Metallic dental artifact reduction in computed tomography (Smart MAR): Improvement of image quality and diagnostic confidence in patients with suspected head and neck pathology and oral implants.

Feldhaus, Felix; Böning, Georg; Jonczyk, Martin; Kahn, Johannes; Fehrenbach, Uli; Maurer, Martin; Renz, D; Hamm, Bernd; Streitparth, Florian (2019). Metallic dental artifact reduction in computed tomography (Smart MAR): Improvement of image quality and diagnostic confidence in patients with suspected head and neck pathology and oral implants. European journal of radiology, 118, pp. 153-160. Elsevier 10.1016/j.ejrad.2019.07.015

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PURPOSE We determined whether the Smart MAR metal artifact reduction tool - a three-stage, projection-based, post processing algorithm - improves subjective and objective image quality and diagnostic confidence in patients with dental artifacts and suspected head and neck pathology compared to standard adaptive statistical iterative reconstructions (ASIR V) alone. METHOD The study included 100 consecutive patients with nonremovable oral implants or dental fillings and suspected oropharyngeal cancer or abscess. CT raw data of a single-source multislice CT scanner were postprocessed using ASIR V alone and with additional Smart MAR reconstruction. Image quality of baseline ASIR V and Smart MAR-based reconstruction series was compared both quantitatively (5 regions of interest, ROIs) and qualitatively (two independent raters). RESULTS Additional Smart MAR reconstruction significantly seems to improve both attenuation and noise adjacent to implants and in more distant areas (all p < 0.001) compared to standard ASIR V reconstructions alone. Signal-to-noise ratio (SNR; p = 0.001) and contrast-to-noise ratio were improved significantly (CNR; p = 0.001). Smart MAR improved visualization of tumor/abscess (detected in 36 of 100 patients, 36%) and representative oropharyngeal tissue (p < 0.001). In 8 of 36 patients (22%), tumor was only detected in Smart MAR series. Mean total DLP was 506.8mGy*cm; average CTDIvol was 5.5 mGy. CONCLUSIONS The supplementary use of the Smart MAR post-processing tool seems to significantly improve both subjective and objective image quality as well as diagnostic confidence and lesion detection in CT of the head and neck. In 22% of cases, the tumor was detected only in Smart MAR reconstructed images.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology

UniBE Contributor:

Maurer, Martin

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1872-7727

Publisher:

Elsevier

Language:

English

Submitter:

Maria de Fatima Henriques Bernardo

Date Deposited:

02 Sep 2019 07:12

Last Modified:

24 Oct 2019 22:58

Publisher DOI:

10.1016/j.ejrad.2019.07.015

PubMed ID:

31439235

Uncontrolled Keywords:

Artifacts Computer-assisted image processing Neck Squamous cell carcinoma

BORIS DOI:

10.7892/boris.132780

URI:

https://boris.unibe.ch/id/eprint/132780

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