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Metal artifact reduction in ultra-high-resolution cone-beam CT imaging with a twin robotic X-ray system

Cone-beam computed tomography (CBCT) has been shown to be a powerful tool for 3D imaging of the appendicular skeleton, allowing for detailed visualization of bone microarchitecture. This study was designed to compare artifacts in the presence of osteosynthetic implants between CBCT and multidetector...

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Autores principales: Kunz, Andreas Steven, Patzer, Theresa Sophie, Grunz, Jan-Peter, Luetkens, Karsten Sebastian, Hartung, Viktor, Hendel, Robin, Fieber, Tabea, Genest, Franca, Ergün, Süleyman, Bley, Thorsten Alexander, Huflage, Henner
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9481547/
https://www.ncbi.nlm.nih.gov/pubmed/36114270
http://dx.doi.org/10.1038/s41598-022-19978-9
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author Kunz, Andreas Steven
Patzer, Theresa Sophie
Grunz, Jan-Peter
Luetkens, Karsten Sebastian
Hartung, Viktor
Hendel, Robin
Fieber, Tabea
Genest, Franca
Ergün, Süleyman
Bley, Thorsten Alexander
Huflage, Henner
author_facet Kunz, Andreas Steven
Patzer, Theresa Sophie
Grunz, Jan-Peter
Luetkens, Karsten Sebastian
Hartung, Viktor
Hendel, Robin
Fieber, Tabea
Genest, Franca
Ergün, Süleyman
Bley, Thorsten Alexander
Huflage, Henner
author_sort Kunz, Andreas Steven
collection PubMed
description Cone-beam computed tomography (CBCT) has been shown to be a powerful tool for 3D imaging of the appendicular skeleton, allowing for detailed visualization of bone microarchitecture. This study was designed to compare artifacts in the presence of osteosynthetic implants between CBCT and multidetector computed tomography (MDCT) in cadaveric wrist scans. A total of 32 scan protocols with varying tube potential and current were employed: both conventional CBCT and MDCT studies were included with tube voltage ranging from 60 to 140 kVp as well as additional MDCT protocols with dedicated spectral shaping via tin prefiltration. Irrespective of scanner type, all examinations were conducted in ultra-high-resolution (UHR) scan mode. For reconstruction of UHR-CBCT scans an additional iterative metal artifact reduction algorithm was employed, an image correction tool which cannot be used in combination with UHR-MDCT. To compare applied radiation doses between both scanners, the volume computed tomography dose index for a 16 cm phantom (CTDI(vol)) was evaluated. Images were assessed regarding subjective and objective image quality. Without automatic tube current modulation or tube potential control, radiation doses ranged between 1.3 mGy (with 70 kVp and 50.0 effective mAs) and 75.2 mGy (with 140 kVp and 383.0 effective mAs) in UHR-MDCT. Using the pulsed image acquisition method of the CBCT scanner, CTDI(vol) ranged between 2.3 mGy (with 60 kVp and 0.6 mean mAs per pulse) and 61.0 mGy (with 133 kVp and 2.5 mean mAs per pulse). In essence, all UHR-CBCT protocols employing a tube potential of 80 kVp or more were found to provide superior overall image quality and artifact reduction compared to UHR-MDCT (all p < .050). Interrater reliability of seven radiologists regarding image quality was substantial for tissue assessment and moderate for artifact assessment with Fleiss kappa of 0.652 (95% confidence interval 0.618–0.686; p < 0.001) and 0.570 (95% confidence interval 0.535–0.606; p < 0.001), respectively. Our results demonstrate that the UHR-CBCT scan mode of a twin robotic X-ray system facilitates excellent visualization of the appendicular skeleton in the presence of metal implants. Achievable image quality and artifact reduction are superior to dose-comparable UHR-MDCT and even MDCT protocols employing spectral shaping with tin prefiltration do not achieve the same level of artifact reduction in adjacent soft tissue.
