TY - JOUR
T1 - Application of iterative metal artifact reduction algorithm to CT urography for patients with hip prostheses
AU - Trabzonlu, Tugce Agirlar
AU - Terrazas, Martha
AU - Mozaffary, Amirhossein
AU - Velichko, Yuri S.
AU - Yaghmai, Vahid
N1 - Funding Information:
Supported by educational grants from Siemens Healthineers to T.A. Trabzonlu and A. Mozaffary.
Publisher Copyright:
© American Roentgen Ray Society
PY - 2020
Y1 - 2020
N2 - OBJECTIVE. The purpose of this study is to retrospectively assess the impact of iterative metal artifact reduction (IMAR) with iterative reconstruction (IR) on the image quality and diagnostic performance of CT urography in the evaluation of patients with hip prostheses, compared with IR alone. MATERIALS AND METHODS. CT urography examinations that were reconstructed using IR with and without IMAR were analyzed for 57 patients (29 women and 28 men; mean age, 74 years [range, 22-94 years]) with hip prostheses (40 unilateral and 17 bilateral). For quantitative analysis, image noise within the bladder was measured. Two radiologists (radiologist 1 [RAD1] and radiologist 2 [RAD2]) qualitatively evaluated the images using both a 5-point scale to assess the degree of visualization of artifacts and a 6-point scale to determine diagnostic confidence in visualization of the bladder, ureters, prostate or uterus, pelvic calcifications, and genitourinary abnormalities involving the bladder, distal ureters, prostate, uterus, and ovaries. RESULTS. The combination of IMAR and an IR technique provided improvement in quantitative and qualitative measurements (p < 0.05). Forty-three genitourinary abnormalities were detected in 29 patients. Quantitative and qualitative comparisons of scans obtained with and without the use of IMAR, respectively, revealed image noise of 99.6 versus 173.3 HU and the following radiologist scores: for improvement of artifacts, 3.2 versus 1.6 (for RAD1) and 3.1 versus 1.6 (for RAD2); for visualization of the bladder, 3.6 versus 1.5 (RAD1) and 3.8 versus 1.6 (RAD2); visualization of the ureters, 3.8 versus 1.6 (RAD1) and 3.9 versus 1.7 (RAD2); visualization of the uterus, 4.3 versus 2.8 (RAD1) and 4.3 versus 2.6 (RAD2); visualization of the prostate, 4.5 versus 2.3 (RAD1) and 4.5 versus 2.2 (RAD2); diagnostic confidence for calcifications, 4.7 versus 3.5 (RAD1) and 4.7 versus 3.3 (RAD2); and diagnostic confidence for genitourinary abnormalities, 5.0 versus 3.2 (RAD1) and 4.8 versus 2.9 (RAD2), respectively. CONCLUSION. The addition of IMAR to IR led to statistically significant improvement in the retrospective diagnostic performance and image quality of CT urography for patients with hip prostheses, compared with IR alone.
AB - OBJECTIVE. The purpose of this study is to retrospectively assess the impact of iterative metal artifact reduction (IMAR) with iterative reconstruction (IR) on the image quality and diagnostic performance of CT urography in the evaluation of patients with hip prostheses, compared with IR alone. MATERIALS AND METHODS. CT urography examinations that were reconstructed using IR with and without IMAR were analyzed for 57 patients (29 women and 28 men; mean age, 74 years [range, 22-94 years]) with hip prostheses (40 unilateral and 17 bilateral). For quantitative analysis, image noise within the bladder was measured. Two radiologists (radiologist 1 [RAD1] and radiologist 2 [RAD2]) qualitatively evaluated the images using both a 5-point scale to assess the degree of visualization of artifacts and a 6-point scale to determine diagnostic confidence in visualization of the bladder, ureters, prostate or uterus, pelvic calcifications, and genitourinary abnormalities involving the bladder, distal ureters, prostate, uterus, and ovaries. RESULTS. The combination of IMAR and an IR technique provided improvement in quantitative and qualitative measurements (p < 0.05). Forty-three genitourinary abnormalities were detected in 29 patients. Quantitative and qualitative comparisons of scans obtained with and without the use of IMAR, respectively, revealed image noise of 99.6 versus 173.3 HU and the following radiologist scores: for improvement of artifacts, 3.2 versus 1.6 (for RAD1) and 3.1 versus 1.6 (for RAD2); for visualization of the bladder, 3.6 versus 1.5 (RAD1) and 3.8 versus 1.6 (RAD2); visualization of the ureters, 3.8 versus 1.6 (RAD1) and 3.9 versus 1.7 (RAD2); visualization of the uterus, 4.3 versus 2.8 (RAD1) and 4.3 versus 2.6 (RAD2); visualization of the prostate, 4.5 versus 2.3 (RAD1) and 4.5 versus 2.2 (RAD2); diagnostic confidence for calcifications, 4.7 versus 3.5 (RAD1) and 4.7 versus 3.3 (RAD2); and diagnostic confidence for genitourinary abnormalities, 5.0 versus 3.2 (RAD1) and 4.8 versus 2.9 (RAD2), respectively. CONCLUSION. The addition of IMAR to IR led to statistically significant improvement in the retrospective diagnostic performance and image quality of CT urography for patients with hip prostheses, compared with IR alone.
KW - CT urography
KW - Hip prosthesis
KW - Iterative metal artifact reduction
KW - Metal artifact
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UR - http://www.scopus.com/inward/citedby.url?scp=85077016492&partnerID=8YFLogxK
U2 - 10.2214/AJR.19.21748
DO - 10.2214/AJR.19.21748
M3 - Article
C2 - 31642697
AN - SCOPUS:85077016492
SN - 0361-803X
VL - 214
SP - 137
EP - 143
JO - American Journal of Roentgenology
JF - American Journal of Roentgenology
IS - 1
ER -