Segmentation of artifacts and anatomy in CT metal artifact reduction.

PURPOSE: Metal objects present in x-ray computed tomography (CT) scans are accompanied by physical phenomena that render CT projections inconsistent with the linear assumption made for analytical reconstruction. The inconsistencies create artifacts in reconstructed images. Metal artifact reduction algorithms replace the inconsistent projection data passing through metals with estimates of the true underlying projection data, but when the data estimates are inaccurate, secondary artifacts are generated. The secondary artifacts may be as unacceptable as the original metal artifacts; therefore, better projection data estimation is critical. This research uses computer vision techniques to create better estimates of the underlying projection data using observations about the appearance and nature of metal artifacts.
METHODS: The authors developed a method of estimating underlying projection data through the use of an intermediate image, called the prior image. This method generates the prior image by segmenting regions of the originally reconstructed image, and discriminating between regions that are likely to be metal artifacts and those that are likely to represent anatomical structures. Regions identified as metal artifact are replaced with a constant soft-tissue value, while structures such as bone or air pockets are preserved. This prior image is reprojected (forward projected), and the reprojections guide the estimation of the underlying projection data using previously published interpolation techniques. The algorithm is tested on head CT test cases containing metal implants and compared against existing methods.
RESULTS: Using the new method of prior image generation on test images, metal artifacts were eliminated or reduced and fewer secondary artifacts were present than with previous methods. The results apply even in the case of multiple metal objects, which is a challenging problem. The authors did not observe secondary artifacts that were comparable to or worse than the original metal artifacts, as sometimes occurred with the other methods. The accuracy of the prior was found to be more critical than the particular interpolation method.
CONCLUSIONS: Metals produce predictable artifacts in CT images of the head. Using the new method, metal artifacts can be discriminated from anatomy, and the discrimination can be used to reduce metal artifacts.