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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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.
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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