Top

Published in:

01-10-2013 | Computed Tomography

Metal artefact reduction from dental hardware in carotid CT angiography using iterative reconstructions

Authors: Fabian Morsbach, Moritz Wurnig, Daniel M. Kunz, Andreas Krauss, Bernhard Schmidt, Spyros S. Kollias, Hatem Alkadhi

Published in: European Radiology | Issue 10/2013

Abstract

Purpose

To determine the value of a metal artefact reduction (MAR) algorithm with iterative reconstructions for dental hardware in carotid CT angiography.

Methods

Twenty-four patients (six of which were women; mean age 70 ± 12 years) with dental hardware undergoing carotid CT angiography were included. Datasets were reconstructed with filtered back projection (FBP) and using a MAR algorithm employing normalisation and an iterative frequency-split (IFS) approach. Three blinded, independent readers measured CT attenuation values and evaluated image quality and degrees of artefacts using axial images, multi-planar reformations (MPRs) and maximal intensity projections (MIP) of the carotid arteries.

Results

CT attenuation values of the internal carotid artery on images with metal artefacts were significantly higher in FBP (324 ± 104HU) datasets compared with those reconstructed with IFS (278 ± 114HU; P < 0.001) and with FBP on images without metal artefacts (293 ± 106HU; P = 0.006). Quality of IFS images was rated significantly higher on axial, MPR and MIP images (P < 0.05, each), and readers found significantly less artefacts impairing the diagnostic confidence of the internal carotid artery (P < 0.05, each).

Conclusion

The MAR algorithm with the IFS approach allowed for a significant reduction of artefacts from dental hardware in carotid CT angiography, hereby increasing image quality and improving the accuracy of CT attenuation measurements.

Key points

• CT angiography of the neck has proven value for evaluating carotid disease

• Neck CT angiography images are often degraded by artefacts from dental implants

• A metal artefact reduction algorithm with iterative reconstruction reduces artefacts significantly

• Visualisation of the internal carotid artery is improved

Utter GH, Hollingworth W, Hallam DK, Jarvik JG, Jurkovich GJ (2006) Sixteen-slice CT angiography in patients with suspected blunt carotid and vertebral artery injuries. J Am Coll Surg 203:838–848PubMedCrossRef

Delgado Almandoz JE, Romero JM, Pomerantz SR, Lev MH (2010) Computed tomography angiography of the carotid and cerebral circulation. Radiol Clin North Am 48:265–281, vii–viiiPubMedCrossRef

Josephson SA, Bryant SO, Mak HK, Johnston SC, Dillon WP, Smith WS (2004) Evaluation of carotid stenosis using CT angiography in the initial evaluation of stroke and TIA. Neurology 63:457–460PubMedCrossRef

Koelemay MJ, Nederkoorn PJ, Reitsma JB, Majoie CB (2004) Systematic review of computed tomographic angiography for assessment of carotid artery disease. Stroke 35:2306–2312PubMedCrossRef

Latchaw RE, Alberts MJ, Lev MH et al (2009) Recommendations for imaging of acute ischemic stroke: a scientific statement from the American Heart Association. Stroke 40:3646–3678PubMedCrossRef

Kim JJ, Dillon WP, Glastonbury CM, Provenzale JM, Wintermark M (2010) Sixty-four-section multidetector CT angiography of carotid arteries: a systematic analysis of image quality and artifacts. AJNR Am J Neuroradiol 31:91–99PubMedCrossRef

Ramgren B, Bjorkman-Burtscher IM, Holtas S, Siemund R (2012) CT angiography of intracranial arterial vessels: impact of tube voltage and contrast media concentration on image quality. Acta Radiol 53:929–934PubMedCrossRef

Kuroda Y, Hosoya T, Oda A et al (2011) Inverse-direction scanning improves the image quality of whole carotid CT angiography with 64-MDCT. Eur J Radiol 80:749–754PubMedCrossRef

Saba L, Mallarin G (2009) Window settings for the study of calcified carotid plaques with multidetector CT angiography. AJNR Am J Neuroradiol 30:1445–1450PubMedCrossRef

10.

Barrett JF, Keat N (2004) Artifacts in CT: recognition and avoidance. Radiographics 24:1679–1691PubMedCrossRef

11.

Borisch I, Boehme T, Butz B, Hamer OW, Feuerbach S, Zorger N (2007) Screening for carotid injury in trauma patients: image quality of 16-detector-row computed tomography angiography. Acta Radiol 48:798–805PubMedCrossRef

12.

Lell MM, Hinkmann F, Nkenke E et al (2010) Dual energy CTA of the supraaortic arteries: technical improvements with a novel dual source CT system. Eur J Radiol 76:e6–e12PubMedCrossRef

13.

Watzke O, Kalender WA (2004) A pragmatic approach to metal artifact reduction in CT: merging of metal artifact reduced images. Eur Radiol 14:849–856PubMedCrossRef

14.

Kalender WA, Hebel R, Ebersberger J (1987) Reduction of CT artifacts caused by metallic implants. Radiology 164:576–577PubMed

15.

Boas FE, Fleischmann D (2011) Evaluation of two iterative techniques for reducing metal artifacts in computed tomography. Radiology 259:894–902PubMedCrossRef

16.

