Evaluation of New Commercially Available Metal Artifact Reduction (MAR) Algorithm on Both Image Quality and Relative Dosimetry for Patients with Hip Prosthesis or Dental Fillings

Streaking artifacts on computed tomography (CT) images are caused by high density materials such as hip prosthesis, surgical clips and dental fillings. The artifacts can lead to compromised clinical outcome due to the inability to differentiate tumor volume and the uncertainties in dose calculation. The goals of our study are to evaluate how GE’s smart metal artifact reduction (MAR) algorithm impacts image quality on phantoms and dosimetry on head and neck patients with dental fillings and pelvic patients with hip prosthesis. Treatment plans calculated on the MAR and non-MAR datasets with the same beam arrangements and fluence are compared. Dose differences between the MAR and non-MAR datasets are not significant. However, substantial reductions of metal artifacts are observed when MAR algorithm is applied. Planning on the MAR dataset is recommended since it improves image quality and CT number accuracy. It also negates the need to contour the artifacts and override the density which can be time consuming.