ArticleQuantitative imaging in medicine and surgery2023
Dosimetric impact of CT metal artifact reduction for spinal implants in stereotactic body radiotherapy planning.
Article in Quantitative imaging in medicine and surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 8 citations in OpenAlex.
- Advanced Monte Carlo Modeling of Automatic Exposure Control Vulnerabilities: Patient Positioning and Metallic Artifact Effects on Emergency CAP CT Dose Distribution.Journal of imaging informatics in medicine · 2026Article
- Mitigating dosimetric perturbations from large metal implants utilizing spot-scanning proton arc therapy.Medical dosimetry : official journal of the American Association of Medical Dosimetrists · 2026Article
- Challenges in Radiotherapy for Mandibular Cancer With Titanium Implant Reconstruction: A Case Report.Cureus · 2025Article
- High-Resolution C-arm Computed Tomography for Evaluation of Stent Expansion and Apposition after Intracranial Stent Implantation.Journal of Korean Neurosurgical Society · 2025Article
- Improved automatic segmentation of brain metastasis gross tumor volume in computed tomography images for radiotherapy: a position attention module for U-Net architecture.Quantitative imaging in medicine and surgery · 2024Article
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Metal artifacts due to spinal implants may affect the accuracy of dose calculation for radiotherapy. However, the dosimetric impact of metal artifact reduction (MAR) for spinal implants in stereotactic body radiotherapy (SBRT) plans has not been well studied. The objective of this study was to evaluate the dosimetric impact of MAR in spinal SBRT planning with three clinically common dose calculation algorithms. Methods: Gammex phantom and 10 patients' computed tomography (CT) images were studied to investigate the effects of titanium implants. A commercial orthopedic MAR algorithm was employed to reduce artifacts. Dose calculations for SBRT were conducted on both artifact-corrected and uncorrected images using three commercial algorithms [analytical anisotropic algorithm (AAA), Acuros XB (AXB), and Monte Carlo (MC)]. Dose discrepancies between artifact-corrected and uncorrected cases were appraised using a dose-volume histogram (DVH) and 3-dimensional (3D) gamma analysis with different distance to agreement (DTA) and dose difference criteria. The gamma agreement index (GAI) was denoted as G(∆D, DTA). Statistical analysis of Results: The phantom study demonstrated that titanium metal artifacts can be effectively reduced. The patient cases study showed that dose differences between the artifact-corrected and uncorrected datasets were small evaluated by gamma index and DVH. Gamma analysis found that even the strict criterion local G(1,1) had average values ≥93.9% for the three algorithms. For all DVH metrics, average differences did not exceed 0.7% in planning target volume (PTV) and 2.1% in planning risk volume of spinal cord (PRV-SC). Statistical analysis showed that the observed dose differences of MC method were significantly larger than those of AAA (P<0.01 for D98% of PTV and P<0.001 for D0.1cc of spinal cord) and AXB methods (P<0.001 for D98% and P<0.0001 for D0.1cc). Conclusions: Dosimetric impact of artifacts caused by titanium implants is not significant in spinal SBRT planning, which indicates that dose calculation algorithms might not be very sensitive to CT number variation caused by titanium inserts.
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