The impact of a metal artefact reduction algorithm on treatment planning for patients undergoing radiotherapy of the pelvis

Background and purpose: Metallic implants cause artefacts in computed tomography (CT) images and can introduce significant errors to structure visualisation and dosimetric calculation within the radiotherapy planning process. This study evaluated an orthopaedic metal artefact reduction algorithm and...

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Main Authors: John King, Shona Whittam, David Smith, Bashar Al-Qaisieh
Format: Article
Language:English
Published: Elsevier 2022-10-01
Series:Physics and Imaging in Radiation Oncology
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2405631622000975
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author John King
Shona Whittam
David Smith
Bashar Al-Qaisieh
author_facet John King
Shona Whittam
David Smith
Bashar Al-Qaisieh
author_sort John King
collection DOAJ
description Background and purpose: Metallic implants cause artefacts in computed tomography (CT) images and can introduce significant errors to structure visualisation and dosimetric calculation within the radiotherapy planning process. This study evaluated an orthopaedic metal artefact reduction algorithm and its effect on the CT number, image noise, structure delineation, and treatment dose. Methods: Raw CT data were reconstructed using standard filtered back projection and an artefact reduction algorithm to create ‘standard’ and ‘corrected’ images. A phantom containing tissue-mimicking inserts and two titanium plugs was imaged. The average CT number was compared to baseline data acquired without metal inserts. Data from 11 pelvic external beam radiotherapy (EBRT) patients with bi- or uni-lateral hip implants were retrospectively analysed. The clinically used treatment plans were re-computed on the corrected images. A prostate-mimicking phantom containing metal ‘implants’ was imaged, and 11 observers contoured both reconstructions. Results: The artefact reduction algorithm improved the CT number in those areas most affected by metal artefacts and decreased noise by 19 % (P =.04) Changes in dose distributions on corrected images compared to those calculated using the current clinical protocol were clinically insignificant. Volumes contoured on the corrected phantom images had larger Dice coefficients than those contoured on the standard images (P =.001), as well as a 36 % lower standard deviation in volumes. Conclusion: This study demonstrates that the metal artefact reduction software reduces the error in CT numbers, can improve delineation accuracy, and can reduce inter-observer variability. It has the potential to streamline the planning pathway and improve treatment planning accuracy.
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spelling doaj.art-30314108f46b44ff9379de9d21d391612022-12-22T04:23:15ZengElsevierPhysics and Imaging in Radiation Oncology2405-63162022-10-0124138143The impact of a metal artefact reduction algorithm on treatment planning for patients undergoing radiotherapy of the pelvisJohn King0Shona Whittam1David Smith2Bashar Al-Qaisieh3Leeds Cancer Centre, St James’s University Hospital, Bexley Wing, Beckett St, Leeds LS97FT, United KingdomLeeds Cancer Centre, St James’s University Hospital, Bexley Wing, Beckett St, Leeds LS97FT, United KingdomCorresponding author.; Leeds Cancer Centre, St James’s University Hospital, Bexley Wing, Beckett St, Leeds LS97FT, United KingdomLeeds Cancer Centre, St James’s University Hospital, Bexley Wing, Beckett St, Leeds LS97FT, United KingdomBackground and purpose: Metallic implants cause artefacts in computed tomography (CT) images and can introduce significant errors to structure visualisation and dosimetric calculation within the radiotherapy planning process. This study evaluated an orthopaedic metal artefact reduction algorithm and its effect on the CT number, image noise, structure delineation, and treatment dose. Methods: Raw CT data were reconstructed using standard filtered back projection and an artefact reduction algorithm to create ‘standard’ and ‘corrected’ images. A phantom containing tissue-mimicking inserts and two titanium plugs was imaged. The average CT number was compared to baseline data acquired without metal inserts. Data from 11 pelvic external beam radiotherapy (EBRT) patients with bi- or uni-lateral hip implants were retrospectively analysed. The clinically used treatment plans were re-computed on the corrected images. A prostate-mimicking phantom containing metal ‘implants’ was imaged, and 11 observers contoured both reconstructions. Results: The artefact reduction algorithm improved the CT number in those areas most affected by metal artefacts and decreased noise by 19 % (P =.04) Changes in dose distributions on corrected images compared to those calculated using the current clinical protocol were clinically insignificant. Volumes contoured on the corrected phantom images had larger Dice coefficients than those contoured on the standard images (P =.001), as well as a 36 % lower standard deviation in volumes. Conclusion: This study demonstrates that the metal artefact reduction software reduces the error in CT numbers, can improve delineation accuracy, and can reduce inter-observer variability. It has the potential to streamline the planning pathway and improve treatment planning accuracy.http://www.sciencedirect.com/science/article/pii/S2405631622000975Computed tomographyRadiotherapyArtefact reductionPelvis radiotherapy
spellingShingle John King
Shona Whittam
David Smith
Bashar Al-Qaisieh
The impact of a metal artefact reduction algorithm on treatment planning for patients undergoing radiotherapy of the pelvis
Physics and Imaging in Radiation Oncology
Computed tomography
Radiotherapy
Artefact reduction
Pelvis radiotherapy
title The impact of a metal artefact reduction algorithm on treatment planning for patients undergoing radiotherapy of the pelvis
title_full The impact of a metal artefact reduction algorithm on treatment planning for patients undergoing radiotherapy of the pelvis
title_fullStr The impact of a metal artefact reduction algorithm on treatment planning for patients undergoing radiotherapy of the pelvis
title_full_unstemmed The impact of a metal artefact reduction algorithm on treatment planning for patients undergoing radiotherapy of the pelvis
title_short The impact of a metal artefact reduction algorithm on treatment planning for patients undergoing radiotherapy of the pelvis
title_sort impact of a metal artefact reduction algorithm on treatment planning for patients undergoing radiotherapy of the pelvis
topic Computed tomography
Radiotherapy
Artefact reduction
Pelvis radiotherapy
url http://www.sciencedirect.com/science/article/pii/S2405631622000975
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