ArticleQuantitative imaging in medicine and surgery2026
The potential of high-Z contrast media for vessel visualization near metal implants: a photon-counting detector CT phantom study with virtual monoenergetic images and iterative metal artifact reduction.
Article in Quantitative imaging in medicine and surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Metal artifacts in computed tomography (CT) can be reduced with high energy virtual monoenergetic images (VMI) and iterative metal artifact reduction (IMAR) algorithms. At high VMI energies, however, iodinated contrast media show decreased attenuation. High atomic number (high-Z) contrast media potentially preserve vessel contrast near metal implants even at high VMI energies. Hence, the purpose of this study was to assess the effect of high-Z contrast media on vessel visualization near metal implants in photon-counting detector (PCD)-CT across VMI energies, with and without IMAR and for different metal types. Methods: A pelvis phantom containing titanium or steel inserts and contrast media inserts including iodine, bismuth, holmium, or tungsten was scanned using photon-counting detector computed tomography (PCD-CT). VMI (40-190 keV, 1 keV steps) were reconstructed with and without IMAR. Three predefined regions of interest (ROI) were placed in the background (background noise, standard deviation of HU), in the contrast media inserts (vessel attenuation, mean HU), and between the metal and contrast inserts (metal artifacts, defined as standard deviation of HU). An artifact-adjusted contrast-to-noise ratio (CNR) was calculated using background noise, vessel attenuation and metal artifacts, and averaged across three VMI energy ranges: 40-90, 90-140, and 140-190 keV. Peak CNR was the maximum value across all VMI energies. Wilcoxon rank sum tests with Benjamini-Hochberg correction were applied. Results: Metal artifacts decreased with increasing VMI energy (P<0.001). Titanium caused fewer artifacts than steel, and IMAR further reduced artifacts from both metal types: at 40-90 keV without IMAR, metal artifacts averaged over all contrast media were 71 Hounsfield units (HU) (titanium) vs. 116 HU (steel), decreasing to 27 and 32 HU with IMAR (P<0.001). At 40-90 keV in titanium with IMAR, holmium showed the highest vessel attenuation and CNR (451 HU/24), followed by iodine (296 HU/15), bismuth (267 HU/14) and tungsten (259 HU/13). At 140-190 keV, tungsten showed the highest vessel attenuation and CNR (269 HU/19), followed by bismuth (250 HU/17), holmium (144 HU/10) and iodine (31 HU/2). Peak CNR [34] was achieved with holmium, titanium, IMAR, and VMI at 40 keV. Conclusions: High-Z contrast media provide superior vessel contrast compared to iodine near metal implants in PCD-CT, both at low VMI energy with holmium and at high VMI energy with tungsten and bismuth, where metal artifacts are additionally reduced. Under metal artifact conditions, vessel contrast can be further improved by applying IMAR.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.