Optimal combination periprosthetic vasculature visualization and metal artifact reduction by spectral computed tomography using virtual monoenergetic images in total hip arthroplasty

Abstract Objectives To investigate the optimal parameters of spectral CT for preferably visualizing the periprosthetic vasculature and metal artifact reduction (MAR) in total hip arthroplasty (THA). Methods A total of 34 THA of 30 patients were retrospectively included. Image reconstructions include...

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Main Authors: Jie Zhao, Qiang Cheng, Chuan Liu, Qiqi Wang, Yuchan Lv, Ziyi Tang, Yuxi Luo, Haitao Yang
Format: Article
Language:English
Published: SpringerOpen 2023-10-01
Series:Insights into Imaging
Subjects:
Online Access:https://doi.org/10.1186/s13244-023-01533-3
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author Jie Zhao
Qiang Cheng
Chuan Liu
Qiqi Wang
Yuchan Lv
Ziyi Tang
Yuxi Luo
Haitao Yang
author_facet Jie Zhao
Qiang Cheng
Chuan Liu
Qiqi Wang
Yuchan Lv
Ziyi Tang
Yuxi Luo
Haitao Yang
author_sort Jie Zhao
collection DOAJ
description Abstract Objectives To investigate the optimal parameters of spectral CT for preferably visualizing the periprosthetic vasculature and metal artifact reduction (MAR) in total hip arthroplasty (THA). Methods A total of 34 THA of 30 patients were retrospectively included. Image reconstructions included conventional image (CI), CI combined with MAR (CIMAR), and virtual monoenergetic images (VMI) combined with MAR (VMIMAR) at 50–120 keV. The attenuation and standard deviation of the vessel and artifact, and the width of artifact were measured. Qualitative scoring was evaluated including the vascular contour, the extent of artifact, and overall diagnostic evaluation. Results The attenuation, noise of the vessel and artifact, and the width of artifact decreased as the energy level increased (p < 0.001). The downtrend was relatively flat at 80–120 keV, and the vascular attenuation dropped to 200 HU at 90 keV. The qualitative rating of vascular contour was significantly higher at CIMAR (3.47) and VMIMAR 60–80 keV (2.82–3.65) compared with CI (2.03) (p ≤ 0.029), and the highest score occurred at 70 and 80 keV (3.65 and 3.56). The score of the extent of artifact was higher at VMIMAR 80 keV than CIMAR (3.53 VS 3.12, p = 0.003). The score of the overall diagnostic evaluation was higher at VMIMAR 70 and 80 keV (3.32 and 3.53, respectively) than CIMAR (3.12) (p ≤ 0.035). Conclusion Eighty kiloelectron volts on VMIMAR, providing satisfactorily reduced metal artifacts and improved vascular visualization, can be an optimal recommended parameter of spectrum CT for the assessment of periprosthetic vasculature in THA patients. Critical relevance statement The metal artifact is gradually reducing with increasing energy level; however, the vascular visualization is worsening. The vascular visualization is terrible above 100 keV, while the vessel is disturbed by artifacts below 70 keV. The best performance is found at 80 keV. Key points • VMIMAR can provide both reduced metal artifacts and improved vascular visualization. • Eighty kiloelectron volts on VMIMAR performs best in vascular visualization of total hip arthroplasty patients. • Energy spectrum CT is recommended for routine use in patients with total hip arthroplasty. Graphical Abstract
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spelling doaj.art-b52cd039efd14c1f82147c0c30f915812023-11-20T09:38:51ZengSpringerOpenInsights into Imaging1869-41012023-10-0114111210.1186/s13244-023-01533-3Optimal combination periprosthetic vasculature visualization and metal artifact reduction by spectral computed tomography using virtual monoenergetic images in total hip arthroplastyJie Zhao0Qiang Cheng1Chuan Liu2Qiqi Wang3Yuchan Lv4Ziyi Tang5Yuxi Luo6Haitao Yang7Department of Radiology, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Orthopedics, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Radiology, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Radiology, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Radiology, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Radiology, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Radiology, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Radiology, The