Metal Artifact Reduction on Chest Computed Tomography Examinations: Comparison of the Iterative Metallic Artefact Reduction Algorithm and the Monoenergetic Approach

Objective The aim of the study was to compare iterative metallic artefact reduction (iMAR) and monochromatic imaging on metal artifact reduction. Materials and Methods Follow-up of 29 occluded pulmonary arteriovenous malformations was obtained with dual-energy computed tomography with reconstruction of averaged images using filtered back projection (group 1), iMAR (group 2), and creation of high-energy monoenergetic images (group 3). Two types of coils had been used: (a) nickel only (group A, n = 18) and (b) nickel and platinum (group B, n = 11). Results Compared with group 1, groups 2 and 3 images showed significant reduction in artifact severity. Compared with group 3, group 2 images showed less artifacts on subjective (artifact severity score: P = 0.0118; score of visibility of surrounding structures: P = 0.0056) and objective (artifact attenuation: P 0.05). In group B, metal artifacts were only significantly reduced in group 2 images. Conclusions Iterative metallic artefact reduction reduces metal artifacts more efficiently than monoenergetic imaging.