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Research ArticleHead & Neck
Open Access

Diagnostic Value of Model-Based Iterative Reconstruction Combined with a Metal Artifact Reduction Algorithm during CT of the Oral Cavity

Y. Kubo, K. Ito, M. Sone, H. Nagasawa, Y. Onishi, N. Umakoshi, T. Hasegawa, T. Akimoto and M. Kusumoto
American Journal of Neuroradiology November 2020, 41 (11) 2132-2138; DOI: https://doi.org/10.3174/ajnr.A6767
Y. Kubo
aFrom the Department of Diagnostic Radiology (Y.K., K.I., M.S., H.N., Y.O., N.U., T.H., M.K.), National Cancer Center Hospital, Tokyo, Japan
bDepartment of Cancer Medicine (Y.K., T.A.), Jikei University Graduate School of Medicine, Tokyo, Japan
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K. Ito
aFrom the Department of Diagnostic Radiology (Y.K., K.I., M.S., H.N., Y.O., N.U., T.H., M.K.), National Cancer Center Hospital, Tokyo, Japan
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M. Sone
aFrom the Department of Diagnostic Radiology (Y.K., K.I., M.S., H.N., Y.O., N.U., T.H., M.K.), National Cancer Center Hospital, Tokyo, Japan
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H. Nagasawa
aFrom the Department of Diagnostic Radiology (Y.K., K.I., M.S., H.N., Y.O., N.U., T.H., M.K.), National Cancer Center Hospital, Tokyo, Japan
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Y. Onishi
aFrom the Department of Diagnostic Radiology (Y.K., K.I., M.S., H.N., Y.O., N.U., T.H., M.K.), National Cancer Center Hospital, Tokyo, Japan
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N. Umakoshi
aFrom the Department of Diagnostic Radiology (Y.K., K.I., M.S., H.N., Y.O., N.U., T.H., M.K.), National Cancer Center Hospital, Tokyo, Japan
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T. Hasegawa
aFrom the Department of Diagnostic Radiology (Y.K., K.I., M.S., H.N., Y.O., N.U., T.H., M.K.), National Cancer Center Hospital, Tokyo, Japan
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T. Akimoto
bDepartment of Cancer Medicine (Y.K., T.A.), Jikei University Graduate School of Medicine, Tokyo, Japan
cDivision of Radiation Oncology and Particle Therapy (T.A.), National Cancer Center Hospital East, Kashiwa, Japan
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M. Kusumoto
aFrom the Department of Diagnostic Radiology (Y.K., K.I., M.S., H.N., Y.O., N.U., T.H., M.K.), National Cancer Center Hospital, Tokyo, Japan
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  • FIG 1.
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    FIG 1.

    Representative CT images of the degree of metal artifact reduction. The image quality of metal artifact reduction was scored using the following 5-point scale: 1, severe metal artifacts in a large area; 2, severe metals artifact in a small area; 3, moderate metal artifacts; 4, minimal metal artifacts; and 5, no metal artifacts.

  • FIG 2.
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    FIG 2.

    Flow diagram of the inclusion of potentially eligible patients.

  • FIG 3.
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    FIG 3.

    Boxplot comparison of the artifact index values calculated using the 2 reconstruction algorithms: hybrid-IR+MAR and MBIR+MAR. The asterisk indicates a significant difference (P < .01).

  • FIG 4.
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    FIG 4.

    Axial CT images of a 32-year-old man with left-tongue cancer. Reconstruction was performed using hybrid-IR+MAR (A) and MBIR+MAR (B). As shown, MBIR+MAR provided superior reduction of dental artifacts and a better depiction of the tumor (arrows).

  • FIG 5.
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    FIG 5.

    Analysis of the correlation between the image-quality score of artifact reduction and the number of dental fillings or implants between the 2 reconstruction algorithms: hybrid-IR+MAR and MBIR+MAR.

Tables

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    Table 1:

    Characteristics of the study population

    VariableValue
    Age (mean) (yr)62.9 ± 12.3 
    Sex (male/female)31:9
    Tumor location
     Oral tongue11
     Tonsil11
     Floor of mouth6
     Palate4
     Base of tongue4
     Gingiva3
     Buccal mucosa1
    Histopathologic type
     Squamous cell carcinoma32
     Malignant lymphoma3
     Clear cell carcinoma2
     Adenocarcinoma1
     Adenosquamous cell carcinoma1
     Mucoepidermoid carcinoma1
    • View popup
    Table 2:

    Quantitative evaluation of CT attenuation (HU) of the apex of the tongue and nuchal muscle

    Hybrid-IR+MAR (Mean)MBIR+MAR (Mean)Difference
    95% CIP Valuea
    Mean of apex of the tongue (HU)103.7 ± 52.591.9 ± 50.68.2–15.4<.01b
    Mean of nuchal muscle (HU)64.9 ± 6.764.0 ± 6.70.1–1.5.025b
    SD of apex of the tongue (HU)82.9 ± 56.074.1 ± 64.12.7–14.8<.01b
    SD of nuchal muscle (HU)8.9 ± 1.67.5 ± 2.01.1–1.7<.01b
    • ↵a Paired t test.

    • ↵b Significant difference.

    • View popup
    Table 3:

    Qualitative evaluation of image-quality scores of representative structures

    Representative StructuresHybrid-IR+MAR (Mean)MBIR+MAR (Mean)P Valuea
    Apex of the tongue2.78 ± 0.723.02 ± 0.75<.01b
    Base of the tongue4.11 ± 0.294.27 ± 0.41<.01b
    Parapharyngeal space4.58 ± 0.334.68 ± 0.27<.01b
    Superior portion of internal jugular vein4.77 ± 0.244.88 ± 0.18<.01b
    Parotid gland4.50 ± 0.404.67 ± 0.37<.01b
    • ↵a Wilcoxon signed rank test.

    • ↵b Significant difference.

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American Journal of Neuroradiology: 41 (11)
American Journal of Neuroradiology
Vol. 41, Issue 11
1 Nov 2020
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Diagnostic Value of Model-Based Iterative Reconstruction Combined with a Metal Artifact Reduction Algorithm during CT of the Oral Cavity
Y. Kubo, K. Ito, M. Sone, H. Nagasawa, Y. Onishi, N. Umakoshi, T. Hasegawa, T. Akimoto, M. Kusumoto
American Journal of Neuroradiology Nov 2020, 41 (11) 2132-2138; DOI: 10.3174/ajnr.A6767

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Diagnostic Value of Model-Based Iterative Reconstruction Combined with a Metal Artifact Reduction Algorithm during CT of the Oral Cavity
Y. Kubo, K. Ito, M. Sone, H. Nagasawa, Y. Onishi, N. Umakoshi, T. Hasegawa, T. Akimoto, M. Kusumoto
American Journal of Neuroradiology Nov 2020, 41 (11) 2132-2138; DOI: 10.3174/ajnr.A6767
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