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spelling pubmed-94815472022-09-18 Metal artifact reduction in ultra-high-resolution cone-beam CT imaging with a twin robotic X-ray system Kunz, Andreas Steven Patzer, Theresa Sophie Grunz, Jan-Peter Luetkens, Karsten Sebastian Hartung, Viktor Hendel, Robin Fieber, Tabea Genest, Franca Ergün, Süleyman Bley, Thorsten Alexander Huflage, Henner Sci Rep Article Cone-beam computed tomography (CBCT) has been shown to be a powerful tool for 3D imaging of the appendicular skeleton, allowing for detailed visualization of bone microarchitecture. This study was designed to compare artifacts in the presence of osteosynthetic implants between CBCT and multidetector computed tomography (MDCT) in cadaveric wrist scans. A total of 32 scan protocols with varying tube potential and current were employed: both conventional CBCT and MDCT studies were included with tube voltage ranging from 60 to 140 kVp as well as additional MDCT protocols with dedicated spectral shaping via tin prefiltration. Irrespective of scanner type, all examinations were conducted in ultra-high-resolution (UHR) scan mode. For reconstruction of UHR-CBCT scans an additional iterative metal artifact reduction algorithm was employed, an image correction tool which cannot be used in combination with UHR-MDCT. To compare applied radiation doses between both scanners, the volume computed tomography dose index for a 16 cm phantom (CTDI(vol)) was evaluated. Images were assessed regarding subjective and objective image quality. Without automatic tube current modulation or tube potential control, radiation doses ranged between 1.3 mGy (with 70 kVp and 50.0 effective mAs) and 75.2 mGy (with 140 kVp and 383.0 effective mAs) in UHR-MDCT. Using the pulsed image acquisition method of the CBCT scanner, CTDI(vol) ranged between 2.3 mGy (with 60 kVp and 0.6 mean mAs per pulse) and 61.0 mGy (with 133 kVp and 2.5 mean mAs per pulse). In essence, all UHR-CBCT protocols employing a tube potential of 80 kVp or more were found to provide superior overall image quality and artifact reduction compared to UHR-MDCT (all p < .050). Interrater reliability of seven radiologists regarding image quality was substantial for tissue assessment and moderate for artifact assessment with Fleiss kappa of 0.652 (95% confidence interval 0.618–0.686; p < 0.001) and 0.570 (95% confidence interval 0.535–0.606; p < 0.001), respectively. Our results demonstrate that the UHR-CBCT scan mode of a twin robotic X-ray system facilitates excellent visualization of the appendicular skeleton in the presence of metal implants. Achievable image quality and artifact reduction are superior to dose-comparable UHR-MDCT and even MDCT protocols employing spectral shaping with tin prefiltration do not achieve the same level of artifact reduction in adjacent soft tissue. Nature Publishing Group UK 2022-09-16 /pmc/articles/PMC9481547/ /pubmed/36114270 http://dx.doi.org/10.1038/s41598-022-19978-9 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Kunz, Andreas Steven
Patzer, Theresa Sophie
Grunz, Jan-Peter
Luetkens, Karsten Sebastian
Hartung, Viktor
Hendel, Robin
Fieber, Tabea
Genest, Franca
Ergün, Süleyman
Bley, Thorsten Alexander
Huflage, Henner
Metal artifact reduction in ultra-high-resolution cone-beam CT imaging with a twin robotic X-ray system
title Metal artifact reduction in ultra-high-resolution cone-beam CT imaging with a twin robotic X-ray system
title_full Metal artifact reduction in ultra-high-resolution cone-beam CT imaging with a twin robotic X-ray system
title_fullStr Metal artifact reduction in ultra-high-resolution cone-beam CT imaging with a twin robotic X-ray system
title_full_unstemmed Metal artifact reduction in ultra-high-resolution cone-beam CT imaging with a twin robotic X-ray system
title_short Metal artifact reduction in ultra-high-resolution cone-beam CT imaging with a twin robotic X-ray system
title_sort metal artifact reduction in ultra-high-resolution cone-beam ct imaging with a twin robotic x-ray system
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9481547/
https://www.ncbi.nlm.nih.gov/pubmed/36114270
http://dx.doi.org/10.1038/s41598-022-19978-9
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