Artifacts caused by insufficient contrast medium filling during C-arm cone-beam CT scans: a phantom study.

We investigated artifacts due to late-arriving contrast medium (CM) during C-arm cone-beam computed tomography. We scanned a phantom filled with water or with 100, 50, or 5% v/v concentrations of CM and then virtually produced CM-delayed projection data by partially replacing the projection images. Artifacts as a function of concentration, percentage of filling time, and size and position of the filling area were assessed. In addition, we used an automatic power injector with different injection delays to inject CM during the scans. A decrease in filling times caused by a lag in CM arrival during the scan resulted in a decrease in pixel values, distortion of the filling area, and appearance of streak artifacts. Even a delay of approximately 20% in CM arrival in the total scan time resulted in obvious distortion of the filling area. The distortion and streak artifacts tended to worsen at higher CM concentrations. Use of a minimum CM concentration based on the purpose of the examination and constant filling at the target region are effective for avoiding these artifacts.