PMID- 37968474
OWN - NLM
STAT- Publisher
LR  - 20231116
IS  - 1432-1084 (Electronic)
IS  - 0938-7994 (Linking)
DP  - 2023 Nov 16
TI  - Impact of different metal artifact reduction techniques in photon-counting 
      computed tomography head and neck scans in patients with dental hardware.
LID - 10.1007/s00330-023-10430-8 [doi]
AB  - OBJECTIVES: Metal artifacts remain a challenge in computed tomography. We 
      investigated the potential of photon-counting computed tomography (PCD-CT) for 
      metal artifact reduction using an iterative metal artifact reduction (iMAR) 
      algorithm alone and in combination with high keV monoenergetic images (140 keV) 
      in patients with dental hardware. MATERIAL AND METHODS: Consecutive patients with 
      dental implants were prospectively included in this study and received PCD-CT 
      imaging of the craniofacial area. Four series were reconstructed (standard 
      [PCD-CT(std)], monoenergetic at 140 keV [PCD-CT(140keV)], iMAR corrected 
      [PCD-CT(iMAR)], combination of iMAR and 140 keV monoenergetic 
      [PCD-CT(iMAR+140keV)]). All reconstructions were assessed qualitatively by four 
      radiologists (independent and blinded reading on a 5-point Likert scale [5 = 
      excellent; no artifact]) regarding overall image quality, artifact severity, and 
      delineation of adjacent and distant anatomy. To assess signal homogeneity and 
      evaluate the magnitude of artifact reduction, we performed quantitative measures 
      of coefficient of variation (CV) and a region of interest (ROI)-based relative 
      change in artifact reduction [PCD-CT/PCD-CT(std)]. RESULTS: We enrolled 48 
      patients (mean age 66.5 +/- 11.2 years, 50% (n = 24) males; mean BMI 25.2 +/- 4.7 
      kg/m(2); mean CTDI(vol) 6.2 +/- 6 mGy). We found improved overall image quality, 
      reduced artifacts and superior delineation of both adjacent and distant anatomy 
      for the iMAR vs. non-iMAR reconstructions (all p < 0.001). No significant effect 
      of the different artifact reduction approaches on CV was observed (p = 0.42). The 
      ROI-based analysis indicated the most effective artifact reduction for the iMAR 
      reconstructions, which was significantly higher compared to PCD-CT(140keV) (p < 
      0.001). CONCLUSION: PCD-CT offers highly effective approaches for metal artifact 
      reduction with the potential to overcome current diagnostic challenges in 
      patients with dental implants. CLINICAL RELEVANCE STATEMENT: Metallic artifacts 
      pose a significant challenge in CT imaging, potentially leading to missed 
      findings. Our study shows that PCD-CT with iMAR post-processing reduces 
      artifacts, improves image quality, and can possibly reveal pathologies previously 
      obscured by artifacts, without additional dose application. KEY POINTS: 
      * Photon-counting detector CT (PCD-CT) offers highly effective approaches for 
      metal artifact reduction in patients with dental fillings/implants. * Iterative 
      metal artifact reduction (iMAR) is superior to high keV monoenergetic 
      reconstructions at 140 keV for artifact reduction and provides higher image 
      quality. * Signal homogeneity of the reconstructed images is not affected by the 
      different artifact reduction techniques.
CI  - (c) 2023. The Author(s).
FAU - Pallasch, Fabian Bernhard
AU  - Pallasch FB
AUID- ORCID: 0000-0003-2011-0939
AD  - Department of Radiology, University Medical Center Freiburg, Hugstetter Str. 55, 
      79106, Freiburg im Breisgau, Germany. Fabian.pallasch@uniklinik-freiburg.de.
FAU - Rau, Alexander
AU  - Rau A
AD  - Department of Radiology, University Medical Center Freiburg, Hugstetter Str. 55, 
      79106, Freiburg im Breisgau, Germany.
FAU - Reisert, Marco
AU  - Reisert M
AD  - Department of Radiology, University Medical Center Freiburg, Hugstetter Str. 55, 
      79106, Freiburg im Breisgau, Germany.
FAU - Rau, Stephan
AU  - Rau S
AD  - Department of Radiology, University Medical Center Freiburg, Hugstetter Str. 55, 
      79106, Freiburg im Breisgau, Germany.
FAU - Diallo, Thierno
AU  - Diallo T
AD  - Department of Radiology, University Medical Center Freiburg, Hugstetter Str. 55, 
      79106, Freiburg im Breisgau, Germany.
FAU - Stein, Thomas
AU  - Stein T
AD  - Department of Radiology, University Medical Center Freiburg, Hugstetter Str. 55, 
      79106, Freiburg im Breisgau, Germany.
FAU - Faby, Sebastian
AU  - Faby S
AD  - Siemens Healthcare GmbH, Siemensstr. 3, 91301, Forchheim, Germany.
FAU - Bamberg, Fabian
AU  - Bamberg F
AD  - Department of Radiology, University Medical Center Freiburg, Hugstetter Str. 55, 
      79106, Freiburg im Breisgau, Germany.
FAU - Weiss, Jakob
AU  - Weiss J
AD  - Department of Radiology, University Medical Center Freiburg, Hugstetter Str. 55, 
      79106, Freiburg im Breisgau, Germany.
LA  - eng
GR  - 35-4223.10/20/Ministerium fur Wirtschaft, Arbeit und Wohnungsbau 
      Baden-Wurttemberg/
PT  - Journal Article
DEP - 20231116
PL  - Germany
TA  - Eur Radiol
JT  - European radiology
JID - 9114774
SB  - IM
OTO - NOTNLM
OT  - Artifacts
OT  - Dental implants
OT  - Head and neck neoplasms
OT  - Image processing (Computer-assisted)
OT  - Multidetector computed tomography
EDAT- 2023/11/16 06:45
MHDA- 2023/11/16 06:45
CRDT- 2023/11/16 00:00
PHST- 2023/06/03 00:00 [received]
PHST- 2023/10/02 00:00 [accepted]
PHST- 2023/09/18 00:00 [revised]
PHST- 2023/11/16 06:45 [medline]
PHST- 2023/11/16 06:45 [pubmed]
PHST- 2023/11/16 00:00 [entrez]
AID - 10.1007/s00330-023-10430-8 [pii]
AID - 10.1007/s00330-023-10430-8 [doi]
PST - aheadofprint
SO  - Eur Radiol. 2023 Nov 16. doi: 10.1007/s00330-023-10430-8.