Metal artifact reduction for flat panel detector intravenous CT angiography in patients with intracranial metallic implants after endovascular and surgical treatment

Pjontek, Rastislav; Önenköprülü, Belgin; Scholz, Bernhard; Kyriakou, Yiannis; Schubert, Gerrit Alexander; Nikoubashman, Omid; Othman, Ahmed E.; Wiesmann, Martin; Brockmann, Marc A.

doi:10.1136/neurintsurg-2015-011787

Cited by 30 publications

(25 citation statements)

References 34 publications

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“…Previous studies that used other MAR algorithms to evaluate intracranial metallic implants on CTA or flat-panel detector CT images observed significant improvement in the interpretation of surrounding structures. 10 11 12 13 Prell et al 10 found improved brain tissue modeling and implant visibility using an interpolation-based 3D correction algorithm for MAR; that algorithm was further modified by Psychogios et al, 11 who achieved a significant reduction of artifacts around metallic implants and improved delineation of the surrounding structures.…”

Section: Discussionmentioning

confidence: 99%

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Metal Artifact Reduction for Orthopedic Implants: Brain CT Angiography in Patients with Intracranial Metallic Implants

et al. 2018

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BackgroundThe purpose of this study was to qualitatively and quantitatively evaluate the effects of a metal artifact reduction for orthopedic implants (O-MAR) for brain computed tomographic angiography (CTA) in patients with aneurysm clips and coils.MethodsThe study included 36 consecutive patients with 47 intracranial metallic implants (42 aneurysm clips, 5 coils) who underwent brain CTA. The computed tomographic images with and without the O-MAR were independently reviewed both quantitatively and qualitatively by two reviewers. For quantitative analysis, image noises near the metallic implants of non-O-MAR and O-MAR images were compared. For qualitative analysis, image quality improvement and the presence of new streak artifacts were assessed.ResultsImage noise was significantly reduced near metallic implants (P < 0.01). Improvement of implant-induced streak artifacts was observed in eight objects (17.0%). However, streak artifacts were aggravated in 11 objects (23.4%), and adjacent vessel depiction was worsened in eight objects (17.0%). In addition, new O-MAR-related streak artifacts were observed in 32 objects (68.1%). New streak artifacts were more prevalent in cases with overlapping metallic implants on the same axial plane than in those without (P = 0.018). Qualitative assessment revealed that the overall image quality was not significantly improved in O-MAR images.ConclusionIn conclusion, the use of the O-MAR in patients with metallic implants significantly reduces image noise. However, the degree of the streak artifacts and surrounding vessel depiction were not significantly improved on O-MAR images.

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Section: Discussionmentioning

confidence: 99%

“… 8 9 Several studies have found that metal artifact reduction (MAR) is useful for CTA or flat-panel detector CT in patients with intracranial metallic implants. 10 11 12 13 …”

Section: Introductionmentioning

confidence: 99%

Metal Artifact Reduction for Orthopedic Implants: Brain CT Angiography in Patients with Intracranial Metallic Implants

et al. 2018

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“…They found that metal artefact severity was reduced in high-keV images across changes in the metal artefact types [11]. Other study done by Pjontek et al (2015) found that contrast media and metal artefact reduction software (MARS) in angiographic CT is significantly improves image quality in patient after coiling or clipping [12]. Saake et al (2012) use intravenous contrast media in angiographic CT follow-up imaging of intracranial flow diverting device.…”

Section: Introductionmentioning

confidence: 99%

“…However, the limitations are most of the techniques do not remove all sources of streaking artefacts, cause loss of spatial resolution in images and introduce the secondary artefacts that may lead to misinterpretation [8][9][10]. Other than reconstruction technique, the use of contrast media is also proposed as metal artefact reduction technique [11][12][13]. Contrast media are a group of medical drugs used to improve the visibility of internal organs and structures in imaging techniques.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of efficacy of metal artefact reduction technique using contrast media in Computed Tomography

Yusob

Zukhi

Tajuddin

et al. 2017

J. Phys.: Conf. Ser.

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Abstract. The aim of this study was to evaluate the efficacy of metal artefact reduction using contrasts media in Computed Tomography (CT) imaging. A water-based abdomen phantom of diameter 32 cm (adult body size) was fabricated using polymethyl methacrylate (PMMA) material. Three different contrast agents (iodine, barium and gadolinium) were filled in small PMMA tubes and placed inside a water-based PMMA adult abdomen phantom. The orthopedic metal screw was placed in each small PMMA tube separately. These two types of orthopedic metal screw (stainless steel and titanium alloy) were scanned separately. The orthopedic metal crews were scanned with single-energy CT at 120 kV and dual-energy CT at fast kV-switching between 80 kV and 140 kV. The scan modes were set automatically using the current modulation care4Dose setting and the scans were set at different pitch and slice thickness. The use of the contrast media technique on orthopedic metal screws were optimised by using pitch = 0.60 mm, and slice thickness = 5.0 mm. The use contrast media can reduce the metal streaking artefacts on CT image, enhance the CT images surrounding the implants, and it has potential use in improving diagnostic performance in patients with severe metallic artefacts. These results are valuable for imaging protocol optimisation in clinical applications.

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“…Recent improvements in metal artifact reduction algorithms (MARA) led to a significant improvement in image appearance and post-interventional evaluation [2–5]. Previous studies have shown that application of a dedicated MARA in post-interventional FDCTA improves evaluation of aneurysm reperfusion, parent vessels and small vessels in the level of the implant as well as adjacent brain tissue [6].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of an optimized metal artifact reduction algorithm for flat-detector angiography compared to DSA imaging in follow-up after neurovascular procedures

et al. 2019

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Background Flat detector CT – angiography (FDCTA) has become a valuable imaging tool in post- and peri-interventional imaging after neurovascular procedures. Metal artifacts produced by radiopaque implants like clips or coils still impair image quality. Methods FDCTA was performed in periprocedural or follow-up imaging of 21 patients, who had received neurovascular treatment. Raw data was sent to a dedicated workstation and subsequently a metal artifact reduction algorithm (MARA) was applied. Two neuroradiologists examined the images. Results Application of MARA improved image appearance and led to a significant reduction of metal artifacts. After application of MARA only 8 datasets (34% of the images) were rated as having many or extensive artifacts, before MARA 15 (65%) of the images had extensive or many artifacts. Twenty percent more cases of reperfusion were diagnosed after application of MARA, congruent to the results of digital subtraction angiography (DSA) imaging. Also 3 (13% of datasets) images, which could not be evaluated before application of MARA, could be analyzed after metal artifact reduction and reperfusion could be excluded. Conclusion Application of MARA improved image evaluation, reduced the extent of metal artifacts, and more cases of reperfusion could be detected or excluded, congruent to DSA imaging.

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Metal artifact reduction for flat panel detector intravenous CT angiography in patients with intracranial metallic implants after endovascular and surgical treatment

Cited by 30 publications

References 34 publications

Metal Artifact Reduction for Orthopedic Implants: Brain CT Angiography in Patients with Intracranial Metallic Implants

Metal Artifact Reduction for Orthopedic Implants: Brain CT Angiography in Patients with Intracranial Metallic Implants

Evaluation of efficacy of metal artefact reduction technique using contrast media in Computed Tomography

Evaluation of an optimized metal artifact reduction algorithm for flat-detector angiography compared to DSA imaging in follow-up after neurovascular procedures

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