Eficacia de la reducción de artefactos metálicos de energía única en angiotomografía computarizada para pacientes con...

To evaluate the impact of a single-energy metal artifact reduction algorithm on image quality in lower extremity CT angiography (CTA) of patients with metallic implants.

This retrospective, single-center study included patients with metallic implants in the lower extremity who underwent lower extremity CTA between January 2021 and December 2024. All scans were performed on a 320-detector row CT scanner. Standard images were reconstructed with hybrid iterative reconstruction, and an additional reconstruction was performed with a projection-based single-energy metal artifact reduction (SEMAR) algorithm. Objective image quality was assessed by measuring image noise in target tissues (arteries, muscle, subcutaneous fat, cortical bone, medullary bone) on both standard and SEMAR images. Subjective image quality was evaluated for arteries, muscle, and bone using a 5-point scale. Scores ≥4 were considered diagnostic. Paired t-tests or Wilcoxon signed-rank tests were used for comparisons, as appropriate RESULTS: The study group included 30 patients. SEMAR reconstruction significantly reduced image noise and artifact index in all evaluated tissues compared to standard images with objective assessment (p<0.001 for each target tissue). Subjective evaluation of diagnostic-quality showed marked improvements with the SEMAR algorithm for each target tissue compared to the standard images using a 5-point scale (p<0.001 for each). For arterial structures, only 5 of 30 cases (16.6 %) were considered diagnostic on the standard images (score 4 or 5), whereas with SEMAR 28 of 30 cases (93.3 %) were diagnostic.

SEMAR significantly reduced artifacts and image noise, restoring diagnostic image quality for vessels and surrounding tissues.