Laura Filograna1,2, Nicola Magarelli3, Antonio Leone3, Chiara de Waure4, Giovanna Elisa Calabrò4, Tim Finkenstaedt5, Michael John Thali6, Lorenzo Bonomo3. 1. Department of Radiological Sciences, Institute of Radiology, Catholic University of Rome, School of Medicine, University Hospital "A. Gemelli", Largo A. Gemelli 8, 00168, Rome, Italy. laura.filograna@rm.unicatt.it. 2. Department of Forensic Medicine and Imaging, Institute of Forensic Medicine, University of Zurich, Winterthurerstrasse 190/52, 8057, Zurich, Switzerland. laura.filograna@rm.unicatt.it. 3. Department of Radiological Sciences, Institute of Radiology, Catholic University of Rome, School of Medicine, University Hospital "A. Gemelli", Largo A. Gemelli 8, 00168, Rome, Italy. 4. Research Centre for Health Technology Assessment, Department of Public Health, Section of Hygiene, Catholic University of Rome, School of Medicine, University Hospital "A. Gemelli", Largo F. Vito 1, 00168, Rome, Italy. 5. Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland. 6. Department of Forensic Medicine and Imaging, Institute of Forensic Medicine, University of Zurich, Winterthurerstrasse 190/52, 8057, Zurich, Switzerland.
Abstract
OBJECTIVES: The objective was to evaluate the performances of dose-reduced dual-energy computed tomography (DECT) in decreasing metallic artifacts from orthopedic devices compared with dose-neutral DECT, dose-neutral single-energy computed tomography (SECT), and dose-reduced SECT. MATERIALS AND METHODS: Thirty implants in 20 consecutive cadavers underwent both SECT and DECT at three fixed CT dose indexes (CTDI): 20.0, 10.0, and 5.0 mGy. Extrapolated monoenergetic DECT images at 64, 69, 88, 105, 120, and 130 keV, and individually adjusted monoenergy for optimized image quality (OPTkeV) were generated. In each group, the image quality of the seven monoenergetic images and of the SECT image was assessed qualitatively and quantitatively by visually rating and by measuring the maximum streak artifact respectively. RESULTS: The comparison between SECT and OPTkeV evaluated overall within all groups showed a significant difference (p <0.001), with OPTkeV images providing better images. Comparing OPTkeV with the other DECT images, a significant difference was shown (p <0.001), with OPTkeV and 130-keV images providing the qualitatively best results. The OPTkeV images of 5.0-mGy acquisitions provided percentages of images with scores 1 and 2 of 36 % and 30 % respectively, compared with 0 % and 33.3 % of the corresponding SECT images of 10- and 20-mGy acquisitions. Moreover, DECT reconstructions at the OPTkeV of the low-dose group showed higher CT numbers than the SECT images of dose groups 1 and 2. CONCLUSIONS: This study demonstrates that low-dose DECT permits a reduction of artifacts due to metallic implants to be obtained in a similar manner to neutral-dose DECT and better than reduced or neutral-dose SECT.
OBJECTIVES: The objective was to evaluate the performances of dose-reduced dual-energy computed tomography (DECT) in decreasing metallic artifacts from orthopedic devices compared with dose-neutral DECT, dose-neutral single-energy computed tomography (SECT), and dose-reduced SECT. MATERIALS AND METHODS: Thirty implants in 20 consecutive cadavers underwent both SECT and DECT at three fixed CT dose indexes (CTDI): 20.0, 10.0, and 5.0 mGy. Extrapolated monoenergetic DECT images at 64, 69, 88, 105, 120, and 130 keV, and individually adjusted monoenergy for optimized image quality (OPTkeV) were generated. In each group, the image quality of the seven monoenergetic images and of the SECT image was assessed qualitatively and quantitatively by visually rating and by measuring the maximum streak artifact respectively. RESULTS: The comparison between SECT and OPTkeV evaluated overall within all groups showed a significant difference (p <0.001), with OPTkeV images providing better images. Comparing OPTkeV with the other DECT images, a significant difference was shown (p <0.001), with OPTkeV and 130-keV images providing the qualitatively best results. The OPTkeV images of 5.0-mGy acquisitions provided percentages of images with scores 1 and 2 of 36 % and 30 % respectively, compared with 0 % and 33.3 % of the corresponding SECT images of 10- and 20-mGy acquisitions. Moreover, DECT reconstructions at the OPTkeV of the low-dose group showed higher CT numbers than the SECT images of dose groups 1 and 2. CONCLUSIONS: This study demonstrates that low-dose DECT permits a reduction of artifacts due to metallic implants to be obtained in a similar manner to neutral-dose DECT and better than reduced or neutral-dose SECT.
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