Performances of low-dose dual-energy CT in reducing artifacts from implanted metallic orthopedic devices

OBJECTIVES: The objective was to evaluate the performances of dose-reduced dual-energy computed tomography (DECT) in decreasing metallic artifacts from orthopedic devices compared with dose-neutral DECT, dose-neutral single-energy computed tomography (SECT), and dose-reduced SECT. MATERIALS AND METHODS: Thirty implants in 20 consecutive cadavers underwent both SECT and DECT at three fixed CT dose indexes (CTDI): 20.0, 10.0, and 5.0 mGy. Extrapolated monoenergetic DECT images at 64, 69, 88, 105, 120, and 130 keV, and individually adjusted monoenergy for optimized image quality (OPTkeV) were generated. In each group, the image quality of the seven monoenergetic images and of the SECT image was assessed qualitatively and quantitatively by visually rating and by measuring the maximum streak artifact respectively. RESULTS: The comparison between SECT and OPTkeV evaluated overall within all groups showed a significant difference (p <0.001), with OPTkeV images providing better images. Comparing OPTkeV with the other DECT images, a significant difference was shown (p