IJMPCERO  Vol.6 No.2 , May 2017
Evaluation of New Commercially Available Metal Artifact Reduction (MAR) Algorithm on Both Image Quality and Relative Dosimetry for Patients with Hip Prosthesis or Dental Fillings
Abstract: Streaking artifacts on computed tomography (CT) images are caused by high density materials such as hip prosthesis, surgical clips and dental fillings. The artifacts can lead to compromised clinical outcome due to the inability to differentiate tumor volume and the uncertainties in dose calculation. The goals of our study are to evaluate how GE’s smart metal artifact reduction (MAR) algorithm impacts image quality on phantoms and dosimetry on head and neck patients with dental fillings and pelvic patients with hip prosthesis. Treatment plans calculated on the MAR and non-MAR datasets with the same beam arrangements and fluence are compared. Dose differences between the MAR and non-MAR datasets are not significant. However, substantial reductions of metal artifacts are observed when MAR algorithm is applied. Planning on the MAR dataset is recommended since it improves image quality and CT number accuracy. It also negates the need to contour the artifacts and override the density which can be time consuming. 
Cite this paper: Huang, V. and Kohli, K. (2017) Evaluation of New Commercially Available Metal Artifact Reduction (MAR) Algorithm on Both Image Quality and Relative Dosimetry for Patients with Hip Prosthesis or Dental Fillings. International Journal of Medical Physics, Clinical Engineering and Radiation Oncology, 6, 124-138. doi: 10.4236/ijmpcero.2017.62012.

[1]   Boas, F.E. and Fleischmann, D. (2011) Evaluation of Two Iterative Techniques for Reducing Metal Artifacts in Computed Tomography. Radiology, 259, 894-902.

[2]   Barrett, J.F. and Keat, N. (2004) Artifacts in CT: Recognition and Avoidance 1. Radiographics, 24, 1679-1691.

[3]   De Man, B., Nuyts, J., Dupont, P., Marchal, G. and Suetens, P. (1999) Metal Streak Artifacts in X-Ray Computed Tomography: A Simulation Study. IEEE Transactions on Nuclear Science, 46, 691-696.

[4]   Abdoli, M., Mehranian, A., Ailianou, A., Becker, M. and Zaidi, H. (2016) Assessment of Metal Artifact Reduction Methods in Pelvic CT. Medical Physics, 43, 1588-1597.

[5]   Hirata, K., Utsunomiya, D., Oda, S., Kidoh, M., Funama, Y., Yuki, H. and Yamashita, Y. (2015) Added Value of a Single-Energy Projection-Based Metal-Artifact Reduction Algorithm for the Computed Tomography Evaluation of Oral Cavity Cancers. Japanese Journal of Radiology, 33, 650-656.

[6]   Jeong, S., Kim, S.H., Hwang, E.J., Shin, C.I., Han, J.K. and Choi, B.I. (2015) Usefulness of a Metal Artifact Reduction Algorithm for Orthopedic Implants in Abdominal CT: Phantom and Clinical Study Results. American Journal of Roentgenology, 204, 307-317.

[7]   Korpics, M., Surucu, M., Mescioglu, I., Alite, F., Block, A.M., Choi, M. and Roeske, J.C. (2016) Observer Evaluation of a Metal Artifact Reduction Algorithm Applied to Head and Neck Cone Beam Computed Tomographic Images. International Journal of Radiation Oncology Biology Physics, 96, 897-904.

[8]   Wang, J., Wang, S., Chen, Y., Wu, J., Coatrieux, J.L. and Luo, L. (2013) Metal Artifact Reduction in CT Using Fusion Based Prior Image. Medical Physics, 40, Article Number: 081903.

[9]   Wuest, W., May, M.S., Brand, M., Bayerl, N., Krauss, A., Uder, M. and Lell, M. (2015) Improved Image Quality in Head and Neck CT Using a 3D Iterative Approach to Reduce Metal Artifact. American Journal of Neuroradiology, 36, 1988-1993.

[10]   Abdoli, M., Dierckx, R.A. and Zaidi, H. (2012) Metal Artifact Reduction Strategies for Improved Attenuation Correction in Hybrid PET/CT Imaging. Medical Physics, 39, 3343-3360.

[11]   Han, S.C., Chung, Y.E., Lee, Y.H., Park, K.K., Kim, M.J. and Kim, K.W. (2014) Metal Artifact Reduction Software Used with Abdominopelvic Dual-Energy CT of Patients with Metal Hip Prostheses: Assessment of Image Quality and Clinical Feasibility. American Journal of Roentgenology, 203, 788-795.

[12]   Brook, O.R., Gourtsoyianni, S., Brook, A., Mahadevan, A., Wilcox, C. and Raptopoulos, V. (2012) Spectral CT with Metal Artifacts Reduction Software for Improvement of Tumor Visibility in the Vicinity of Gold Fiducial Markers. Radiology, 263, 696-705.

[13]   Axente, M., Paidi, A., Von Eyben, R., Zeng, C., Bani-Hashemi, A., Krauss, A. and Hristov, D. (2015) Clinical Evaluation of the Iterative Metal Artifact Reduction Algorithm for CT Simulation in Radiotherapy. Medical Physics, 42, 1170-1183.

[14]   Li, H., Noel, C., Chen, H., Harold Li, H., Low, D., Moore, K. and Mutic, S. (2012) Clinical Evaluation of a Commercial Orthopedic Metal Artifact Reduction Tool for CT Simulations in Radiation Therapy. Medical Physics, 39, 7507-7517.

[15]   Huang, J.Y., Kerns, J.R., Nute, J.L., Liu, X., Balter, P.A., Stingo, F.C. and Kry, S.F. (2015) An Evaluation of Three Commercially Available Metal Artifact Reduction Methods for CT Imaging. Physics in Medicine and Biology, 60, 1047-1067.

[16]   Shen, Z.L., Xia, P., Klahr, P. and Djemil, T. (2015) Dosimetric Impact of Orthopedic Metal Artifact Reduction (O-MAR) on Spine SBRT Patients. Journal of Applied Clinical Medical Physics, 16, 106-116.

[17]   Spadea, M.F., Verburg, J.M., Baroni, G. and Seco, J. (2014) The Impact of Low-Z and High-Z Metal Implants in IMRT: A Monte Carlo Study of Dose Inaccuracies in Commercial Dose Algorithms. Medical Physics, 41, Article Number: 011702.

[18]   Reft, C., Alecu, R., Das, I.J., Gerbi, B.J., Keall, P., Lief, E. and Van Dyk, J. (2003) Dosimetric Considerations for Patients with HIP Prostheses Undergoing Pelvic Irradiation. Report of the AAPM Radiation Therapy Committee Task Group 63. Medical Physics, 30, 1162-1182.

[19]   Pal, D., Dong, S., Genitsarios, I. and Hsieh, J. (2013) Smart Metal Artifact Reduction [White Paper]. Technical Report, General Electric Healthcare Company, Chicago. ion.pdf

[20]   Boos, J., Sawicki, L.M., Lanzman, R.S., Thomas, C., Aissa, J., Schleich, C. and Kröpil, P. (2017) Metal Artifact Reduction (MAR) Based on Two-Compartment Physical Modeling: Evaluation in Patients with Hip Implants. Acta Radiologica, 58, 70-76.

[21]   Huang, J.Y., Followill, D.S., Howell, R.M., Liu, X., Mirkovic, D., Stingo, F.C. and Kry, S.F. (2016) Approaches to Reducing Photon Dose Calculation Errors near Metal Implants. Medical Physics, 43, 5117-5130.