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Published in: Neuroradiology 7/2013

01-07-2013 | Diagnostic Neuroradiology

Impact of a new metal artefact reduction algorithm in the noninvasive follow-up of intracranial clips, coils, and stents with flat-panel angiographic CTA: initial results

Authors: Marios-Nikos Psychogios, Bernhard Scholz, Christopher Rohkohl, Yiannis Kyriakou, Alexander Mohr, Peter Schramm, Dorothee Wachter, Katrin Wasser, Michael Knauth

Published in: Neuroradiology | Issue 7/2013

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Abstract

Introduction

Flat-panel angiographic CT after intravenous contrast agent application (ivACT) is increasingly used as a follow-up examination after coiling, clipping, or stenting. The purpose of this study was to evaluate the feasibility of a new metal artefact reduction algorithm (MARA) in patients treated for intracranial aneurysms and stenosis.

Methods

IvACT was performed on a flat-panel detector angiography system after intravenous application of 80 ml contrast media. The uncorrected raw images were transferred to a prototype reconstruction workstation where the MARA was applied. Two experienced neuroradiologists examined the corrected and uncorrected images on a commercially available workstation.

Results

Artefacts around the implants were detected in all 16 uncorrected cases, while eight cases showed remaining artefacts after correction with the MARA. In the cases without correction, there were 11 cases with “extensive” artefacts and five cases with “many” artefacts. After correction, seven cases showed “few” and only one case “many” artefacts (Wilcoxon test, P < 0.001). Parent vessels were characterized as “not identifiable” in 62 % of uncorrected images, while the delineation of parent vessels were classified as “excellent” in 50 % of the cases after correction (Wilcoxon test, P = 0.001).

