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Pjontek, Rastislav; Önenköprülü, Belgin; Scholz, Bernhard; Kyriakou, Yiannis; Schubert, Gerrit A; Nikoubashman, Omid; Othman, Ahmed; Wiesmann, Martin; Brockmann, Marc A

Metal artifact reduction for flat panel detector intravenous CT angiography in patients with intracranial metallic implants after endovascular and surgical treatment

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  • Media type: E-Article
  • Title: Metal artifact reduction for flat panel detector intravenous CT angiography in patients with intracranial metallic implants after endovascular and surgical treatment
  • Contributor: Pjontek, Rastislav; Önenköprülü, Belgin; Scholz, Bernhard; Kyriakou, Yiannis; Schubert, Gerrit A; Nikoubashman, Omid; Othman, Ahmed; Wiesmann, Martin; Brockmann, Marc A
  • imprint: BMJ, 2016
  • Published in: Journal of NeuroInterventional Surgery
  • Language: English
  • DOI: 10.1136/neurintsurg-2015-011787
  • ISSN: 1759-8478; 1759-8486
  • Origination:
  • Footnote:
  • Description: <jats:sec><jats:title>Background</jats:title><jats:p>Flat panel detector CT angiography with intravenous contrast agent injection (IV CTA) allows high-resolution imaging of cerebrovascular structures. Artifacts caused by metallic implants like platinum coils or clips lead to degradation of image quality and are a significant problem.</jats:p></jats:sec><jats:sec><jats:title>Objective</jats:title><jats:p>To evaluate the influence of a prototype metal artifact reduction (MAR) algorithm on image quality in patients with intracranial metallic implants.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Flat panel detector CT after intravenous application of 80 mL contrast agent was performed with an angiography system (Artis zee; Siemens, Forchheim, Germany) using a 20 s rotation protocol (200° rotation angle, 20 s acquisition time, 496 projections). The data before and after MAR of 26 patients with a total of 34 implants (coils, clips, stents) were independently evaluated by two blinded neuroradiologists.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>MAR improved the assessability of the brain parenchyma and small vessels (diameter &lt;1 mm) in the neighborhood of metallic implants and at a distance of 6 cm (p&lt;0.001 each, Wilcoxon test). Furthermore, MAR significantly improved the assessability of parent vessel patency and potential aneurysm remnants (p&lt;0.005 each, McNemar test). MAR, however, did not improve assessability of stented vessels.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>When an intravenous contrast protocol is used, MAR significantly ameliorates the assessability of brain parenchyma, vessels, and treated aneurysms in patients with intracranial coils or clips.</jats:p></jats:sec>