ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2019
Dual-energy CT and ceramic or titanium prostheses material reduce CT artifacts and provide superior image quality of total knee arthroplasty.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 23 citations in OpenAlex.
- Osteoporosis and osteoporosis therapies as determinants of implant fixation failure in arthroplasty and spinal fusion constructs: a position statement from the Fracture Working Group of the Council of Scientific Advisors of the International Osteoporosis Foundation.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026Review
- Changes in Periprosthetic Bone Mineral Density Following Arthroplasty: An In-Depth Review and Current Perspectives.Current osteoporosis reports · 2025Review
- Combining iterative metal artifact reduction and virtual monoenergetic images severely reduces hip prosthesis-associated artifacts in photon-counting detector CT.Scientific reports · 2023Article
- Metallic Artifact Reduction in Midfacial CT Scans Using Patient-Specific Polymer Implants Enhances Image Quality.Journal of personalized medicine · 2023Article
- Comparison of Image Quality and Radiation Dose Between Single-Energy and Dual-Energy Images for the Brain With Stereotactic Frames on Dual-Energy Cerebral CT.Frontiers in radiology · 2022Article
- From the Performance to the Essence: The Biological Mechanisms of How Tantalum Contributes to Osteogenesis.BioMed research international · 2020Review
- A New Diagnostic Approach for Periprosthetic Acetabular Fractures Based on 3D Modeling: A Study Protocol.Diagnostics (Basel, Switzerland) · 2019Article
- Radiological Imaging Evaluation of the Failing Total Hip Replacement.Frontiers in surgery · 2019Review
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Authors and funding
10 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo evaluate the influence of different scan parameters for single-energy CT and dual-energy CT, as well as the impact of different material used in a TKA prosthesis on image quality and the extent of metal artifacts.
methodsEight pairs of TKA prostheses from different vendors were examined in a phantom set-up. Each pair consisted of a conventional CoCr prosthesis and the corresponding anti-allergic prosthesis (full titanium, ceramic, or ceramic-coated) from the same vendor. Nine different (seven dual-energy CT and two single-energy CT) scan protocols with different characteristics were used to determine the most suitable CT protocol for TKA imaging. Quantitative image analysis included assessment of blooming artifacts (metal implants appear thicker on CT than they are, given as virtual growth in mm in this paper) and streak artifacts (thick dark lines around metal). Qualitative image analysis was used to investigate the bone-prosthesis interface.
resultsThe full titanium prosthesis and full ceramic knee showed significantly fewer blooming artifacts compared to the standard CoCr prosthesis (mean virtual growth 0.6-2.2 mm compared to 2.9-4.6 mm, p < 0.001). Dual-energy CT protocols showed less blooming (range 3.3-3.8 mm) compared to single-energy protocols (4.6-5.5 mm). The full titanium and full ceramic prostheses showed significantly fewer streak artifacts (mean standard deviation 77-86 Hounsfield unit (HU)) compared to the standard CoCr prosthesis (277-334 HU, p < 0.001). All dual-energy CT protocols had fewer metal streak artifacts (215-296 HU compared to single-energy CT protocols (392-497 HU)). Full titanium and ceramic prostheses were ranked superior with regard to the image quality at the bone/prosthesis interface compared to a standard CoCr prosthesis, and all dual-energy CT protocols were ranked better than single-energy protocols.
conclusionsDual-energy CT and ceramic or titanium prostheses reduce CT artifacts and provide superior image quality of total knee arthroplasty at the bone/prosthesis interface. These findings support the use of dual-energy CT as a solid imaging base for clinical decision-making and the use of full-titanium or ceramic prostheses to allow for better CT visualization of the bone-prosthesis interface.
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