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Reduction of Metal Artifacts From Alloy Hip Prostheses in Computer Tomography

Wang, Fengdan MD*; Xue, Huadan MD*; Yang, Xianda MD, PhD; Han, Wei PhD; Qi, Bing BSCS*; Fan, Yu MD§; Qian, Wenwei MD§; Wu, Zhihong MD§; Zhang, Yan MD*; Jin, Zhengyu MD*

Journal of Computer Assisted Tomography: November/December 2014 - Volume 38 - Issue 6 - p 828–833
doi: 10.1097/RCT.0000000000000125
CT Physics and Technology

Objective The objective of this study was to evaluate the feasibility of reducing artifacts from large metal implants with gemstone spectral imaging (GSI) and metal artifact reduction software (MARS).

Methods Twenty-three in-vivo cobalt-chromium-molybdenum alloy total hip prostheses were prospectively scanned by fast kV-switching GSI between 80 and 140 kVp. The computed tomography images were reconstructed with monochromatic energy and with/without MARS. Both subjective and objective measurements were performed to assess the severity of metal artifacts.

Results Increasing photon energy was associated with reduced metal artifacts in GSI images (P < 0.001). Combination of GSI with MARS further diminished the metal artifacts (P < 0.001). Artifact reduction at 3 anatomical levels (femoral head, neck, and shaft) were evaluated, with data showing that GSI and MARS could reduce metal artifacts at all 3 levels (P = 0.011, P < 0.001, and P = 0.003, respectively). Nevertheless, in certain cases, GSI without MARS produced more realistic images for the clinical situation.

Conclusions Proper usage of GSI with/without MARS could reduce the computed tomography artifacts of large metal parts and improve the radiological evaluation of postarthroplasty patients.

From the *Department of Radiology, Peking Union Medical College Hospital, †Department of Pathophysiology, Institute of Basic Medical Sciences, ‡Statistics Office, and §Department of Orthopedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.

Received for publication February 16, 2014; accepted May 2, 2014.

Reprints: Yan Zhang, MD, Department of Radiology, Peking Union Medical College Hosptial, Dongdan District, Beijing, China 100730 (e-mail:

This article was oral presented at ECR 2014.

The authors declare no conflict of interest.

© 2014 by Lippincott Williams & Wilkins