Measuring femoral lesions despite CT metal artefacts: a cadaveric study.

Objective: Computed tomography is the modality of choice for measuring osteolysis but suffers from metal-induced artefacts obscuring periprosthetic tissues. Previous papers on metal artefact reduction (MAR) show qualitative improvements, but their algorithms have not found acceptance for clinical ap...

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Publicado en:Skeletal Radiology Vol. 41; no. 5; pp. 547 - 556
Autores principales: Malan DF, Botha CP, Kraaij G, Joemai RM, van der Heide HJ, Nelissen RG, Valstar ER, Malan, Daniel F, Botha, Charl P, Kraaij, Gert, Joemai, Raoul M S, van der Heide, Huub J L, Nelissen, Rob G H H, Valstar, Edward R
Formato: research Journal Article
Publicado: Springer Nature May2012
Acceso en línea:Ver este registro en EBSCOhost
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      dt: May2012
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      pub: Springer Nature
      place: New York, New York
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        atl: Measuring femoral lesions despite CT metal artefacts: a cadaveric study.
      aug:
        au:
          Malan DF
          Botha CP
          Kraaij G
          Joemai RM
          van der Heide HJ
          Nelissen RG
          Valstar ER
          Malan, Daniel F
          Botha, Charl P
          Kraaij, Gert
          Joemai, Raoul M S
          van der Heide, Huub J L
          Nelissen, Rob G H H
          Valstar, Edward R
        affil: Department of Orthopaedics, Leiden University Medical Center, J11-R Albinusdreef 2, 2333ZA Leiden, The Netherlands
      sug:
        subj:
          Artifacts
          Femur Radiography
          Metals
          Osteolysis Radiography
          Prostheses and Implants
          Tomography, X-Ray Computed Methods
          Aged
          Aged, 80 and Over
          Algorithms
          Cadaver
          Female
          Human
          Male
          Osteolysis Etiology
          Phantoms, Imaging
          Prosthesis Failure Adverse Effects
          Radiographic Image Enhancement Methods
          Aged: 65+ years
          Aged, 80 & over
          Female
          Male
      ab: Objective: Computed tomography is the modality of choice for measuring osteolysis but suffers from metal-induced artefacts obscuring periprosthetic tissues. Previous papers on metal artefact reduction (MAR) show qualitative improvements, but their algorithms have not found acceptance for clinical applications. We investigated to what extent metal artefacts interfere with the segmentation of lesions adjacent to a metal femoral implant and whether metal artefact reduction improves the manual segmentation of such lesions.Materials and Methods: We manually created 27 periprosthetic lesions in 10 human cadaver femora. We filled the lesions with a fibrotic interface tissue substitute. Each femur was fitted with a polished tapered cobalt-chrome prosthesis and imaged twice--once with the metal, and once with a substitute resin prosthesis inserted. Metal-affected CTs were processed using standard back-projection as well as projection interpolation (PI) MAR. Two experienced users segmented all lesions and compared segmentation accuracy.Results: We achieved accurate delineation of periprosthetic lesions in the metal-free images. The presence of a metal implant led us to underestimate lesion volume and introduced geometrical errors in segmentation boundaries. Although PI MAR reduced streak artefacts, it led to greater underestimation of lesion volume and greater geometrical errors than without its application.Conclusion: CT metal artefacts impair image segmentation. PI MAR can improve subjective image appearance but causes loss of detail and lower image contrast adjacent to prostheses. Our experiments showed that PI MAR is counterproductive for manual segmentation of periprosthetic lesions and should be used with care.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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