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CT artifacts from port systems: Virtual monoenergetic reconstructions from spectral-detector CT reduce artifacts and
Kai Roman Laukamp1, David Zopfs2, Anton Wagner2
1Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Straße 62, 50937, Cologne, Germany; Department of Radiology, University Hospitals Cleveland Medical Center, 11000 Euclid Ave, 44106 Cleveland, OH, USA; Department of Radiology, Case Western Reserve University, 10900 Euclid Ave, 44106, Cleveland, OH, USA.
Purpose:
CT artifacts from port-systems are a common problem in staging- and restaging-examinations and reduce image quality and diagnostic assessment. The purpose of this study was to investigate the reduction of these artifacts using virtual monoenergetic images (VMI) from dual-energy spectral-detector CT (SDCT) in comparison to conventional CT-images (CI).
Method:
50 SDCT-datasets of patients with artifacts from port-chamber and port-catheters were included in this IRB-approved, retrospective study. CI and VMI (range, 40-200 keV, 10 keV increment) were reconstructed from the same acquisition. The quantitative image analysis was performed ROI-based assessing mean and standard deviation of attenuation (HU) in most pronounced hypo- and hyperdense artifacts surrounding to the port-chamber and the distal end of the port-catheter in the superior vena cava. Subjectively, artifact reduction and diagnostic assessment of surrounding soft tissue were rated on 5-point Likert-scales.
Results:
In comparison to CI, VMI of higher keV-values showed strong reduction of hypo- and hyperattenuating artifacts around the port-chamber and port-catheter (CI/VMI200keV: hypodense -104.7 ± 124.7HU/10.8 ± 58.1HU and -101.6 ± 101.5HU/-36.7 ± 32.9HU; hyperdense 240.8 ± 151.6HU/79.6 ± 81.3HU and 108.6 ± 129.3HU/25.9 ± 31.9HU; all p < 0.001). Image noise could also be reduced significantly. The subjective analysis showed significantly reduced artifacts around the port-chamber and port-catheter (CI/VMI200keV: hypodense 3(1-4)/5(4-5) and 3(2-4)/5(4-5); hyperdense 3(1-4)/5(4-5) and 3(2-3)/5(3-5); all p < 0.001) and improved diagnostic assessment of pectoral/subclavian soft tissue for VMI of ≥100keV. Ratings for diagnostic assessment were best between 140-200 keV. Overall interrater agreement was high (ICC = 0.79).
Conclusions:
Higher keV VMI enabled a significant reduction of artifacts from port-systems around the chamber and the catheter leading to improved assessment of surrounding soft tissue.
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