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Proceedings Paper

Method for metal artifact avoidance in C-arm cone-beam CT
Author(s): P. Wu; N. Sheth; A. Sisniega; A. Uneri; R. Han; R. Vijayan; P. Vagdargi; B. Kreher; H. Kunze; G. Kleinszig; S. Vogt; S.-F. Lo; N. Theodore; J. H. Siewerdsen
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Paper Abstract

Purpose: Metal artifacts remain a challenge for CBCT systems in diagnostic imaging and image-guided surgery, obscuring visualization of metal instruments and surrounding anatomy. We present a method to predict C-arm CBCT orbits that will avoid metal artifacts by acquiring projection data that is least affected by polyenergetic bias. Methods: The metal artifact avoidance (MAA) method operates with a minimum of prior information, is compatible with simple mobile C-arms that are increasingly prevalent in routine use, and is consistent with either 3D filtered backprojection (FBP), more advanced (polyenergetic) model-based image reconstruction (MBIR), and/or metal artifact reduction (MAR) post-processing methods. MAA consists of the following steps: (i) coarse localization of metal objects in the field of view (FOV) via two or more low-dose scout views, coarse backprojection, and segmentation (e.g., with a U-Net); (ii) a simple model-based prediction of metal-induced x-ray spectral shift for all source-detector vertices (gantry rotation and tilt angles) accessible by the imaging system; and (iii) definition of a source-detector orbit that minimizes the view-to-view inconsistency in spectral shift. The method was evaluated in anthropomorphic phantom study emulating pedicle screw placement in spine surgery. Results: Phantom studies confirmed that the MAA method could accurately predict tilt angles that minimize metal artifacts. The proposed U-Net segmentation method was able to localize complex distributions of metal instrumentation (over 70% Dice coefficient) with 6 low-dose scout projections acquired during routine pre-scan collision check. CBCT images acquired at MAA-prescribed tilt angles demonstrated ~50% reduction in “blooming” artifacts (measured as FWHM of the screw shaft). Geometric calibration for tilted orbits at prescribed angular increments with interpolation for intermediate values demonstrated accuracy comparable to non-tilted circular trajectories in terms of the modulation transfer function. Conclusion: The preliminary results demonstrate the ability to predict C-arm orbits that provide projection data with minimal spectral bias from metal instrumentation. Such orbits exhibit strongly reduced metal artifacts, and the projection data are compatible with additional post-processing (metal artifact reduction, MAR) methods to further reduce artifacts and/or reduce noise. Ongoing studies aim to improve the robustness of metal object localization from scout views and investigate additional benefits of non-circular C-arm trajectories.

Paper Details

Date Published: 16 March 2020
PDF: 9 pages
Proc. SPIE 11312, Medical Imaging 2020: Physics of Medical Imaging, 1131226 (16 March 2020); doi: 10.1117/12.2549840
Show Author Affiliations
P. Wu, Johns Hopkins Univ. (United States)
N. Sheth, Johns Hopkins Univ. (United States)
A. Sisniega, Johns Hopkins Univ. (United States)
A. Uneri, Johns Hopkins Univ. (United States)
R. Han, Johns Hopkins Univ. (United States)
R. Vijayan, Johns Hopkins Univ. (United States)
P. Vagdargi, Johns Hopkins Univ. (United States)
B. Kreher, Siemens Healthineers (Germany)
H. Kunze, Siemens Healthineers (Germany)
G. Kleinszig, Siemens Healthineers (Germany)
S. Vogt, Siemens Healthineers (Germany)
S.-F. Lo, Johns Hopkins Univ. (United States)
N. Theodore, Johns Hopkins Univ. (United States)
J. H. Siewerdsen, Johns Hopkins Univ. (United States)

Published in SPIE Proceedings Vol. 11312:
Medical Imaging 2020: Physics of Medical Imaging
Guang-Hong Chen; Hilde Bosmans, Editor(s)

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