title: Total hip prosthesis CT with single-energy projection-based metallic artifact reduction: impact on the visualization of specific periprosthetic soft tissue structures.
abstract: OBJECTIVE
  To compare the image quality of CT with iterative reconstruction alone and in association with projection-based single-energy metal artifact reduction (SEMAR) for the visualization of specific periarticular soft tissue structures in patients with hip prostheses.
  
  
  METHODS
  CT studies from 48 consecutive patients with a hip prosthesis (24 unilateral and 24 bilateral) were retrospectively reconstructed using two different methods: iterative reconstruction (IR) alone and IR associated with SEMAR. The influence of metallic artifacts on the identification of various periarticular structures was evaluated subjectively by two readers. The image quality was compared in patients with unilateral and bilateral prostheses.
  
  
  RESULTS
  Visualization of periprosthetic soft tissue was significantly improved by the SEMAR algorithm (p < 0.0001). When SEMAR was associated with IR, the gluteus minimus and medius tendons, obturator internus muscle, prostate/uterus and bladder could be seen with medium or high confidence. There were no significant differences in image quality between patients with unilateral or bilateral prosthesis when SEMAR was used (p > 0.2). This algorithm increased the detection of periarticular masses by 30%.
  
  
  CONCLUSIONS
  SEMAR significantly improves the image quality of periarticular soft-tissue structures in patients with hip prostheses.
authors.affiliation: Service D'imagerie Guilloz, CHU-Nancy, Hôpital Central, 29, Av Marechal Lattre de Tassigny, 54035, Nancy, France, ped_gt@hotmail.com.
authors.forename: Pedro Augusto
authors.initials: PA
authors.lastname: Gondim Teixeira
authors.forename: Jean-Baptiste
authors.initials: JB
authors.lastname: Meyer
authors.forename: Cedric
authors.initials: C
authors.lastname: Baumann
authors.forename: Ariane
authors.initials: A
authors.lastname: Raymond
authors.forename: François
authors.initials: F
authors.lastname: Sirveaux
authors.forename: Henry
authors.initials: H
authors.lastname: Coudane
authors.forename: Alain
authors.initials: A
authors.lastname: Blum
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D016477:Artifacts; D005260:Female; D006621:Hip Joint / Q000000981:diagnostic imaging* / Q000601:surgery; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008670:Metals; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging*; D015588:Observer Variation; D011856:Radiographic Image Enhancement / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013710:Tendons / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D008670:Metals