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Published on: May 17, 2018
Metal artefact reduction from dental hardware in carotid CT angiography using iterative reconstructions
Fabian Morsbach1, Moritz Wurnig, Daniel M Kunz
1Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland.
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.
