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AJNR Awards, New Junior Editors, and more. Read the latest AJNR updates

Research ArticlePatient Safety

Artifact Reduction of Different Metallic Implants in Flat Detector C-Arm CT

S.-C. Hung, C.-C. Wu, C.-J. Lin, W.-Y. Guo, C.-B. Luo, F.-C. Chang and C.-Y. Chang
American Journal of Neuroradiology July 2014, 35 (7) 1288-1292; DOI: https://doi.org/10.3174/ajnr.A3851
S.-C. Hung
aFrom the Department of Radiology (S.-C.H., C.-C.W., C.-J.L., W.-Y.G., C.-B.L., F.-C.C., C.-Y.C.), Taipei Veterans General Hospital, Taipei, Taiwan
bDepartment of Biomedical Imaging and Radiological Sciences (S.-C.H.)
cSchool of Medicine (S.-C.H., C.-C.W., C.-J.L., W.-Y.G., C.-B.L., F.-C.C., C.-Y.C.), National Yang-Ming University, Taipei, Taiwan.
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C.-C. Wu
aFrom the Department of Radiology (S.-C.H., C.-C.W., C.-J.L., W.-Y.G., C.-B.L., F.-C.C., C.-Y.C.), Taipei Veterans General Hospital, Taipei, Taiwan
cSchool of Medicine (S.-C.H., C.-C.W., C.-J.L., W.-Y.G., C.-B.L., F.-C.C., C.-Y.C.), National Yang-Ming University, Taipei, Taiwan.
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C.-J. Lin
aFrom the Department of Radiology (S.-C.H., C.-C.W., C.-J.L., W.-Y.G., C.-B.L., F.-C.C., C.-Y.C.), Taipei Veterans General Hospital, Taipei, Taiwan
cSchool of Medicine (S.-C.H., C.-C.W., C.-J.L., W.-Y.G., C.-B.L., F.-C.C., C.-Y.C.), National Yang-Ming University, Taipei, Taiwan.
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W.-Y. Guo
aFrom the Department of Radiology (S.-C.H., C.-C.W., C.-J.L., W.-Y.G., C.-B.L., F.-C.C., C.-Y.C.), Taipei Veterans General Hospital, Taipei, Taiwan
cSchool of Medicine (S.-C.H., C.-C.W., C.-J.L., W.-Y.G., C.-B.L., F.-C.C., C.-Y.C.), National Yang-Ming University, Taipei, Taiwan.
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C.-B. Luo
aFrom the Department of Radiology (S.-C.H., C.-C.W., C.-J.L., W.-Y.G., C.-B.L., F.-C.C., C.-Y.C.), Taipei Veterans General Hospital, Taipei, Taiwan
cSchool of Medicine (S.-C.H., C.-C.W., C.-J.L., W.-Y.G., C.-B.L., F.-C.C., C.-Y.C.), National Yang-Ming University, Taipei, Taiwan.
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F.-C. Chang
aFrom the Department of Radiology (S.-C.H., C.-C.W., C.-J.L., W.-Y.G., C.-B.L., F.-C.C., C.-Y.C.), Taipei Veterans General Hospital, Taipei, Taiwan
cSchool of Medicine (S.-C.H., C.-C.W., C.-J.L., W.-Y.G., C.-B.L., F.-C.C., C.-Y.C.), National Yang-Ming University, Taipei, Taiwan.
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C.-Y. Chang
aFrom the Department of Radiology (S.-C.H., C.-C.W., C.-J.L., W.-Y.G., C.-B.L., F.-C.C., C.-Y.C.), Taipei Veterans General Hospital, Taipei, Taiwan
cSchool of Medicine (S.-C.H., C.-C.W., C.-J.L., W.-Y.G., C.-B.L., F.-C.C., C.-Y.C.), National Yang-Ming University, Taipei, Taiwan.
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    Fig 1.

    Hounsfield unit value range and noise were measured by two 1.5 × 1.5 cm2 square ROIs. The first region of interest (ROI1) is placed in the region with most severe artifacts in the vicinity of the metal implant (A). The second region of interest (ROI0) is placed in the section just above the target metal object, which is degraded by metallic artifacts (B).

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    Fig 2.

    A, Comparison of Hounsfield unit range among different objects. B, Comparison of noise among different metal objects.

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    Fig 3.

    Illustrative case 1. FDCT without MAR (A) and with MAR (B) of a left-side ICA aneurysm post–coil embolization. The metal artifacts are significantly reduced, and the postcorrected images enable clearer evaluation of adjacent parenchyma.

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    Fig 4.

    A, Comparison of Hounsfield unit range among different coil lengths. B, Comparison of noise among different coil lengths.

Tables

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    Table 1:

    Quantitative assessment of metal artifacts before and after reduction

    ObjectsHU RangeP ValueNoiseP Value
    BeforeAfter% ChangeBeforeAfter% Change
    ROI0 (n = 28)247.2 ± 37.5247.3 ± 37.30.04NS36.3 ± 4.836.2 ± 4.70.2NS
    Coiling ± stenting (n = 20)2005.6 ± 804.0282.6 ± 55.885.9<.001251.7 ± 94.442.9 ± 10.382.9<.001
        <25 cm (n = 6)1613.7 ± 709.7296 ± 44.781.7.006198.4 ± 83.842.8 ± 7.378.4.007
        25–100 cm (n = 7)1954.9 ± 634.2257.6 ± 23.586.8<.001238.6 ± 49.338.9 ± 5.683.7<.001
        >100 cm (n = 7)2392.3 ± 945.6296 ± 80.787.6.001310.3 ± 113.546.9 ± 15.084.9.001
    Liquid embolizer (n = 6)1377.3 ± 646.6428.5 ± 259.068.9.019206.0 ± 86.356.9 ± 21.672.3.007
    Shunt (n = 2)1226.5 ± 259.5368.0 ± 76.470.9NS109.8 ± 2.644.0 ± 0.760.013
    Overall (ROI1) (n = 28)1815.3 ± 793.7319.9 ± 136.682.3<.001231.7 ± 95.945.9 ± 14.080.2<.001
    • Note:—NS indicates no significance.

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    Table 2:

    Results of the observer study rating the imaging quality with MAR

    ObjectsRater 1 ScoreP ValueRater 2 ScoreP Value
    −10123−10123
    Coiling ± stenting000182001136
    Liquid embolizer0024000330
    Shunt0020002000
    Overall004222.002024166<.001
    • View popup
    Table 3:

    Inter-rater agreement of the observer study

    Overall AgreementRater 1, Score ≤ 2 (%)Rater 2, Score ≤ 2 (%)κ
    Overall imaging quality0.85785.778.6.517
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American Journal of Neuroradiology: 35 (7)
American Journal of Neuroradiology
Vol. 35, Issue 7
1 Jul 2014
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Cite this article
S.-C. Hung, C.-C. Wu, C.-J. Lin, W.-Y. Guo, C.-B. Luo, F.-C. Chang, C.-Y. Chang
Artifact Reduction of Different Metallic Implants in Flat Detector C-Arm CT
American Journal of Neuroradiology Jul 2014, 35 (7) 1288-1292; DOI: 10.3174/ajnr.A3851

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Artifact Reduction of Different Metallic Implants in Flat Detector C-Arm CT
S.-C. Hung, C.-C. Wu, C.-J. Lin, W.-Y. Guo, C.-B. Luo, F.-C. Chang, C.-Y. Chang
American Journal of Neuroradiology Jul 2014, 35 (7) 1288-1292; DOI: 10.3174/ajnr.A3851
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