De Man B, Nuyts J, Dupont P, Marchal G, Suetens P (2001) An iterative maximum-likelihood polychromatic algorithm for CT. IEEE Trans Med Imaging 20:999–1008PubMedCrossRef

17.

Dong J, Kondo A, Abe K, Hayakawa Y (2011) Successive iterative restoration applied to streak artifact reduction in X-ray CT image of dento-alveolar region. Int J Comput Assist Radiol Surg 6:635–640PubMedCrossRef

18.

Bamberg F, Dierks A, Nikolaou K, Reiser MF, Becker CR, Johnson TR (2011) Metal artifact reduction by dual energy computed tomography using monoenergetic extrapolation. Eur Radiol 21:1424–142PubMedCrossRef

19.

Guggenberger R, Winklhofer S, Osterhoff G et al (2012) Metallic artefact reduction with monoenergetic dual-energy CT: systematic ex vivo evaluation of posterior spinal fusion implants from various vendors and different spine levels. Eur Radiol 22:2357–2364PubMedCrossRef

20.

Stolzmann P, Winklhofer S, Schwendener N, Alkadhi H, Thali MJ, Ruder TD (2013) Monoenergetic computed tomography reconstructions reduce beam hardening artifacts from dental restorations. Forensic Sci Med Pathol. doi:10.1007/s12024-013-9420-z

21.

Meyer E, Raupach R, Lell M, Schmidt B, Kachelriess M (2012) Frequency split metal artifact reduction (FSMAR) in computed tomography. Med Phys 39:1904–1916PubMedCrossRef

22.

Lell MM, Meyer E, Kuefner MA et al (2012) Normalized metal artifact reduction in head and neck computed tomography. Invest Radiol 47:415–421PubMedCrossRef

23.

Morsbach F, Bickelhaupt S, Wanner GA, Krauss A, Schmidt B, Alkadhi H (2013) Reduction of metal artifacts from hip prostheses on CT images of the pelvis: value of iterative reconstructions. Radiology. doi:10.1148/radiol.13122089

24.

Meyer E, Raupach R, Lell M, Schmidt B, Kachelriess M (2010) Normalized metal artifact reduction (NMAR) in computed tomography. Med Phys 37:5482–5493PubMedCrossRef

25.

Bouthillier A, van Loveren HR, Keller JT (1996) Segments of the internal carotid artery: a new classification. Neurosurgery 38:425–432, discussion 432–423PubMed

26.

Shrout PE, Fleiss JL (1979) Intraclass correlations: uses in assessing rater reliability. Psychol Bull 86:420–428PubMedCrossRef

27.

Brown JH, Lustrin ES, Lev MH, Ogilvy CS, Taveras JM (1999) Reduction of aneurysm clip artifacts on CT angiograms: a technical note. AJNR Am J Neuroradiol 20:694–696PubMed

28.

Vertinsky AT, Schwartz NE, Fischbein NJ, Rosenberg J, Albers GW, Zaharchuk G (2008) Comparison of multidetector CT angiography and MR imaging of cervical artery dissection. AJNR Am J Neuroradiol 29:1753–1760PubMedCrossRef

29.

Klinke T, Daboul A, Maron J et al (2012) Artifacts in magnetic resonance imaging and computed tomography caused by dental materials. PLoS One 7:e31766PubMedCrossRef

30.

Rapalino O, Kamalian S, Payabvash S et al (2012) Cranial CT with adaptive statistical iterative reconstruction: improved image quality with concomitant radiation dose reduction. AJNR Am J Neuroradiol 33:609–615PubMedCrossRef

31.

Kilic K, Erbas G, Guryildirim M, Arac M, Ilgit E, Coskun B (2011) Lowering the dose in head CT using adaptive statistical iterative reconstruction. AJNR Am J Neuroradiol 32:1578–1582PubMedCrossRef

32.

Niu YT, Mehta D, Zhang ZR et al (2012) Radiation dose reduction in temporal bone CT with iterative reconstruction technique. AJNR Am J Neuroradiol 33:1020–1026PubMedCrossRef

Title: Metal artefact reduction from dental hardware in carotid CT angiography using iterative reconstructions
Authors: Fabian Morsbach
Moritz Wurnig
Daniel M. Kunz
Andreas Krauss
Bernhard Schmidt
Spyros S. Kollias
Hatem Alkadhi
Publication date: 01-10-2013
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 10/2013
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-013-2885-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Metal artefact reduction from dental hardware in carotid CT angiography using iterative reconstructions

Abstract

Purpose

Methods

Results

Conclusion

Key points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Key points

Please log in to get access to this content

Other articles of this Issue 10/2013

Intravoxel incoherent motion MR imaging: comparison of diffusion and perfusion characteristics between nasopharyngeal carcinoma and post-chemoradiation fibrosis

Safety and effectiveness of percutaneous sacroplasty: a single-centre experience in 58 consecutive patients with tumours or osteoporotic insufficient fractures treated under fluoroscopic guidance

Role of preoperative MR imaging in the evaluation of patients with persistent or recurrent gynaecological malignancies before pelvic exenteration

Intravoxel incoherent motion model-based liver lesion characterisation from three b-value diffusion-weighted MRI

Thickening of the inferior glenohumeral capsule: an ultrasound sign for shoulder capsular contracture

Time-of-flight angiography: a viable alternative to contrast-enhanced MR angiography and fat-suppressed T1w images for the diagnosis of cervical artery dissection?