title: Computed Tomography Imaging of a Hip Prosthesis Using Iterative Model-Based Reconstruction and Orthopaedic Metal Artefact Reduction: A Quantitative Analysis.
abstract: OBJECTIVE
  To quantify the combined use of iterative model-based reconstruction (IMR) and orthopaedic metal artefact reduction (O-MAR) in reducing metal artefacts and improving image quality in a total hip arthroplasty phantom.
  
  
  METHODS
  Scans acquired at several dose levels and kVps were reconstructed with filtered back-projection (FBP), iterative reconstruction (iDose) and IMR, with and without O-MAR. Computed tomography (CT) numbers, noise levels, signal-to-noise-ratios and contrast-to-noise-ratios were analysed.
  
  
  RESULTS
  Iterative model-based reconstruction results in overall improved image quality compared to iDose and FBP (P < 0.001). Orthopaedic metal artefact reduction is most effective in reducing severe metal artefacts improving CT number accuracy by 50%, 60%, and 63% (P < 0.05) and reducing noise by 1%, 62%, and 85% (P < 0.001) whereas improving signal-to-noise-ratios by 27%, 47%, and 46% (P < 0.001) and contrast-to-noise-ratios by 16%, 25%, and 19% (P < 0.001) with FBP, iDose, and IMR, respectively.
  
  
  CONCLUSIONS
  The combined use of IMR and O-MAR strongly improves overall image quality and strongly reduces metal artefacts in the CT imaging of a total hip arthroplasty phantom.
authors.affiliation: From the *Department of Radiology, Isala Hospital, Zwolle, The Netherlands; †Philips Medical Systems, Brussels, Belgium; ‡Philips Medical Systems, Eindhoven, The Netherlands; §Department of Innovation and Science, Isala Hospital, Zwolle, The Netherlands; ∥Department of Radiology, AMC, Amsterdam, The Netherlands; and ¶MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands.
authors.forename: Ruud H H
authors.initials: RH
authors.lastname: Wellenberg
authors.forename: Martijn F
authors.initials: MF
authors.lastname: Boomsma
authors.forename: Jochen A C
authors.initials: JA
authors.lastname: van Osch
authors.forename: Alain
authors.initials: A
authors.lastname: Vlassenbroek
authors.forename: Julien
authors.initials: J
authors.lastname: Milles
authors.forename: Mireille A
authors.initials: MA
authors.lastname: Edens
authors.forename: Geert J
authors.initials: GJ
authors.lastname: Streekstra
authors.forename: Cornelis H
authors.initials: CH
authors.lastname: Slump
authors.forename: Mario
authors.initials: M
authors.lastname: Maas
mesh_terms: D000465:Algorithms; D016477:Artifacts; D006621:Hip Joint / Q000000981:diagnostic imaging* / Q000601:surgery; D006622:Hip Prosthesis; D006801:Humans; D008670:Metals; D019047:Phantoms, Imaging; D011856:Radiographic Image Enhancement / Q000379:methods*; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000295:instrumentation / Q000379:methods*
chemical_list: D008670:Metals