Ultra-high resolution photon-counting CT with tin prefiltration for bone-metal interface visualization.

To investigate the metal artifact suppression potential of combining tin prefiltration and virtual monoenergetic imaging (VMI) for osseous microarchitecture depiction in ultra-high-resolution (UHR) photon-counting CT (PCCT) of the lower extremity. Derived from tin-filtered UHR scans at 140 kVp, polychromatic datasets (T3D) and VMI reconstructions at 70, 110, 150, and 190 keV were compared in 117 patients with lower extremity metal implants (53 female; 62.1 ± 18.0 years). Three implant groups were investigated (total arthroplasty [n = 48], osteosynthetic material [n = 43], and external fixation [n = 26]). Image quality was assessed with regions of interest placed in the most pronounced artifacts and adjacent soft tissue, measuring the respective attenuation. Additionally, artifact extent, bone-metal interface interpretability and overall image quality were independently evaluated by three radiologists. Artifact reduction was superior with increasing keV level of VMI. While T3D was superior to VMI Tin-filtered UHR-PCCT scans of the lower extremity combined with VMI reconstructions allow for efficient artifact reduction in the vicinity of bone-metal interfaces.

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Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: The Department of Diagnostic and Interventional Radiology receives research funding from the German Research Foundation (DFG) for photon-counting CT studies. Jan-Peter Grunz [grant number Z-3BC/02], Philipp Gruschwitz [grant number Z-02CSP/18] and Theresa Sophie Patzer [grant number ZZ-36] are financially supported by the Interdisciplinary Center of Clinical Research Würzburg. Thorsten Alexander Bley, Andreas Steven Kunz and Jan-Peter Grunz have received speaker honoraria from Siemens Healthineers within the past three years. The Department of Diagnostic and Interventional Radiology receives ongoing research funding by Siemens Healthineers outside of the presented work. The authors of this manuscript declare no further relationships with any companies, whose products or services may be related to the subject matter of the article.