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Analysis of metal artifact reduction tools for dental hardware in CT scans of the oral cavity: kVp, iterative reconstruction, dual-energy CT, metal artifact reduction software: does it make a difference?

  • Head and Neck Radiology
  • Published:
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Abstract

Introduction

Metal artifacts may negatively affect radiologic assessment in the oral cavity. The aim of this study was to evaluate different metal artifact reduction techniques for metal artifacts induced by dental hardware in CT scans of the oral cavity.

Methods

Clinical image quality was assessed using a Thiel-embalmed cadaver. A Catphan phantom and a polymethylmethacrylate (PMMA) phantom were used to evaluate physical-technical image quality parameters such as artifact area, artifact index (AI), and contrast detail (IQFinv). Metal cylinders were inserted in each phantom to create metal artifacts. CT images of both phantoms and the Thiel-embalmed cadaver were acquired on a multislice CT scanner using 80, 100, 120, and 140 kVp; model-based iterative reconstruction (Veo); and synthesized monochromatic keV images with and without metal artifact reduction software (MARs). Four radiologists assessed the clinical image quality, using an image criteria score (ICS).

Results

Significant influence of increasing kVp and the use of Veo was found on clinical image quality (p = 0.007 and p = 0.014, respectively). Application of MARs resulted in a smaller artifact area (p < 0.05). However, MARs reconstructed images resulted in lower ICS.

Conclusion

Of all investigated techniques, Veo shows to be most promising, with a significant improvement of both the clinical and physical-technical image quality without adversely affecting contrast detail. MARs reconstruction in CT images of the oral cavity to reduce dental hardware metallic artifacts is not sufficient and may even adversely influence the image quality.

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Ethical Standards and Patient Consent

We declare that all human and animal studies have been approved by the Ethics Committee of Ghent University, B67020095736, and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. The Thiel body was obtained from the Department of Anatomy of Ghent University. The patient willingly donated their body to science.

Conflict of interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Ghent University, Department of Basic Medical Sciences, Proeftuinstraat 86, B-9000, Gent, Belgium

    An De Crop, Tom Van Hoof, Katharina D’Herde, Hubert Thierens & Klaus Bacher

  2. AZ Sint Jan Bruges Ostend AV, Department of Radiology, Bruges, Belgium

    Jan Casselman, Elke Vereecke & Nicolas Bossu

  3. Ghent University, Dental School, Unit for Oral and Maxillofacial Imaging, Ghent, Belgium

    Melissa Dierens

  4. Hospital Lisboa Central, Department of Neuroradiology, Lisbon, Portugal

    Jaime Pamplona

Authors
  1. An De Crop
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  2. Jan Casselman
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  3. Tom Van Hoof
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  4. Melissa Dierens
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  5. Elke Vereecke
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  6. Nicolas Bossu
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  10. Klaus Bacher
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Correspondence to An De Crop.

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De Crop, A., Casselman, J., Van Hoof, T. et al. Analysis of metal artifact reduction tools for dental hardware in CT scans of the oral cavity: kVp, iterative reconstruction, dual-energy CT, metal artifact reduction software: does it make a difference?. Neuroradiology 57, 841–849 (2015). https://doi.org/10.1007/s00234-015-1537-1

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  • DOI: https://doi.org/10.1007/s00234-015-1537-1

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