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Skeletal Radiology

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Open Access 07-10-2023 | Computed Tomography | Scientific Article

Superior metal artifact reduction of tin-filtered low-dose CT in imaging of lumbar spinal instrumentation compared to conventional computed tomography

Authors: Christoph Stern, Florian Wanivenhaus, Andrea B. Rosskopf, Mazda Farshad, Reto Sutter

Published in: Skeletal Radiology | Issue 4/2024

Abstract

Objective

To compare the image quality of low-dose CT (LD-CT) with tin filtration of the lumbar spine after metal implants to standard clinical CT, and to evaluate the potential for metal artifact and dose reduction.

Materials and methods

CT protocols were optimized in a cadaver torso. Seventy-four prospectively included patients with metallic lumbar implants were scanned with both standard CT (120 kV) and tin-filtered LD-CT (Sn140kV). CT dose parameters and qualitative measures (1 = worst,4 = best) were compared. Quantitative measures included noise, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and the width and attenuation of the most prominent hypodense metal artifact. Standard CT and LD-CT were assessed for imaging findings.

Results

Tin-filtered LD-CT was performed with 60% dose saving compared to standard CT (median effective dose 3.22 mSv (quartile 1–3: 2.73–3.49 mSv) versus 8.02 mSv (6.42–9.27 mSv; p < .001). Image quality of CT and tin-filtered low-dose CT was good with excellent depiction of anatomy, while image noise was lower for CT and artifacts were weaker for tin-filtered LD-CT. Quantitative measures also revealed increased noise for tin-filtered low-dose CT (41.5HU), lower SNR (2) and CNR (0.6) compared to CT (32HU,3.55,1.03, respectively) (all p < .001). However, tin-filtered LD-CT performed superior regarding the width and attenuation of hypodense metal artifacts (2.9 mm and -767.5HU for LD-CT vs. 4.1 mm and -937HU for CT; all p < .001). No difference between methods was observed in detection of imaging findings.

Conclusion

Tin-filtered LD-CT with 60% dose saving performs comparable to standard CT in detection of pathology and surgery related complications after lumbar spinal instrumentation, and shows superior metal artifact reduction.

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Title: Superior metal artifact reduction of tin-filtered low-dose CT in imaging of lumbar spinal instrumentation compared to conventional computed tomography
Authors: Christoph Stern
Florian Wanivenhaus
Andrea B. Rosskopf
Mazda Farshad
Reto Sutter
Publication date: 07-10-2023
Publisher: Springer Berlin Heidelberg
Keywords: Computed Tomography
Computed Tomography
Published in: Skeletal Radiology / Issue 4/2024
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI: https://doi.org/10.1007/s00256-023-04467-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Superior metal artifact reduction of tin-filtered low-dose CT in imaging of lumbar spinal instrumentation compared to conventional computed tomography

Abstract

Objective

Materials and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Materials and methods

Results

Conclusion

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