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Updated: Dec 15, 2025
Cone Beam Intraoperative Computed Tomography-based Image Guidance for Minimally Invasive Transforaminal Interbody Fusion
Published on: August 6, 2019
Evaluation of Software-Based Metal Artifact Reduction in Intraoperative 3D Imaging of the Spine Using a Mobile Cone
Maxim Privalov1, Marcus Mohr1, Benedict Swartman1
1Medical Imaging and Navigation in Trauma and Orthopaedic Surgery, BG Trauma Center Ludwigshafen at Heidelberg University Hospital, Ludwig-Guttmann-Str. 13, 67071, Ludwigshafen, Germany.
Abstract:
The aim of our study was to evaluate whether software-based artifact reduction can achieve an improved image quality, using intraoperative 3D imaging in spinal surgery. A total of 49 intraoperative 3D image datasets of patients, who underwent surgery with pedicle screw placement, were retrospectively evaluated. The visibility of anatomical structures and the diameter of the pedicle screws were examined, with and without the application of the artifact reduction software. All software prototypes can improve the visibility of anatomical structures (P < 0.01), except MAR (metal artifact reduction) combined with IRIS (iterative reconstruction in image space) (P = 0.04). The algorithms MAR and MAR-2 can reduce the blooming artifacts significantly (P < 0.01), but SL (Shepp & Logan) cannot (P = 0.08-0.988). In summary, software-based artifact reduction for intraoperative 3D datasets can improve the current image quality. Additional information regarding the implant placement and the fracture reduction is therefore generated for the surgeon.
