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Evaluation of Software-Based Metal Artifact Reduction in Intraoperative 3D Imaging of the Spine Using a Mobile Cone Beam CT

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Abstract

The aim of our study was to evaluate whether software-based artifact reduction can achieve an improved image quality, using intraoperative 3D imaging in spinal surgery. A total of 49 intraoperative 3D image datasets of patients, who underwent surgery with pedicle screw placement, were retrospectively evaluated. The visibility of anatomical structures and the diameter of the pedicle screws were examined, with and without the application of the artifact reduction software. All software prototypes can improve the visibility of anatomical structures (P < 0.01), except MAR (metal artifact reduction) combined with IRIS (iterative reconstruction in image space) (P = 0.04). The algorithms MAR and MAR-2 can reduce the blooming artifacts significantly (P < 0.01), but SL (Shepp & Logan) cannot (P = 0.08–0.988). In summary, software-based artifact reduction for intraoperative 3D datasets can improve the current image quality. Additional information regarding the implant placement and the fracture reduction is therefore generated for the surgeon.

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Acknowledgments

Karl Barth (Siemens AG, Healthcare Sector, Erlangen, Germany) made a special contribution to this study. He provided us with the software prototypes for artifact reduction and supported us in their application.

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Authors and Affiliations

  1. Medical Imaging and Navigation in Trauma and Orthopaedic Surgery, BG Trauma Center Ludwigshafen at Heidelberg University Hospital, Ludwig-Guttmann-Str. 13, 67071, Ludwigshafen, Germany

    Maxim Privalov, Marcus Mohr, Benedict Swartman, Nils Beisemann, Holger Keil, Jochen Franke, Paul Alfred Grützner & Sven Yves Vetter

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  1. Maxim Privalov
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  2. Marcus Mohr
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Correspondence to Sven Yves Vetter.

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Conflict of Interest

The authors declare the following potential conflicts of interest concerning the research, authorship, and publication of this article: The BG Trauma Center Ludwigshafen and Siemens Healthcare AG in Erlangen, Germany cooperate in the field of medical imaging and image-guided surgery. This cooperation influenced neither the outcome of the study nor the manuscript.

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.

Informed Consent

Since only existing anonymized image data was used, no informed consent was required for the present study.

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Privalov, M., Mohr, M., Swartman, B. et al. Evaluation of Software-Based Metal Artifact Reduction in Intraoperative 3D Imaging of the Spine Using a Mobile Cone Beam CT. J Digit Imaging 33, 1136–1143 (2020). https://doi.org/10.1007/s10278-020-00324-2

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  • DOI: https://doi.org/10.1007/s10278-020-00324-2

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