Clinical evaluation of volume of interest imaging combined with metal artifact reduction reconstruction techniques in coiling and stent assisted coiling during neurointerventional procedures.

PURPOSE: Three-dimensional (3D) scans with flat detector angiographic systems are widely used for neurointerventions by providing detailed vascular information. However, its associated radiation dose and streak metal artifact generated by implanted treatment devices remain issues. This work evaluates the feasibility and clinical value of volume of interest imaging combined with metal artifact reduction (VOI+MAR) to generate high quality 3D images with reduced radiation dose and metal artifacts.
MATERIAL AND METHODS: Full volume (FV) and VOI scans were acquired in 25 patients with intracranial aneurysms and treated with either endovascular coiling (n=9) or stent assisted coiling (n=16) procedures. FV and VOI scans were reconstructed with conventional syngo DynaCT and VOI +MAR prototype software, respectively.
RESULTS: Quantitative evaluation results demonstrated that compared with standard FV syngo DynaCT images, overall image quality was improved in the VOI+MAR reconstructed images, with streak metal artifacts considerably reduced or even removed; details of soft tissue in the vicinity of the metal devices was well preserved or recovered in the majority of cases. Radiation dose to patients calculated by dose area product was found to be significantly reduced using VOI scans.
CONCLUSION: This study confirmed the feasibility of using VOI+MAR prototype software to achieve high image quality of a small volume of clinical interest and to reduce radiation dose. This technique has potential to improve patient safety and treatment outcomes. © Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.