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Iterative Metal Artifact Reduction (iMAR) of the Non-adhesive Liquid Embolic Agent Onyx in Computed Tomography : An Experimental Study.

Authors :
Schmitt N
Weyland CS
Wucherpfennig L
Herweh C
Bendszus M
Möhlenbruch MA
Vollherbst DF
Source :
Clinical neuroradiology [Clin Neuroradiol] 2022 Sep; Vol. 32 (3), pp. 695-703. Date of Electronic Publication: 2021 Oct 13.
Publication Year :
2022

Abstract

Background: A drawback of Onyx, one of the most used embolic agents for endovascular embolization of intracranial arteriovenous malformations (AVM), is the generation of imaging artifacts (IA) in computed tomography (CT). Since these artifacts can represent an obstacle for the detection of periprocedural bleeding, this study investigated the effect of artifact reduction by an iterative metal artifact reduction (iMAR) software in CT in a brain phantom.<br />Methods: Two different in vitro models with two-dimensional tube and three-dimensional AVM-like configuration were filled with Onyx 18. The models were inserted into a brain imaging phantom and images with (n = 5) and without (n = 10) an experimental hemorrhage adjacent were acquired. Afterwards, the iMAR algorithm was applied for artifact reduction. The IAs of the original and the post-processed images were graded quantitatively and qualitatively. Moreover, qualitative definition of the experimental hemorrhage was investigated.<br />Results: Comparing the IAs of the original and the post-processed CT images, quantitative and qualitative analysis showed a lower degree of IAs in the post-processed images, i.e. quantitative analysis: 2D tube model: 23.92 ± 8.02 Hounsfield units (HU; no iMAR; mean ± standard deviation) vs. 5.93 ± 0.43 HU (with iMAR; p < 0.001); qualitative analysis: 3D AVM model: 4.93 ± 0.18 vs. 3.40 ± 0.48 (p < 0.001). Furthermore, definition of the experimental hemorrhage was better in the post-processed images of both in vitro models (2D tube model: p = 0.004; 3D AVM model: p = 0.002).<br />Conclusion: The iMAR algorithm can significantly reduce the IAs evoked by Onyx 18 in CT. Applying iMAR could thus improve the accuracy of postprocedural CT imaging after embolization with Onyx in clinical practice.<br /> (© 2021. The Author(s).)

Details

Language :
English
ISSN :
1869-1447
Volume :
32
Issue :
3
Database :
MEDLINE
Journal :
Clinical neuroradiology
Publication Type :
Academic Journal
Accession number :
34643742
Full Text :
https://doi.org/10.1007/s00062-021-01101-6