title: Periprosthetic Artifact Reduction Using Virtual Monochromatic Imaging Derived From Gemstone Dual-Energy Computed Tomography and Dedicated Software.
abstract: OBJECTIVE
  The aim of this study was to explore the usefulness of combined virtual monochromatic imaging and metal artifact reduction software (MARS) for the evaluation of musculoskeletal periprosthetic tissue.
  
  
  METHODS
  Measurements were performed in periprosthetic and remote regions in 80 patients using a high-definition scanner. Polychromatic images with and without MARS and virtual monochromatic images were obtained.
  
  
  RESULTS
  Periprosthetic polychromatic imaging (PI) showed significant differences compared with remote areas among the 3 tissues explored (P < 0.0001). No significant differences were observed between periprosthetic and remote tissues using monochromatic imaging with MARS (P = 0.053 bone, P = 0.32 soft tissue, and P = 0.13 fat). However, such differences were significant using PI with MARS among bone (P = 0.005) and fat (P = 0.02) tissues. All periprosthetic areas were noninterpretable using PI, compared with 11 (9%) using monochromatic imaging.
  
  
  CONCLUSIONS
  The combined use of virtual monochromatic imaging and MARS reduced periprosthetic artifacts, achieving attenuation levels comparable to implant-free tissue.
authors.affiliation: From the Department of Computed Tomography, Diagnóstico Maipú, Buenos Aires, Argentina.
authors.forename: Exequiel
authors.initials: E
authors.lastname: Reynoso
authors.forename: Carlos
authors.initials: C
authors.lastname: Capunay
authors.forename: Alejandro
authors.initials: A
authors.lastname: Rasumoff
authors.forename: Javier
authors.initials: J
authors.lastname: Vallejos
authors.forename: Jimena
authors.initials: J
authors.lastname: Carpio
authors.forename: Karen
authors.initials: K
authors.lastname: Lago
authors.forename: Patricia
authors.initials: P
authors.lastname: Carrascosa
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D001175:Arthrography / Q000379:methods; D016477:Artifacts; D005260:Female; D006801:Humans; D008297:Male; D008670:Metals; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D019047:Phantoms, Imaging; D019736:Prostheses and Implants; D011856:Radiographic Image Enhancement / Q000379:methods*; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods; D015900:Radiography, Dual-Energy Scanned Projection / Q000379:methods*; D015203:Reproducibility of Results; D012542:Scattering, Radiation; D012680:Sensitivity and Specificity; D012984:Software; D014965:X-Rays
chemical_list: D008670:Metals