CT radiation dose reduction in patients with total hip arthroplasties using model-based iterative reconstruction and orthopaedic metal artefact reduction

• Published in: Skeletal radiology 2019-11, Vol.48 (11), p.1775-1785
• Main Authors: Wellenberg, Ruud H. H., van Osch, Jochen A. C., Boelhouwers, Henk J., Edens, Mireille A., Streekstra, Geert J., Ettema, Harmen B., Boomsma, Martijn F.
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Artefacts; Arthroplasty, Replacement, Hip; Biomedical materials; Bladder; Computed tomography; CT imaging; Female; Hip; Hip Joint - diagnostic imaging; Humans; Image contrast; Image quality; Image reconstruction; Imaging; Implants, Artificial; Iterative methods; Male; Medical imaging; Medicine; Medicine & Public Health; Metals; Middle Aged; Muscles; Noise; Nuclear Medicine; Orthopedics; Pathology; Prostheses; Prosthesis; Radiation; Radiation Dosage; Radiographic Image Interpretation, Computer-Assisted - methods; Radiology; Reduction; Reduction (metal working); Reproducibility of Results; Scientific; Scientific Article; Soft tissues; Surgical implants; Tomography; Tomography, X-Ray Computed - methods
• ISSN: 0364-2348; 1432-2161
• DOI: 10.1007/s00256-019-03206-z

Objective To evaluate the impact of radiation dose reduction on image quality in patients with metal-on-metal total hip arthroplasties (THAs) using model-based iterative reconstruction (MBIR) combined with orthopaedic metal artefact reduction (O-MAR). Materials and methods Patients with metal-on-metal THAs received a pelvic CT with a full (FD) and a reduced radiation dose (RD) with −20%, −40%, −57%, or −80% CT radiation dose respectively, when assigned to group 1, 2, 3, or 4 respectively. FD acquisitions were reconstructed with iterative reconstruction, iDose 4 . RD acquisitions were additionally reconstructed with iterative model-based reconstruction (IMR) levels 1–3 with different levels of noise suppression. CT numbers, noise and contrast-to-noise ratios were measured in muscle, fat and bladder. Subjective image quality was evaluated on seven aspects including artefacts, osseous structures, prosthetic components and soft tissues. Results Seventy-six patients were randomly assigned to one of the four groups. While reducing radiation dose by 20%, 40%, 57%, or 80% in combination with IMR, CT numbers remained constant. Compared with iDose 4 , the noise decreased ( p