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Evaluation of a metal artifact reduction algorithm applied to post-interventional flat detector CT in comparison to pre-treatment CT in patients with acute subarachnoid haemorrhage

  • Vascular-Interventional
  • Published:
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Abstract

Objectives

Metal artefacts can impair accurate diagnosis of haemorrhage using flat detector CT (FD-CT), especially after aneurysm coiling. Within this work we evaluate a prototype metal artefact reduction algorithm by comparison of the artefact-reduced and the non-artefact-reduced FD-CT images to pre-treatment FD-CT and multi-slice CT images.

Methods

Twenty-five patients with acute aneurysmal subarachnoid haemorrhage (SAH) were selected retrospectively. FD-CT and multi-slice CT before endovascular treatment as well as FD-CT data sets after treatment were available for all patients. The algorithm was applied to post-treatment FD-CT. The effect of the algorithm was evaluated utilizing the pre-post concordance of a modified Fisher score, a subjective image quality assessment, the range of the Hounsfield units within three ROIs, and the pre-post slice-wise Pearson correlation.

Results

The pre-post concordance of the modified Fisher score, the subjective image quality, and the pre-post correlation of the ranges of the Hounsfield units were significantly higher for artefact-reduced than for non-artefact-reduced images. Within the metal-affected slices, the pre-post slice-wise Pearson correlation coefficient was higher for artefact-reduced than for non-artefact-reduced images.

Conclusion

The overall diagnostic quality of the artefact-reduced images was improved and reached the level of the pre-interventional FD-CT images. The metal-unaffected parts of the image were not modified.

Key Points

• After coiling subarachnoid haemorrhage, metal artefacts seriously reduce FD-CT image quality.

• This new metal artefact reduction algorithm is feasible for flat-detector CT.

• After coiling, MAR is necessary for diagnostic quality of affected slices.

• Slice-wise Pearson correlation is introduced to evaluate improvement of MAR in future studies.

• Metal-unaffected parts of image are not modified by this MAR algorithm.

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Abbreviations

FD-CT:

Flat-detector CT

MAR:

Metal artefact reduction

MSCT:

Multi-slice CT

HU:

Hounsfield units

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Acknowledgments

The scientific guarantor of this publication is author Professor Tobias Struffert. The authors Bernhard Scholz and Kevin Royalty are full time Siemens employees. The authors of this manuscript declare no other relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. One of the authors has significant statistical expertise. Written informed consent and Institutional Review Board approval was not required because of the retrospective character of the study. The Methodology of this paper is experimental with retrospectively gained data and performed at one institution.

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Authors and Affiliations

  1. Department of Neuroradiology, University of Erlangen-Nuremberg, Schwabachanlage 6, 91054, Erlangen, Germany

    Angelika Mennecke, Stanislav Svergun, Arnd Dörfler & Tobias Struffert

  2. Siemens Healthcare GmbH, Simon-Hegele-Strasse 1, 91301, Forchheim, Germany

    Bernhard Scholz

  3. Siemens Medical Solutions, USA, Inc., 2501 N. Barrington Rd., Hoffman Estates, IL, 60192, USA

    Kevin Royalty

Authors
  1. Angelika Mennecke
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  2. Stanislav Svergun
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  3. Bernhard Scholz
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  4. Kevin Royalty
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  5. Arnd Dörfler
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  6. Tobias Struffert
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Corresponding author

Correspondence to Angelika Mennecke.

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Mennecke, A., Svergun, S., Scholz, B. et al. Evaluation of a metal artifact reduction algorithm applied to post-interventional flat detector CT in comparison to pre-treatment CT in patients with acute subarachnoid haemorrhage. Eur Radiol 27, 88–96 (2017). https://doi.org/10.1007/s00330-016-4351-1

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  • DOI: https://doi.org/10.1007/s00330-016-4351-1

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