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Metal artifact reduction algorithm for image quality improvement of cone-beam CT images of medium or large cerebral aneurysms treated with stent-assisted coil embolization

  • Interventional Neuroradiology
  • Published:
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Abstract

Purpose

The aim of the present study was to assess image quality improvement using a metal artifact reduction (MAR) algorithm in cases of medium or large cerebral aneurysms treated with stent-assisted coil embolization (SAC), and to analyze factors associated with the usefulness of the MAR algorithm.

Methods

We retrospectively evaluated the cone-beam computed tomography (CBCT) data sets of 18 patients with cerebral aneurysms treated with SAC. For subjective analysis, images of all cases with and without MAR processing were evaluated by five neurosurgeons based on four criteria using a five-point scale. For objective analysis, the CT values of all cases with and without MAR processing were calculated. In addition, we assessed factors associated with the usefulness of the MAR by analyzing the nine cases in which the median score for criterion 1 improved by more than two points.

Results

MAR processing improved the median scores for all four criteria in 17/18 cases (94.4%). Mean CT values of the region of interest at the site influenced by metal artifacts were significantly reduced after MAR processing. The maximum diameter of the coil mass (< 17 mm; odds ratio [OR], 4.0; 95% confidence interval [CI], 1.2–13.9; p = 0.02) and vessel length covered by metal artifacts (< 24 mm; OR, 2.3; 95% CI, 1.1–4.7; p = 0.03) was significantly associated with the usefulness of the MAR.

Conclusions

This study suggests the feasibility of a MAR algorithm to improve the image quality of CBCT images in patients who have undergone SAC for medium or large aneurysms.

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Abbreviations

AchA:

Anterior choroidal artery

AcomA:

Anterior communicating artery

BA:

Basilar artery

cav:

Cavernous sinus

CE-CBCT:

Contrast-enhanced cone-beam computed tomography

FOV:

Field of view

HU:

Hounsfield unit

ICA:

Internal carotid artery

IQR:

Interquartile range

MAR:

Metal artifact reduction

MCA:

Middle cerebral artery

MIP:

Maximum intensity projection

Pcom:

Posterior communicating artery

ROC:

Receiver operating characteristic

RR:

Relative risk

SAC:

Stent-assisted coil embolization

SCA:

Superior cerebellar artery

SD:

Standard deviation

SHA:

Superior hypophyseal artery

VA:

Vertebral artery

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Acknowledgments

We thank Mr. C. Dahmani and Mr. I. Kojima (Siemens Healthcare) for technical support related to the metal artifact reduction software.

Funding

This study was funded by Siemens Healthcare.

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Authors and Affiliations

  1. Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan

    Satoshi Murai, Masafumi Hiramatsu, Yuji Takasugi, Yu Takahashi, Naoya Kidani, Shingo Nishihiro, Yukei Shinji, Jun Haruma, Tomohito Hishikawa, Kenji Sugiu & Isao Date

Authors
  1. Satoshi Murai
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  2. Masafumi Hiramatsu
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  3. Yuji Takasugi
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  4. Yu Takahashi
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  5. Naoya Kidani
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  6. Shingo Nishihiro
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  7. Yukei Shinji
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  8. Jun Haruma
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  9. Tomohito Hishikawa
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  10. Kenji Sugiu
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  11. Isao Date
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Corresponding author

Correspondence to Masafumi Hiramatsu.

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Conflict of interest

The authors have received research grants from Siemens Healthcare. YT and MH–RELATED: Grant: Siemens Healthcare; Support for travel to meetings for the study and provision of writing assistance. KS–RELATED: Grant: Siemens Healthcare; Support for travel to meeting for the study and payment for lectures.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

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Informed consent was obtained from all individual participants included in the study.

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Murai, S., Hiramatsu, M., Takasugi, Y. et al. Metal artifact reduction algorithm for image quality improvement of cone-beam CT images of medium or large cerebral aneurysms treated with stent-assisted coil embolization. Neuroradiology 62, 89–96 (2020). https://doi.org/10.1007/s00234-019-02297-8

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  • DOI: https://doi.org/10.1007/s00234-019-02297-8

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