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Clin Radiol. 2014 May;69(5):e199-206. doi: 10.1016/j.crad.2013.12.011. Epub 2014 Feb 27.

CT metal artefact reduction for internal fixation of the proximal humerus: value of mono-energetic extrapolation from dual-energy and iterative reconstructions.

Author information

1
Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Switzerland; Department of Forensic Medicine and Radiology, Institute of Forensic Medicine, University of Zurich, Switzerland. Electronic address: sebastian.winklhofer@usz.ch.
2
Department of Orthopedics and Traumatology, Kantonsspital St Gallen, Switzerland.
3
Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Switzerland.
4
Department of Forensic Medicine and Radiology, Institute of Forensic Medicine, University of Zurich, Switzerland.
5
Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Switzerland; Department of Forensic Medicine and Radiology, Institute of Forensic Medicine, University of Zurich, Switzerland.

Abstract

AIM:

To assess the value of dual-energy computed tomography (DECT) and an iterative frequency split-normalized metal artefact reduction (IFS-MAR) algorithm compared to filtered back projections (FBP) from single-energy CT (SECT) for artefact reduction in internally fixated humeral fractures.

MATERIALS AND METHODS:

Six internally fixated cadaveric humeri were examined using SECT and DECT. Data were reconstructed using FBP, IFS-MAR, and mono-energetic DECT extrapolations. Image analysis included radiodensity values and qualitative evaluation of artefacts, image quality, and level of confidence for localizing screw tips.

RESULTS:

Radiodensity values of streak artefacts were significantly different (p < 0.05) between FBP (-104 ± 222) and IFS-MAR (73 ± 122), and between FBP and DECT (32 ± 151), without differences between IFS-MAR and DECT (p < 0.553). Compared to FBP, qualitative artefacts were significantly reduced using IFS-MAR (p < 0.001) and DECT (p < 0.05), without significant differences between IFS-MAR and DECT (p < 0.219). Image quality significantly (p = 0.016) improved for IFS-MAR and DECT compared to FBP, without significant differences between IFS-MAR and DECT (p < 0.553). The level of confidence for screw tip localization was assessed as best for DECT in all cases.

CONCLUSION:

Both IFS-MAR in SECT and mono-energetic DECT produce improved image quality and a reduction of metal artefacts. Screw tip positions can be most confidently assessed using DECT.

PMID:
24582174
DOI:
10.1016/j.crad.2013.12.011
[Indexed for MEDLINE]
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