Metal artifact reduction techniques in musculoskeletal CT-imaging

Area of Science:

• Medical Imaging
• Radiology
• CT Technology

Background:

• Metal artifacts significantly degrade CT image quality.
• Artifacts originate from beam-hardening and photon-starvation effects caused by metal implants.
• Existing methods include modifying acquisition/reconstruction, data manipulation, and specialized software.

Purpose of the Study:

• To review the origin of metal artifacts in CT.
• To discuss the technical background of metal artifact reduction (MAR) algorithms.
• To evaluate the clinical utility of dual-energy CT and MAR software for diverse metallic hardware.

Main Methods:

• Review of commercially available MAR algorithms.
• Analysis of virtual monochromatic imaging (VMI) from dual-energy CT (DECT).
• Assessment of artifact reduction efficacy for various metal implants in clinical practice.

Main Results:

• VMI effectively reduces beam-hardening artifacts.
• MAR software addresses photon-starvation artifacts.
• The combination of VMI and MAR is often beneficial but not universally optimal.
• Implant-specific information is crucial for tailoring artifact reduction strategies.

Conclusions:

• Both VMI and MAR techniques offer distinct advantages and disadvantages for metal artifact reduction.
• The optimal approach for minimizing artifacts depends on the specific clinical scenario and implant type.
• Advances in prosthetic design necessitate corresponding improvements in CT imaging techniques.