 99%

Comparison of quantitative measurements of four manufacturer’s metal artifact reduction techniques for CT imaging with a self-made acrylic phantom

Chou

Chi

Lin

et al. 2020

THC

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BACKGROUND: Metal artifact reduction (MAR) techniques can improve metal artifacts of computed tomography (CT) images. OBJECTIVE: This work focused on conducting a quantitative analysis to compare the effectiveness of four commercial MAR techniques on three types of metal implants (hip implant, spinal implant, and dental filling) with a self-made acrylic phantom. METHODS: A cylindrical phantom was made from acrylic with a groove in the middle, and then three types of metal implants were placed in the groove. The phantom was scanned by four CT scanners and four commercialized MAR techniques were used to analyze the images. The techniques used were single-energy metal artifact reduction (SEMAR, Canon), smart metal artifact reduction software (Smart-MAR, GE), iterative metal artifact reduction (IMAR, Siemens), and metal artifact reduction for orthopedic implants (OMAR, Philips). Quantitative analysis methods included objective and subjective analysis. RESULTS: The expected value of SEMAR, Smart-MAR, IMAR, and OMAR were 36.6, 37.8, 5.0, and 2.3, respectively. SEMAR and Smart-MAR achieved optimal results. CONCLUSION: This study successfully evaluated the effects of four commercial MAR techniques on three types of metal implants in a phantom. All MAR techniques effectively reduced metal artifacts, but the effect was not significant with dental fillings due to high-density material.

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Evaluation of Orthopedic Metal Artifact Reduction Application in Three-Dimensional Computed Tomography Reconstruction of Spinal Instrumentation: A Single Saudi Center Experience

Cited by 5 publications

References 23 publications

15-year follow-up of MoM 36-mm THA: clinical, laboratory, and radiological (CT and MRI) prospective assessment

15-year follow-up of MoM 36-mm THA: clinical, laboratory, and radiological (CT and MRI) prospective assessment

Comparing film measurements and Monte Carlo simulations of dose delivered in a pelvic phantom with titanium hip prosthesis

Comparison of quantitative measurements of four manufacturer’s metal artifact reduction techniques for CT imaging with a self-made acrylic phantom

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