TY - JOUR
T1 - Reduction of Metal Artifacts and Improvement in Dose Efficiency Using Photon-Counting Detector Computed Tomography and Tin Filtration
AU - Zhou, Wei
AU - Bartlett, David J.
AU - Diehn, Felix E.
AU - Glazebrook, Katrina N.
AU - Kotsenas, Amy L.
AU - Carter, Rickey E.
AU - Fletcher, Joel G.
AU - McCollough, Cynthia H.
AU - Leng, Shuai
N1 - Funding Information:
Received for publication May 24, 2018; and accepted for publication, after revision, September 29, 2018. From the *Department of Radiology, Mayo Clinic, Rochester, MN; and †Health Sciences Research, Mayo Clinic, Jacksonville, FL. Conflicts of interest and sources of funding: Drs McCollough and Fletcher receive industry funding from Siemens Healthcare. For the remaining authors, none were declared. Research reported in this article was supported by the National Institutes of Health under award number BRP 016966 and C06 RR018898. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Supplemental digital contents are available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (www.investigativeradiology.com). Correspondence to: Shuai Leng, PhD, Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905. E-mail: leng.shuai@mayo.edu. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved. ISSN: 0020-9996/19/5404–0204 DOI: 10.1097/RLI.0000000000000535
Publisher Copyright:
© 2019 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2019/4/1
Y1 - 2019/4/1
N2 - Objectives The aim of this study was to investigate the impact on metal artifacts and dose efficiency of using a tin filter in combination with high-energy threshold (TH) images of a photon-counting detector (PCD) computed tomography (CT) system. Materials and Methods A 3D-printed spine with pedicle screws was scanned on a PCD-CT system with and without tin filtration. Image noise and severity of artifacts were measured for low-energy threshold (TL) and TH images. In a prospective, institutional review board-approved, Health Insurance Portability and Accountability Act-compliant study, 20 patients having a clinical energy-integrating detector (EID) CT were scanned on a PCD-CT system using tin filtration. Images were reviewed by 3 radiologists to evaluate visualization of anatomic structures, diagnostic confidence, and image preference. Artifact severity and image noise were measured. Wilcoxon signed rank was used to test differences between PCD-CT TH and EID-CT images. Results Phantom TH images with tin filtration reduced metal artifacts and had comparable noise (32 HU) to TL images (29 HU) acquired without tin filtration. Visualization scores for the cortex, trabeculae, and implant-trabecular interface from PCD-CT TH images (4.4 ± 0.9, 4.4 ± 1.0, and 4.4 ± 1.0) were significantly higher (P < 0.0001) than EID-CT images (3.3 ± 1.3, 3.3 ± 1.2, and 3.3 ± 1.6). A strong preference was shown for PCD-CT TH images due to improved diagnostic confidence and decreased artifact severity. Noise in PCD-CT TH images (93 ± 41 HU) was significantly lower than that in EID-CT images (133 ± 92 HU, P < 0.05). Conclusions Threshold high images acquired with tin filtration on PCD-CT demonstrated a substantial decrease in metal artifacts and an increase in dose efficiency compared with EID-CT.
AB - Objectives The aim of this study was to investigate the impact on metal artifacts and dose efficiency of using a tin filter in combination with high-energy threshold (TH) images of a photon-counting detector (PCD) computed tomography (CT) system. Materials and Methods A 3D-printed spine with pedicle screws was scanned on a PCD-CT system with and without tin filtration. Image noise and severity of artifacts were measured for low-energy threshold (TL) and TH images. In a prospective, institutional review board-approved, Health Insurance Portability and Accountability Act-compliant study, 20 patients having a clinical energy-integrating detector (EID) CT were scanned on a PCD-CT system using tin filtration. Images were reviewed by 3 radiologists to evaluate visualization of anatomic structures, diagnostic confidence, and image preference. Artifact severity and image noise were measured. Wilcoxon signed rank was used to test differences between PCD-CT TH and EID-CT images. Results Phantom TH images with tin filtration reduced metal artifacts and had comparable noise (32 HU) to TL images (29 HU) acquired without tin filtration. Visualization scores for the cortex, trabeculae, and implant-trabecular interface from PCD-CT TH images (4.4 ± 0.9, 4.4 ± 1.0, and 4.4 ± 1.0) were significantly higher (P < 0.0001) than EID-CT images (3.3 ± 1.3, 3.3 ± 1.2, and 3.3 ± 1.6). A strong preference was shown for PCD-CT TH images due to improved diagnostic confidence and decreased artifact severity. Noise in PCD-CT TH images (93 ± 41 HU) was significantly lower than that in EID-CT images (133 ± 92 HU, P < 0.05). Conclusions Threshold high images acquired with tin filtration on PCD-CT demonstrated a substantial decrease in metal artifacts and an increase in dose efficiency compared with EID-CT.
KW - CT
KW - metal artifact reduction
KW - photon-counting detector
KW - tin filtration
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U2 - 10.1097/RLI.0000000000000535
DO - 10.1097/RLI.0000000000000535
M3 - Article
C2 - 30562270
AN - SCOPUS:85062597883
SN - 0020-9996
VL - 54
SP - 204
EP - 211
JO - Investigative radiology
JF - Investigative radiology
IS - 4
ER -