Experimental Evaluation of Metal Artifact Avoidance and Reduction for Anterior Cervical Discectomy and Fusion Surgery

Rohleder M, Yao M, Fan F, Bayer S, Maier A, Kreher B, Wang B (2025)

Publication Type: Conference contribution

Publication year: 2025

Journal

Publisher: SPIE

Book Volume: 13405

Conference Proceedings Title: Progress in Biomedical Optics and Imaging - Proceedings of SPIE

Event location: San Diego, CA, USA

ISBN: 9781510685888

DOI: 10.1117/12.3046299

Abstract

Purpose: This experimental study investigates the effects of metal artifact avoidance through tilted 3D-scans (MAA) and metal artifact reduction (MAR) on intraoperative CBCT image quality in anterior cervical discectomy and fusion (ACDF) surgery. We assess how varying the C-Arm tilt and applying MAR influences the visibility of the gap between the cranial implant surface and the vertebral endplate, thereby improving the accuracy of implant placement verification. Methods: A high-fidelity phantom was utilized to evaluate the effects of MAA and MAR on image quality. The phantom mimics the clinical scenario of ACDF surgery, with CBCT scans acquired across a range of tilt angles. The impact on the gap visibility between the implant and the caudal vertebra endplate was assessed, and contrast-to-noise ratio (CNR) was computed for quantitative analysis. Results: The study revealed that gap-bone CNR improved by a factor of 3.4 using MAA and by a factor of 2.5 with the combination of tilted trajectories and MAR. While MAA demonstrated a significant enhancement in CNR, the application of MAR counter intuitively did not result in a notable improvement in gap visibility, likely due to the secondary disturbances introduced by the MAR algorithm. Conclusion: The findings indicate that optimizing tilt angles can significantly improve image quality as measured by CNR. However, while MAR effectively reduces streaking artifacts, it does not enhance gap visibility, suggesting that MAR may not be as impactful in this context. Clinicians may use contextual knowledge to select tilt angles that prioritize critical areas of the phantom, with future work needed to refine MAR techniques and validate these findings through clinical studies.

Authors with CRIS profile

Involved external institutions

West China Medical Center of Sichuan University / 四川大学华西医学中心 China (CN)

How to cite

APA:

Rohleder, M., Yao, M., Fan, F., Bayer, S., Maier, A., Kreher, B., & Wang, B. (2025). Experimental Evaluation of Metal Artifact Avoidance and Reduction for Anterior Cervical Discectomy and Fusion Surgery. In John M. Sabol, Ke Li, Shiva Abbaszadeh (Eds.), Progress in Biomedical Optics and Imaging - Proceedings of SPIE. San Diego, CA, USA: SPIE.

MLA:

Rohleder, Maximilian, et al. "Experimental Evaluation of Metal Artifact Avoidance and Reduction for Anterior Cervical Discectomy and Fusion Surgery." Proceedings of the Medical Imaging 2025: Physics of Medical Imaging, San Diego, CA, USA Ed. John M. Sabol, Ke Li, Shiva Abbaszadeh, SPIE, 2025.

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