Computed Tomography Imaging of a Hip Prosthesis Using Iterative Model-Based Reconstruction and Orthopaedic Metal Artefact Reduction: A Quantitative Analysis

J Comput Assist Tomogr. Nov/Dec 2016;40(6):971-978. doi: 10.1097/RCT.0000000000000449.


Objectives: To quantify the combined use of iterative model-based reconstruction (IMR) and orthopaedic metal artefact reduction (O-MAR) in reducing metal artefacts and improving image quality in a total hip arthroplasty phantom.

Methods: Scans acquired at several dose levels and kVps were reconstructed with filtered back-projection (FBP), iterative reconstruction (iDose) and IMR, with and without O-MAR. Computed tomography (CT) numbers, noise levels, signal-to-noise-ratios and contrast-to-noise-ratios were analysed.

Results: Iterative model-based reconstruction results in overall improved image quality compared to iDose and FBP (P < 0.001). Orthopaedic metal artefact reduction is most effective in reducing severe metal artefacts improving CT number accuracy by 50%, 60%, and 63% (P < 0.05) and reducing noise by 1%, 62%, and 85% (P < 0.001) whereas improving signal-to-noise-ratios by 27%, 47%, and 46% (P < 0.001) and contrast-to-noise-ratios by 16%, 25%, and 19% (P < 0.001) with FBP, iDose, and IMR, respectively.

Conclusions: The combined use of IMR and O-MAR strongly improves overall image quality and strongly reduces metal artefacts in the CT imaging of a total hip arthroplasty phantom.

MeSH terms

  • Algorithms
  • Artifacts*
  • Hip Joint / diagnostic imaging*
  • Hip Joint / surgery
  • Hip Prosthesis*
  • Humans
  • Metals
  • Phantoms, Imaging
  • Radiographic Image Enhancement / methods*
  • Radiographic Image Interpretation, Computer-Assisted / methods*
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Tomography, X-Ray Computed / instrumentation
  • Tomography, X-Ray Computed / methods*


  • Metals