Quantitative analysis of metal artifact reduction in total hip arthroplasty using virtual monochromatic imaging and orthopedic metal artifact reduction, a phantom study.
OBJECTIVE
To quantify metal artifact reduction using 130 keV virtual monochromatic imaging (VMI) with and without orthopedic metal artifact reduction (O-MAR) in total hip arthroplasty.


METHODS
Conventional polychromatic images and 130 keV VMI of a phantom with pellets representing bone with unilateral or bilateral prostheses were reconstructed with and without O-MAR on a dual-layer CT. Pellets were categorized as unaffected, mildly affected and severely affected.


RESULTS
When 130 keV VMI with O-MAR was compared to conventional imaging with O-MAR, a relative metal artifact reduction in CT values, contrast-to-noise (CNR), signal-to-noise (SNR) and noise in mildly affected pellets (67%, 74%, 48%, 68%, respectively; p < 0.05) was observed but no significant relative metal artifact reduction in severely affected pellets. Comparison between 130 keV VMI without O-MAR and conventional imaging with O-MAR showed relative metal artifact reduction in CT values, CNR, SNR and noise in mildly affected pellets (92%, 72%, 38%, 51%, respectively; p < 0.05) but negative relative metal artifact reduction in CT values and noise in severely affected pellets (- 331% and -223%, respectively; p < 0.05), indicating aggravation of metal artifacts.


CONCLUSION
Overall, VMI of 130 keV with O-MAR provided the strongest metal artifact reduction.
['Selles|Mark|M|http://orcid.org/0000-0002-1511-1438', 'Stuivenberg|Vera H|VH|', 'Wellenberg|Ruud H H|RHH|', 'van de Riet|Loes|L|', 'Nijholt|Ingrid M|IM|', 'van Osch|Jochen A C|JAC|', 'van Hamersvelt|Robbert W|RW|', 'Leiner|Tim|T|', 'Boomsma|Martijn F|MF|']
Hip Arthroplasty CT Dual energy Replacement