Purpose: To compare the quality of helical computed tomography (CT) images of the pelvis in patients with metal hip prostheses reconstructed using adaptive iterative dose reduction (AIDR) and AIDR with single-energy metal artifact reduction (SEMAR-A).
Materials and methods: This retrospective study included 28 patients (mean age, 64.6 ± 11.4 years; 6 men and 22 women). CT images were reconstructed using AIDR and SEMAR-A. Two radiologists evaluated the extent of metal artifacts and the depiction of structures in the pelvic region and looked for mass lesions. A radiologist placed a region of interest within the bladder and recorded CT attenuation.
Results: The metal artifacts were significantly reduced in SEMAR-A as compared to AIDR (p < 0.0001). The depictions of the bladder, ureter, prostate/uterus, rectum, and pelvic sidewall were significantly better with SEMAR-A than with AIDR (p < 0.02). All lesions were diagnosed with SEMAR-A, while some were not diagnosed with AIDR. The median and interquartile range (in parentheses) of CT attenuation within the bladder for AIDR were -34.0 (-46.6 to -15.0) Hounsfield units (HU) and were more variable than those seen for SEMAR-A [5.4 (-1.3 to 11.1)] HU (p = 0.033).
Conclusion: In comparison with AIDR, SEMAR-A provided pelvic CT images of significantly better quality for patients with metal hip prostheses.
Keywords: Computed tomography; Metal artifact reduction; Metal hip prosthesis; Pelvis.