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

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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.
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FIG 2.
Flow diagram of the inclusion of potentially eligible patients.
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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).
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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).
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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.

Table 1:

Characteristics of the study population

Variable	Value
Age (mean) (yr)	62.9 ± 12.3
Sex (male/female)	31:9
Tumor location
Oral tongue	11
Tonsil	11
Floor of mouth	6
Palate	4
Base of tongue	4
Gingiva	3
Buccal mucosa	1
Histopathologic type
Squamous cell carcinoma	32
Malignant lymphoma	3
Clear cell carcinoma	2
Adenocarcinoma	1
Adenosquamous cell carcinoma	1
Mucoepidermoid carcinoma	1

Table 2:

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

Table 3:

Qualitative evaluation of image-quality scores of representative structures

Representative Structures	Hybrid-IR+MAR (Mean)	MBIR+MAR (Mean)	P Value^{^a}
Apex of the tongue	2.78 ± 0.72	3.02 ± 0.75	<.01^{^b}
Base of the tongue	4.11 ± 0.29	4.27 ± 0.41	<.01^{^b}
Parapharyngeal space	4.58 ± 0.33	4.68 ± 0.27	<.01^{^b}
Superior portion of internal jugular vein	4.77 ± 0.24	4.88 ± 0.18	<.01^{^b}
Parotid gland	4.50 ± 0.40	4.67 ± 0.37	<.01^{^b}