CT Metal Artifact Reduction in the Spine: Can an Iterative Reconstruction Technique Improve Visualization?

• DOI: 10.3174/ajnr.a4416
• Publication Date: 2015-08-06T22:20:06Z
• Authors: A.L. Kotsenas; G.J. Michalak; D.R. DeLone; F.E. Diehn; K. Grant; A.F. Halaweish; A. Krauss; R. Raupach; B. Schmidt; C.H. McCollough; J.G. Fletcher
• Keywords: Artifact (error)

<h3>BACKGROUND AND PURPOSE:</h3> Metal-related artifacts from spine instrumentation can obscure relevant anatomy and pathology. We evaluated the ability of CT images reconstructed with without iterative metal artifact reduction to visualize critical anatomic structures in postoperative spines assessed potential for implementation into clinical practice. <h3>MATERIALS METHODS:</h3> archived projection data patients instrumented spinal fusion. were by using weighted filtered back-projection reduction. Two neuroradiologists region hardware assigned a score visualization soft-tissue bone windows (critical totally obscured, <i>n</i> = 0; recognition high diagnostic confidence, 5). Using windows, we measured length most pronounced linear artifacts. For each patient, made recommendations regarding optimal use its impact on confidence. <h3>RESULTS:</h3> Sixty-eight met inclusion criteria. Visualization was significantly improved compared (median, 1 ± 1.5 versus 3 1.3, <i>P</i> &lt; .001), improvement worst visualized structure 88% (60/68) patients. There not significant osseous structures. Linear reduced 29 11 mm (<i>P</i> .001). In 87% patients, recommended reconstructing instead images, definite confidence 32% (22/68). <h3>CONCLUSIONS:</h3> Iterative improves hardware. Routine generation these addition routine is recommended.