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CT artifacts from port systems: Virtual monoenergetic reconstructions from spectral-detector CT reduce artifacts and improve depiction of surrounding tissue.

Abstract：

PURPOSE:CT artifacts from port-systems are a common problem in staging- and restaging-examinations and reduce image quality and diagnostic assessment. The purpose of this study was to investigate the reduction of these artifacts using virtual monoenergetic images (VMI) from dual-energy spectral-detector CT (SDCT) in comparison to conventional CT-images (CI). METHOD:50 SDCT-datasets of patients with artifacts from port-chamber and port-catheters were included in this IRB-approved, retrospective study. CI and VMI (range, 40-200 keV, 10 keV increment) were reconstructed from the same acquisition. The quantitative image analysis was performed ROI-based assessing mean and standard deviation of attenuation (HU) in most pronounced hypo- and hyperdense artifacts surrounding to the port-chamber and the distal end of the port-catheter in the superior vena cava. Subjectively, artifact reduction and diagnostic assessment of surrounding soft tissue were rated on 5-point Likert-scales. RESULTS:In comparison to CI, VMI of higher keV-values showed strong reduction of hypo- and hyperattenuating artifacts around the port-chamber and port-catheter (CI/VMI200keV: hypodense -104.7 ± 124.7HU/10.8 ± 58.1HU and -101.6 ± 101.5HU/-36.7 ± 32.9HU; hyperdense 240.8 ± 151.6HU/79.6 ± 81.3HU and 108.6 ± 129.3HU/25.9 ± 31.9HU; all p < 0.001). Image noise could also be reduced significantly. The subjective analysis showed significantly reduced artifacts around the port-chamber and port-catheter (CI/VMI200keV: hypodense 3(1-4)/5(4-5) and 3(2-4)/5(4-5); hyperdense 3(1-4)/5(4-5) and 3(2-3)/5(3-5); all p < 0.001) and improved diagnostic assessment of pectoral/subclavian soft tissue for VMI of ≥100keV. Ratings for diagnostic assessment were best between 140-200 keV. Overall interrater agreement was high (ICC = 0.79). CONCLUSIONS:Higher keV VMI enabled a significant reduction of artifacts from port-systems around the chamber and the catheter leading to improved assessment of surrounding soft tissue.

journal_name

Eur J Radiol

journal_title

European journal of radiology

authors

Laukamp KR,Zopfs D,Wagner A,Lennartz S,Pennig L,Borggrefe J,Ramaiya N,Große Hokamp N

doi

10.1016/j.ejrad.2019.108733

subject

Has Abstract

pub_date

2019-12-01 00:00:00

pages

108733

eissn

0720-048X

issn

1872-7727

pii

S0720-048X(19)30383-3

journal_volume

121

pub_type

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CT artifacts from port systems: Virtual monoenergetic reconstructions from spectral-detector CT reduce artifacts and improve depiction of surrounding tissue.