Quality of CT Imaging of Periocular Metallic Foreign Bodies Using Artifact Reduction Software. Issue 5 (September 2019)

• Record Type: Journal Article
• Authors: Willett, Keirnan L.; Sheng, Mike; Gorry, Thomasine; Woo, John H.
• Is Part Of: Ophthalmic plastic and reconstructive surgery. Volume 35:Issue 5(2019)
• Publication Date: 2019-09
• Subjects: Eye -- Surgery -- Periodicals; Ophthalmic plastic surgery -- Periodicals; Reconstructive Surgical Procedures -- Periodicals; Ophthalmologic Surgical Procedures -- Periodicals; Ophthalmology -- Periodicals; Surgery -- Periodicals; 617.70592
• DOI: 10.1097/IOP.0000000000001295
• Languages: English
• ISSNs: 0740-9303

Abstract

Abstract : Purpose: CT is the standard of care for assessment of ocular and orbital trauma; however, artifacts from metallic foreign bodies can limit the utility of CT. The authors hypothesize that implementation of metal artifact reduction techniques can improve image quality and diagnostic confidence for a diverse group of interpreters. Methods: A case series of ten subjects with retained periocular metallic foreign bodies imaged with CT were identified retrospectively from a large urban trauma center. Postacquisition images were processed with an iterative-based metal streak artifact reduction software. The severity of the metal streak artifact was assessed by clinicians including radiologists (4), ophthalmologists (4), and oculoplastic specialists (3) using a numeric scale to grade images on seven clinically relevant criteria. Each image was also analyzed to measure the size of the artifact and degree of streaking. Results: Overall confidence in diagnosis and severity of metallic streak was improved with metallic artifact reduction ( p < 0.001, Wilcoxon signed-rank test). Similarly, confidence in assessing specific features—including extra-ocular muscle, optic nerve, globe rupture, orbital fracture and identification of foreign bodies—was improved after metallic artifact reduction ( p < 0.001, Wilcoxon signed-rank test). The standard deviation of pixel intensity for a path surrounding the foreign body as well as the area of the streak artifact decreased in the metallic artifact reduction-processed images ( p < 0.001, paired t test). Conclusions: Metal artifact reduction in CT has potential benefits in improving image quality and reader confidence for periocular trauma cases in real-world settings. Abstract : Artifact reduction software in CT of retained periocular metallic foreign bodies can improve image quality and reader confidence for a diverse group of practicing clinicians.Supplemental Digital Content is available in the text.