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Orthopedic metallic hardware in routine abdomino-pelvic CT scans: occurrence and clinical significance

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Abstract

Purpose

To study the occurrence of orthopedic metallic hardware in routine abdomen/pelvic computed tomography (CT) scans and their impact on image quality (IQ) and diagnostic evaluation.

Material and methods

In this retrospective single institution study, we analyzed 3500 consecutive abdomen/pelvis CT scans for occurrence of orthopedic metallic hardware. In the cohort of patients with metallic hardware detected on CT scans, subjective and objective IQ analysis was performed to estimate diagnostic acceptability (DA, 4-point scale), subjective noise (SN, 3-point scale), presence of artifacts (PA, 4-point scale) and objective noise. The clinical significance of metallic hardware was determined by evaluating the impact of artifacts on radiological diagnosis according to the clinical indication and disease type.

Results

Orthopedic metallic hardware was encountered in 4.97% of abdomino-pelvic CT scans (n = 174/3500), and artifacts related to the hardware in the region of clinical interest were identified in 82% (n = 144/174) of scans. The overall mean DA was 2.66 (n = 174), and it was severely limited (score < 2) in 32% of cases particularly affecting patients with bilateral hip implants (92.6%, n = 25/27). The artifacts due to hardware significantly limited diagnostic evaluation in 58.6% of cases (PA score ≥ 3), and the image noise was unacceptable in 71% of cases (SN score > 2) in the region of clinical interest.

Conclusion

Orthopedic metallic hardware is encountered in nearly 5% of abdomino-pelvic CT scans and causes significant image degradation limiting diagnostic evaluation in the region of clinical interest.

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Authors and Affiliations

  1. Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, White 270, Boston, MA, 02114, USA

    Vinit Baliyan, Hamed Kordbacheh, Dushyant V. Sahani & Avinash Kambadakone

  2. Department of Radiology and Imaging Sciences, Emory University Hospital, Emory University School of Medicine, Atlanta, GA, 30322, USA

    Amir H. Davarpanah

  3. Department of Radiology, Northwestern Memorial Hospital, Northwestern University - Feinberg School of Medicine, Chicago, IL, 60611, USA

    Amirhossein Mozafarry

Authors
  1. Vinit Baliyan
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  2. Hamed Kordbacheh
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  3. Amir H. Davarpanah
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  4. Amirhossein Mozafarry
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  5. Dushyant V. Sahani
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  6. Avinash Kambadakone
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Corresponding author

Correspondence to Avinash Kambadakone.

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Funding

There is no source of funding for this original article.

Conflict of interest

Vinit Baliyan, Hamed Kordbacheh, Amir H. Davarpanah, Amirhossein Mozafarry and Avinash Kambadakone declare that they have no conflict of interest. Dushyant V. Sahani received grant support for research activities from GE Healthcare, Advisory Board of Allena Pharmaceuticals, Royalties from Elsevier.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Baliyan, V., Kordbacheh, H., Davarpanah, A.H. et al. Orthopedic metallic hardware in routine abdomino-pelvic CT scans: occurrence and clinical significance. Abdom Radiol 44, 1567–1574 (2019). https://doi.org/10.1007/s00261-018-1818-3

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  • DOI: https://doi.org/10.1007/s00261-018-1818-3

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