Optimization of Scan Time in MRI for Total Hip Prostheses: SEMAC Tailoring for Prosthetic Implants Containing Different Types of Metals.

INTRODUCTION: Magnetic resonance imaging (MRI) of soft tissues after total hip arthroplasty is of clinical interest for the diagnosis of various pathologies that are usually invisible with other imaging modalities. As a result, considerable effort has been put into the development of metal artifact reduction MRI strategies, such as slice encoding for metal artifact correction (SEMAC). Generally, the degree of metal artifact reduction with SEMAC directly relates to the overall time spent for acquisition, but there is no specific consensus about the most efficient sequence setup depending on the implant material. The aim of this article is to suggest material-tailored SEMAC protocol settings.
MATERIALS AND METHODS: Five of the most common total hip prostheses (1. Revision prosthesis (S-Rom), 2. Titanium alloy, 3. Müller type (CoNiCRMo alloy), 4. Old Charnley prosthesis (Exeter/Stryker), 5. MS-30 stem (stainless-steel)) were scanned on a 1.5 T MRI clinical scanner with a SEMAC sequence with a range of artifact-resolving slice encoding steps (SES: 2-23) along the slice direction (yielding a total variable scan time ranging from 1 to 10 min). The reduction of the artifact volume in comparison with maximal artifact suppression was evaluated both quantitatively and qualitatively in order to establish a recommended number of steps for each case.
RESULTS: The number of SES that reduced the artifact volume below approximately 300 mm(3) ranged from 3 to 13, depending on the material. Our results showed that although 3 SES steps can be sufficient for artifact reduction for titanium prostheses, at least 11 SES should be used for prostheses made of materials such as certain alloys of stainless steel.
CONCLUSION: Tailoring SES to the implant material and to the desired degree of metal artifact reduction represents a simple tool for workflow optimization of SEMAC imaging near total hip arthroplasty in a clinical setting. KEY POINTS: Five of the most common total hip prostheses have been investigated in vitro. Tailored SEMAC protocols - in terms of scan duration - have been determined. Tailoring was similar for T1-weighted and inversion recovery SEMAC MRI. The suggested prosthesis-related SEMAC adaptation shortens clinical scan times. © Georg Thieme Verlag KG Stuttgart · New York.