Amit Gupta1,2, Verena Carola Obmann1,2,3, Michelle Jordan1,2, Simon Lennartz4, Markus Michael Obmann5, Nils Große Hokamp1,2,4, David Zopfs4, Lenhard Pennig4, Gina Fürtjes6, Nikhil Ramaiya1,2, Robert Gilkeson1,2, Kai Roman Laukamp1,2,4. 1. Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA. 2. Department of Radiology, Case Western Reserve University, Cleveland, OH, USA. 3. Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Switzerland. 4. Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany. 5. Clinic of Radiology and Nuclear Medicine, University Hospital Basel, University of Basel, Basel, Switzerland. 6. Center for Neurosurgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
Abstract
BACKGROUND: After injection into a brachial vein, high contrast media concentration in axillary and subclavian veins can cause artifacts that impair diagnostic utility. This study assessed artifact reduction by artifact-reduction-algorithms (ARA) and virtual-monoenergetic-images (VMI), as well as their combination (VMIARA) compared to conventional CT-images (CI). METHODS: Forty-six spectral-detector-CT (SDCT) examinations of patients that received ARA-reconstructions due to perivenous-artifacts were included in this retrospective study. CI, ARA, VMI, and VMIARA (range: 70-200 keV) were reconstructed. Objective analysis was performed with ROI-based assessment of mean and standard deviation of attenuation (HU) in hypo- and hyperdense artifacts and impaired muscle and arteries as well as artifact-free reference-tissue. Extent of artifact reduction, assessment of surrounding soft tissue and vessels, and appearance of new artifacts were rated visually by two radiologists. RESULTS: Hypo- and hyperdense artifacts showed significant improvement as evidenced by decreasing attenuation differences between artifact impaired and artifact-free reference tissue in ARA, VMI ≥80 keV, and VMIARA between 70-200 keV (e.g., CI/ARA/VMI100keV/VMIARA100keV: hypodense artifacts, (-)264.8±150.9/(-)87.1±78.9/(-)48.6±64.6/9.9±63.9 HU; P<0.001); hyperdense artifacts, 164.2±51.1/82.1±73.2/7.9±34.7/(-)17.3±50.7 HU; P<0.001). Artifacts impairing surrounding muscle and arteries were also reduced by all three approaches. In visual assessment, ARA, VMI ≥100 keV, and VMIARA between 70-200 keV also showed significant artifact reduction and improved assessment; however, for assessment of arteries improvement was not significant using ARA alone. New artifacts were reported, particularly at higher keV-values. CONCLUSIONS: In presence of perivenous-artifacts, ARA, VMI and their combination allow for significant artifact reduction; however, their combination and VMI as a standalone approach yielded best results and should therefore be used, if available. 2021 Quantitative Imaging in Medicine and Surgery. All rights reserved.
BACKGROUND: After injection into a brachial vein, high contrast media concentration in axillary and subclavian veins can cause artifacts that impair diagnostic utility. This study assessed artifact reduction by artifact-reduction-algorithms (ARA) and virtual-monoenergetic-images (VMI), as well as their combination (VMIARA) compared to conventional CT-images (CI). METHODS: Forty-six spectral-detector-CT (SDCT) examinations of patients that received ARA-reconstructions due to perivenous-artifacts were included in this retrospective study. CI, ARA, VMI, and VMIARA (range: 70-200 keV) were reconstructed. Objective analysis was performed with ROI-based assessment of mean and standard deviation of attenuation (HU) in hypo- and hyperdense artifacts and impaired muscle and arteries as well as artifact-free reference-tissue. Extent of artifact reduction, assessment of surrounding soft tissue and vessels, and appearance of new artifacts were rated visually by two radiologists. RESULTS: Hypo- and hyperdense artifacts showed significant improvement as evidenced by decreasing attenuation differences between artifact impaired and artifact-free reference tissue in ARA, VMI ≥80 keV, and VMIARA between 70-200 keV (e.g., CI/ARA/VMI100keV/VMIARA100keV: hypodense artifacts, (-)264.8±150.9/(-)87.1±78.9/(-)48.6±64.6/9.9±63.9 HU; P<0.001); hyperdense artifacts, 164.2±51.1/82.1±73.2/7.9±34.7/(-)17.3±50.7 HU; P<0.001). Artifacts impairing surrounding muscle and arteries were also reduced by all three approaches. In visual assessment, ARA, VMI ≥100 keV, and VMIARA between 70-200 keV also showed significant artifact reduction and improved assessment; however, for assessment of arteries improvement was not significant using ARA alone. New artifacts were reported, particularly at higher keV-values. CONCLUSIONS: In presence of perivenous-artifacts, ARA, VMI and their combination allow for significant artifact reduction; however, their combination and VMI as a standalone approach yielded best results and should therefore be used, if available. 2021 Quantitative Imaging in Medicine and Surgery. All rights reserved.
Authors: Matthew Jay Budoff; Jerold S Shinbane; Janis Child; Sivi Carson; Alex Chau; Stephen H Liu; SongShou Mao Journal: Acad Radiol Date: 2006-02 Impact factor: 3.173
Authors: Thomas G Flohr; Cynthia H McCollough; Herbert Bruder; Martin Petersilka; Klaus Gruber; Christoph Süss; Michael Grasruck; Karl Stierstorfer; Bernhard Krauss; Rainer Raupach; Andrew N Primak; Axel Küttner; Stefan Achenbach; Christoph Becker; Andreas Kopp; Bernd M Ohnesorge Journal: Eur Radiol Date: 2005-12-10 Impact factor: 5.315
Authors: Kai Roman Laukamp; Amit Gupta; Nils Große Hokamp; Verena Carola Obmann; Frank Philipp Graner; Vivian Ho; Pablo Ros; Nikhil Ramaiya; Robert Gilkeson Journal: Acta Radiol Date: 2019-08-18 Impact factor: 1.990
Authors: Kai Roman Laukamp; Simon Lennartz; Victor-Frederic Neuhaus; Nils Große Hokamp; Robert Rau; Markus Le Blanc; Nuran Abdullayev; Anastasios Mpotsaris; David Maintz; Jan Borggrefe Journal: Eur Radiol Date: 2018-05-03 Impact factor: 5.315
Authors: Fabian Bamberg; Alexander Dierks; Konstantin Nikolaou; Maximilian F Reiser; Christoph R Becker; Thorsten R C Johnson Journal: Eur Radiol Date: 2011-01-20 Impact factor: 5.315
Authors: Stefanie Mangold; Sergios Gatidis; Oliver Luz; Benjamin König; Christoph Schabel; Malte N Bongers; Thomas G Flohr; Claus D Claussen; Christoph Thomas Journal: Invest Radiol Date: 2014-12 Impact factor: 6.016
Authors: Lenhard Pennig; David Zopfs; Roman Gertz; Johannes Bremm; Charlotte Zaeske; Nils Große Hokamp; Erkan Celik; Lukas Goertz; Marcel Langenbach; Thorsten Persigehl; Amit Gupta; Jan Borggrefe; Simon Lennartz; Kai Roman Laukamp Journal: Eur Radiol Date: 2021-02-25 Impact factor: 5.315