Metal artifacts in intraoperative O-arm CBCT scans

Area of Science:

• Medical Imaging
• Orthopedic Surgery
• Radiology

Background:

• Cone-beam computed tomography (CBCT) is vital in orthopedic operating rooms.
• Metal implants in CBCT imaging cause significant artifacts, challenging image quality.
• Optimizing CBCT image quality requires addressing metal artifact issues.

Purpose of the Study:

• To develop a robust and quantitative method for determining metal artifacts in CBCT.
• To assess the impact of imaging parameters on metal artifact severity.
• To provide a practical tool for quantifying artifacts in novel CBCT applications.

Main Methods:

• Assessed O-arm CBCT image quality using an anthropomorphic pelvis phantom.
• Included metal implants within the phantom during scans.
• Varied kilovoltage (3 settings) and exposure (2 settings) parameters.

Main Results:

• Metal artifact severity correlated with CBCT imaging protocol parameters.
• Artifact size was moderate across all tested settings.
• Increased kilovoltage and exposure levels significantly worsened artifact severity.

Conclusions:

• The developed method provides a practical and robust way to quantify metal artifacts in CBCT.
• Changes in imaging parameters can have unpredictable, nonlinear effects on image quality.
• Understanding these effects is crucial for optimizing CBCT in orthopedic surgery.