Conclusions

Use of the MARA in our study significantly reduced artefacts around metallic implants on ivACT images and allowed for the delineation of surrounding structures.
Literature
1.
go back to reference Doelken M, Struffert T, Richter G, Engelhorn T, Nimsky C, Ganslandt O, Hammen T, Doerfler A (2008) Flat-panel detector volumetric CT for visualization of subarachnoid hemorrhage and ventricles: preliminary results compared to conventional CT. Neuroradiology 50:517–523PubMedCrossRef Doelken M, Struffert T, Richter G, Engelhorn T, Nimsky C, Ganslandt O, Hammen T, Doerfler A (2008) Flat-panel detector volumetric CT for visualization of subarachnoid hemorrhage and ventricles: preliminary results compared to conventional CT. Neuroradiology 50:517–523PubMedCrossRef
2.
go back to reference Soderman M, Babic D, Holmin S, Andersson T (2008) Brain imaging with a flat detector C-arm: technique and clinical interest of XperCT. Neuroradiology 50:863–868PubMedCrossRef Soderman M, Babic D, Holmin S, Andersson T (2008) Brain imaging with a flat detector C-arm: technique and clinical interest of XperCT. Neuroradiology 50:863–868PubMedCrossRef
3.
go back to reference Psychogios MN, Buhk JH, Schramm P, Xyda A, Mohr A, Knauth M (2010) Feasibility of angiographic CT in peri-interventional diagnostic imaging: a comparative study with multidetector CT. AJNR 31:1226–1231PubMedCrossRef Psychogios MN, Buhk JH, Schramm P, Xyda A, Mohr A, Knauth M (2010) Feasibility of angiographic CT in peri-interventional diagnostic imaging: a comparative study with multidetector CT. AJNR 31:1226–1231PubMedCrossRef
4.
go back to reference Buhk JH, Lingor P, Knauth M (2008) Angiographic CT with intravenous administration of contrast medium is a noninvasive option for follow-up after intracranial stenting. Neuroradiology 50:349–354PubMedCrossRef Buhk JH, Lingor P, Knauth M (2008) Angiographic CT with intravenous administration of contrast medium is a noninvasive option for follow-up after intracranial stenting. Neuroradiology 50:349–354PubMedCrossRef
5.
go back to reference Psychogios MN, Schramm P, Buhk JH, Xyda A, Groschel K, Jung K, Knauth M (2010) Angiographic CT after intravenous contrast agent application: a noninvasive follow-up tool after intracranial angioplasty and stenting. AJNR 31:1886–1891PubMedCrossRef Psychogios MN, Schramm P, Buhk JH, Xyda A, Groschel K, Jung K, Knauth M (2010) Angiographic CT after intravenous contrast agent application: a noninvasive follow-up tool after intracranial angioplasty and stenting. AJNR 31:1886–1891PubMedCrossRef
6.
go back to reference Struffert T, Kloska S, Engelhorn T, Deuerling-Zheng Y, Ott S, Doelken M, Saake M, Kohrmann M, Doerfler A (2011) Optimized intravenous flat detector CT for non-invasive visualization of intracranial stents: first results. Eur Radiol 21:411–418PubMedCrossRef Struffert T, Kloska S, Engelhorn T, Deuerling-Zheng Y, Ott S, Doelken M, Saake M, Kohrmann M, Doerfler A (2011) Optimized intravenous flat detector CT for non-invasive visualization of intracranial stents: first results. Eur Radiol 21:411–418PubMedCrossRef
7.
go back to reference Psychogios MN, Wachter D, Mohr A, Schramm P, Frolich AM, Jung K, Rohde V, Knauth M (2011) Feasibility of flat panel angiographic CT after intravenous contrast agent application in the postoperative evaluation of patients with clipped aneurysms. AJNR 32:1956–1962PubMedCrossRef Psychogios MN, Wachter D, Mohr A, Schramm P, Frolich AM, Jung K, Rohde V, Knauth M (2011) Feasibility of flat panel angiographic CT after intravenous contrast agent application in the postoperative evaluation of patients with clipped aneurysms. AJNR 32:1956–1962PubMedCrossRef
8.
go back to reference Clarencon F, Piotin M, Pistocchi S, Babic D, Blanc R (2012) Evaluation of stent visibility by flat panel detector CT in patients treated for intracranial aneurysms. Neuroradiology 54:1121–1125PubMedCrossRef Clarencon F, Piotin M, Pistocchi S, Babic D, Blanc R (2012) Evaluation of stent visibility by flat panel detector CT in patients treated for intracranial aneurysms. Neuroradiology 54:1121–1125PubMedCrossRef
9.
go back to reference Prell D, Kyriakou Y, Struffert T, Dorfler A, Kalender WA (2010) Metal artifact reduction for clipping and coiling in interventional C-arm CT. AJNR 31:634–639PubMedCrossRef Prell D, Kyriakou Y, Struffert T, Dorfler A, Kalender WA (2010) Metal artifact reduction for clipping and coiling in interventional C-arm CT. AJNR 31:634–639PubMedCrossRef
10.
go back to reference Meyer E, Raupach R, Lell M, Schmidt B, Kachelriess M (2010) Normalized metal artifact reduction (NMAR) in computed tomography. Med Phys 37:5482–5493PubMedCrossRef Meyer E, Raupach R, Lell M, Schmidt B, Kachelriess M (2010) Normalized metal artifact reduction (NMAR) in computed tomography. Med Phys 37:5482–5493PubMedCrossRef
11.
go back to reference Kyriakou Y, Struffert T, Dorfler A, Kalender WA (2009) Basic principles of flat detector computed tomography (FD-CT). Radiologe 49:811–819PubMedCrossRef Kyriakou Y, Struffert T, Dorfler A, Kalender WA (2009) Basic principles of flat detector computed tomography (FD-CT). Radiologe 49:811–819PubMedCrossRef
12.
go back to reference Mordasini P, El-Koussy M, Brekenfeld C, Schroth G, Fischer U, Beck J, Gralla J (2012) Applicability of tableside flat panel detector CT parenchymal cerebral blood volume measurement in neurovascular interventions: preliminary clinical experience. AJNR 33:154–158PubMedCrossRef Mordasini P, El-Koussy M, Brekenfeld C, Schroth G, Fischer U, Beck J, Gralla J (2012) Applicability of tableside flat panel detector CT parenchymal cerebral blood volume measurement in neurovascular interventions: preliminary clinical experience. AJNR 33:154–158PubMedCrossRef
13.
go back to reference Saake M, Struffert T, Goelitz P, Ott S, Seifert F, Ganslandt O, Doerfler A (2012) Angiographic CT with intravenous contrast agent application for monitoring of intracranial flow diverting stents. Neuroradiology 54:727–735PubMedCrossRef Saake M, Struffert T, Goelitz P, Ott S, Seifert F, Ganslandt O, Doerfler A (2012) Angiographic CT with intravenous contrast agent application for monitoring of intracranial flow diverting stents. Neuroradiology 54:727–735PubMedCrossRef
14.
go back to reference Dehdashti AR, Binaghi S, Uske A, Regli L (2006) Comparison of multislice computerized tomography angiography and digital subtraction angiography in the postoperative evaluation of patients with clipped aneurysms. J Neurosurg 104:395–403PubMedCrossRef Dehdashti AR, Binaghi S, Uske A, Regli L (2006) Comparison of multislice computerized tomography angiography and digital subtraction angiography in the postoperative evaluation of patients with clipped aneurysms. J Neurosurg 104:395–403PubMedCrossRef
Metadata
Title
Impact of a new metal artefact reduction algorithm in the noninvasive follow-up of intracranial clips, coils, and stents with flat-panel angiographic CTA: initial results
Authors
Marios-Nikos Psychogios
Bernhard Scholz
Christopher Rohkohl
Yiannis Kyriakou
Alexander Mohr
Peter Schramm
Dorothee Wachter
Katrin Wasser
Michael Knauth
Publication date
01-07-2013
Publisher
Springer Berlin Heidelberg
Published in
Neuroradiology / Issue 7/2013
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI
https://doi.org/10.1007/s00234-013-1165-6

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