title: Monoenergetic computed tomography reconstructions reduce beam hardening artifacts from dental restorations.
abstract: The aim of this study was to assess the potential of monoenergetic computed tomography (CT) images to reduce beam hardening artifacts in comparison to standard CT images of dental restoration on dental post-mortem CT (PMCT). Thirty human decedents (15 male, 58 ± 22 years) with dental restorations were examined using standard single-energy CT (SECT) and dual-energy CT (DECT). DECT data were used to generate monoenergetic CT images, reflecting the X-ray attenuation at energy levels of 64, 69, 88 keV, and at an individually adjusted optimal energy level called OPTkeV. Artifact reduction and image quality of SECT and monoenergetic CT were assessed objectively and subjectively by two blinded readers. Subjectively, beam artifacts decreased visibly in 28/30 cases after monoenergetic CT reconstruction. Inter- and intra-reader agreement was good (k = 0.72, and k = 0.73 respectively). Beam hardening artifacts decreased significantly with increasing monoenergies (repeated-measures ANOVA p < 0.001). Artifact reduction was greatest on monoenergetic CT images at OPTkeV. Mean OPTkeV was 108 ± 17 keV. OPTkeV yielded the lowest difference between CT numbers of streak artifacts and reference tissues (-163 HU). Monoenergetic CT reconstructions significantly reduce beam hardening artifacts from dental restorations and improve image quality of post-mortem dental CT.
authors.affiliation: Department of Forensic Medicine and Imaging, Institute of Forensic Medicine, University of Zurich, Winterthurerstrasse 190/52, 8057, Zurich, Switzerland.
authors.forename: Paul
authors.initials: P
authors.lastname: Stolzmann
authors.forename: Sebastian
authors.initials: S
authors.lastname: Winklhofer
authors.forename: Nicole
authors.initials: N
authors.lastname: Schwendener
authors.forename: Hatem
authors.initials: H
authors.lastname: Alkadhi
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Thali
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Ruder
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D016477:Artifacts; D001344:Autopsy; D016009:Chi-Square Distribution; D003793:Dental Restoration, Permanent; D003794:Dental Restoration, Temporary; D005260:Female; D049429:Forensic Pathology / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011237:Predictive Value of Tests; D011857:Radiographic Image Interpretation, Computer-Assisted; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed