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Comparison of Conventional CT and Duel Energy CT On Metal Artifact Reduction for the Pacemaker Patients in Gamma Knife Radiosurgery

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D Luo

D Luo*,X Wang,E Han,Z Wen,T M Briere,J N Yang,T Pan, UT MD Anderson Cancer Center, Houston, TX


SU-I-GPD-J-79 (Sunday, July 30, 2017) 3:00 PM - 6:00 PM Room: Exhibit Hall

Purpose: Pacemaker patients receiving Gamma Knife (GK) radiosurgery are typically simulated with CT. Since the patients are fixated with either titanium (Ti) or aluminum (Al) pins to the skull, the lesions can be distorted by metal induced artifacts from the frame and Ti or Al pins. Two techniques are promising for reduction of metal artifacts: 1) Conventional single-energy CT (SECT) with metal artifact reduction (MAR), and 2) newer duel energy CT (DECT) with higher keV mono-energy imaging. Both techniques were assessed for their effectiveness of metal artifact reduction for the pacemaker GK radiosurgery.

Methods: An anthropomorphic head phantom (Radiology Support Devices) fixated with one pair of Ti and one pair of Al pins was scanned with SECT and DECT on GE HD 750 64-slice CT and Siemens Flash 64-slice CT, and with SECT on Philips large bore 16-slice CT. The metal artifact reduction techniques of MAR from GE, iMAR (iterative MAR) with the dental option from Siemens, and OMAR from Philips were compared with DECT. All the scans were at the same radiation exposure of 65 mGy. The mono-energy CT from DECT for metal artifact reduction was 140 keV for GE and 110 keV for Siemens. There was no DECT on the Philips large bore CT.

Results: For metal artifact reduction, DECT > MAR or iMAR > SECT > OMAR (“>” means better). More metal artifacts were introduced by Ti than Al on the GE and Philips CT scanners; and more artifacts were introduced by Al on the Siemens than on the GE or Philips CT scanner. OMAR introduced more artifacts than SECT on Philips.

Conclusion: DECT was more effective than MAR or iMAR in reducing the metal artifacts introduced by Ti and Al pins in Gamma Knife Radiosurgery. OMAR of Philips is not recommended in GK pacemaker patients.

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