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Improved Turnaround Times | Median time to first decision: 12 days

Research ArticleBRAIN

Minimizing Clip Artifacts in Multi CT Angiography of Clipped Patients

I. van der Schaaf, M. van Leeuwen, A. Vlassenbroek and B. Velthuis
American Journal of Neuroradiology January 2006, 27 (1) 60-66;
I. van der Schaaf
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M. van Leeuwen
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A. Vlassenbroek
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B. Velthuis
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Article Figures & Data

Figures

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  • Fig 1.
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    Fig 1.

    Phantom. A cylindrical PMMA phantom (A) with a cylinder containing a clip (B).

  • Fig 2.
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    Fig 2.

    Metal artifact of Cobalt clips scanned at pitch 1 positioned in the scanplance (A–C) and perpendicular to the scan plane (D). The metal artifact consists of a black-and-white component. The aspect of the artifact changes with decreasing window width: widest width (A); window width as used in clinical practice (B); and binary picture (C). The artifact volume largely depends on the position of the clip to the scan plane, with much less artifact for a clip perpendicular to the scan plane (D) compared to a clip in the scan plane (B).

  • Fig 3.
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    Fig 3.

    Artifact quantification in patients: quantification of the black-and-white component of the artifact in patients in CTA source images.

    A, Clip artifact in clinical window setting, with background of 32 HU and an SD of 21.

    B, Area of the black component of the artifact enclosing all pixels with HU < 31 (±3 SD).

    C, Area of the white component of the artifact enclosing all pixels with HU > 95 (±3 SD).

  • Fig 4.
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    Fig 4.

    Artifact volume of the Cobalt containing alloly and titanium clip at increasing pitch. Volume of clip artifact at increasing pitch for cobalt-containing alloy (upper, black lines) and titanium (lower, white lines) clip. Both clips were scanned in the high mode (superscript H, open symbols) up to pitch 1, and standard mode (superscript S, closed symbols) up to pitch 1.5 at 90 (triangles), 120 (squares), and 140 (circles) kVp.

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    Fig 5.

    Number of white streaks for the cobalt-containing alloy (upper, black lines) and titanium clips (lower, white lines) scanned in high mode (H) (open symbols, up to P 1) and standard mode (S) (closed symbols, up to P 1.5).

  • Fig 6.
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    Fig 6.

    Aspect of a cobalt clip artifact, positioned in the scanplane, at increasing pitch. The numbers of white streaks increase with increasing pitch.

Tables

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    Table 1:

    Influence of kVp, CBR, slip composition, and orientation on artifact volume

    Ratio
    KVp*
        90 vs 120, High mode1.3
        120 vs 140, High mode1.2
        90 vs 120, Standard mode1.4
        120 vs 140, Standard mode1.2
    Conebeam reconstruction vs linear interpolation*1.1
    Cobalt-containing alloy vs Titanium clip#
        High mode1.3
        Standard mode1.5
    In plane vs perpendicular‡1.4
    • Note:—CBR indicates conebeam reconstruction.

    • * for titanium- and cobalt-containing alloy clip.

    • # for all kVp/mAs combinations.

    • ‡ for both clips in high and standard mode.

    • View popup
    Table 2:

    Clip orientation and diagnostic quality at the clip site

    Position of Clip to Scan PlaneCompletely DiagnosticClinically UsefulNot Diagnostic
    In plane3 (6.3%)25 (52%)20 (42%)
        (24 clips, 48 evaluations*)
    Diagonal6 (15%)25 (63%)9 (23%)
        (20 clips, 40 evaluations)
    Perpendicular3 (25%)8 (67%)1 (8.3%)
        (6 clips, 12 evaluations)
    Total (all positions)12 (12%)58 (58%)30 (30%)
        (50 clips, 100 evaluations)
    • * A double reading per clip site results in twice as many evaluations as clip sites.

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American Journal of Neuroradiology: 27 (1)
American Journal of Neuroradiology
Vol. 27, Issue 1
January, 2006
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Minimizing Clip Artifacts in Multi CT Angiography of Clipped Patients
I. van der Schaaf, M. van Leeuwen, A. Vlassenbroek, B. Velthuis
American Journal of Neuroradiology Jan 2006, 27 (1) 60-66;
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Cite this article
I. van der Schaaf, M. van Leeuwen, A. Vlassenbroek, B. Velthuis
Minimizing Clip Artifacts in Multi CT Angiography of Clipped Patients
American Journal of Neuroradiology Jan 2006, 27 (1) 60-66;

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