Metal Streak Analysis with different Acquisition Settings in Postoperative Spine Imaging: A Phantom Study

Authors: N. D. Osman, M. S. Salikin, M. I. Saripan

Abstract:

CT assessment of postoperative spine is challenging in the presence of metal streak artifacts that could deteriorate the quality of CT images. In this paper, we studied the influence of different acquisition parameters on the magnitude of metal streaking. A water-bath phantom was constructed with metal insertion similar with postoperative spine assessment. The phantom was scanned with different acquisition settings and acquired data were reconstructed using various reconstruction settings. Standardized ROIs were defined within streaking region for image analysis. The result shows increased kVp and mAs enhanced SNR values by reducing image noise. Sharper kernel enhanced image quality compared to smooth kernel, but produced more noise in the images with higher CT fluctuation. The noise between both kernels were significantly different (P <0.05) with increment of noise in the bone kernel images (mean difference = 54.78). The technical settings should be selected appropriately to attain the acceptable image quality with the best diagnostic value.

Keywords: Computed tomography, metal streak, noise, CT fluctuation.

Digital Object Identifier (DOI): doi.org/10.5281/zenodo.1056765

References:

[1] E.E. Rutherford, L.J. Tarplett, E.M. Davies, J.M. Harley, L.J. King, "Lumbar spine fusion and stabilization: Hardware, techniques, and imaging appearances," Radiographics. Vol. 27 (6), pp. 1737 - 1749, 2007.
[2] A. C. Douglas-Akinwande, K. A. Buckwalter, J. Rydberg, J. L. Rankin, R. H. Choplin, "Multichannel CT: Evaluating the spine in postoperative patients with orthopedic hardware," Radiographics. Vol. 26, pp. S97-S110, 2006.
[3] V.W. Lin, C.M. Bono, D.D. Cardenas, et. al, "Spinal cord medicine: principles and practice," 2nd ed., New York: Demos Medical Publishing, 2010, ch.3, pp. 34-45.
[4] D.D.Robertson, P.J.Weiss, E.K. Fishman, D.Magid, and P.S. Walker, "Evaluation of CT techniques for reducing artifacts in the presence of metallic orthopedic implants," J. of Compt. Assist. Tomogr., Vol.12, p.236-241, 1988.
[5] J.F. Barret and N. Keat, "Artifacts in CT: Recognition and Avoidance," RadioGraphics, vol. 24, pp. 1679-1691, 2004.
[6] M. Yazdi and L. Beaulieu, "Artifacts in spiral x-ray CT scanners: Problems and Solutions," World Acad of Sci and Tech, vol. 35, p.96-100, 2007.
[7] M.J. Lee, S. Kim, S.A. Lee, H.T. Song, Y.M. Huh, D.H. Kim, S.H. Han, and J.S. Suh, "Overcoming Artifacts from Metallic Orthopedic Implants at High-Field-Strength MR Imaging and Multidetector CT," RadioGraphics, vol. 27, pp. 791-803, 2007.
[8] P. Stradiotti, A. Curti, G. Castellazzi, and A. Zerbi, "Metal-related artifacts in instrumented spine. Techniques for reducing artifacts in CT and MRI: state of the art," Eur Spine J, vol.18, p.S102-S108, 2009.
[9] M.L. Kataoka, M.G. Hochman, E.K. Rodriguez, P.P.Lin, S. Kubo, and V.D. Raptopolous, "A Review of Factors That Affect Artifact From Metallic Hardware on Multi-Row Detector Computed Tomography," Curr Probl Diagn Radiol, vol.39, pp.125-136, 2010.
[10] W. A. Kalendar, "Computed Tomography: Fundamentals, System Technology, Image Quality, Applications," Munich, Germany: Publicis MCD, Verlag, 2000.
[11] J. Paul, B. Krauss, R. Banckwitz, W. Maentele, R.W. Bauer, T.J. Vogl, "Relationship of clinical protocols and reconstruction kernels with image quality and radiation dose in a 128-slice CT scanner: Study with an antromorphic and water phantom," Eur. J. of Radiology, in press (doi:10.1016/j.ejrad.2011.01.078),
[12] I. Kassim, H. Joosten, J.C. Barnhoorn, B.J.M. Heijmen, and M.L.P. Dirkx, "Implications of artefacts reduction in the planning CT originating from implanted fiducial markers," Med.Dosimetry, in press (doi: 10.1016/j.meddos.2010.02.002).