First Affiliated Hospital of Chongqing Medical UniversityAbstract Objectives To investigate the optimal parameters of spectral CT for preferably visualizing the periprosthetic vasculature and metal artifact reduction (MAR) in total hip arthroplasty (THA). Methods A total of 34 THA of 30 patients were retrospectively included. Image reconstructions included conventional image (CI), CI combined with MAR (CIMAR), and virtual monoenergetic images (VMI) combined with MAR (VMIMAR) at 50–120 keV. The attenuation and standard deviation of the vessel and artifact, and the width of artifact were measured. Qualitative scoring was evaluated including the vascular contour, the extent of artifact, and overall diagnostic evaluation. Results The attenuation, noise of the vessel and artifact, and the width of artifact decreased as the energy level increased (p < 0.001). The downtrend was relatively flat at 80–120 keV, and the vascular attenuation dropped to 200 HU at 90 keV. The qualitative rating of vascular contour was significantly higher at CIMAR (3.47) and VMIMAR 60–80 keV (2.82–3.65) compared with CI (2.03) (p ≤ 0.029), and the highest score occurred at 70 and 80 keV (3.65 and 3.56). The score of the extent of artifact was higher at VMIMAR 80 keV than CIMAR (3.53 VS 3.12, p = 0.003). The score of the overall diagnostic evaluation was higher at VMIMAR 70 and 80 keV (3.32 and 3.53, respectively) than CIMAR (3.12) (p ≤ 0.035). Conclusion Eighty kiloelectron volts on VMIMAR, providing satisfactorily reduced metal artifacts and improved vascular visualization, can be an optimal recommended parameter of spectrum CT for the assessment of periprosthetic vasculature in THA patients. Critical relevance statement The metal artifact is gradually reducing with increasing energy level; however, the vascular visualization is worsening. The vascular visualization is terrible above 100 keV, while the vessel is disturbed by artifacts below 70 keV. The best performance is found at 80 keV. Key points • VMIMAR can provide both reduced metal artifacts and improved vascular visualization. • Eighty kiloelectron volts on VMIMAR performs best in vascular visualization of total hip arthroplasty patients. • Energy spectrum CT is recommended for routine use in patients with total hip arthroplasty. Graphical Abstracthttps://doi.org/10.1186/s13244-023-01533-3Energy spectrum CTVirtual monoenergetic imagingMetal artifact reductionPeriprosthetic vasculature
spellingShingle Jie Zhao
Qiang Cheng
Chuan Liu
Qiqi Wang
Yuchan Lv
Ziyi Tang
Yuxi Luo
Haitao Yang
Optimal combination periprosthetic vasculature visualization and metal artifact reduction by spectral computed tomography using virtual monoenergetic images in total hip arthroplasty
Insights into Imaging
Energy spectrum CT
Virtual monoenergetic imaging
Metal artifact reduction
Periprosthetic vasculature
title Optimal combination periprosthetic vasculature visualization and metal artifact reduction by spectral computed tomography using virtual monoenergetic images in total hip arthroplasty
title_full Optimal combination periprosthetic vasculature visualization and metal artifact reduction by spectral computed tomography using virtual monoenergetic images in total hip arthroplasty
title_fullStr Optimal combination periprosthetic vasculature visualization and metal artifact reduction by spectral computed tomography using virtual monoenergetic images in total hip arthroplasty
title_full_unstemmed Optimal combination periprosthetic vasculature visualization and metal artifact reduction by spectral computed tomography using virtual monoenergetic images in total hip arthroplasty
title_short Optimal combination periprosthetic vasculature visualization and metal artifact reduction by spectral computed tomography using virtual monoenergetic images in total hip arthroplasty
title_sort optimal combination periprosthetic vasculature visualization and metal artifact reduction by spectral computed tomography using virtual monoenergetic images in total hip arthroplasty
topic Energy spectrum CT
Virtual monoenergetic imaging
Metal artifact reduction
Periprosthetic vasculature
url https://doi.org/10.1186/s13244-023-01533-3
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