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- Title
Reduction of CT beam hardening artefacts of ethylene vinyl alcohol copolymer by variation of the tantalum content: evaluation in a standardized aortic endoleak phantom.
- Authors
Treitl, Karla; Scherr, Michael; Förth, Monika; Braun, Franziska; Maxien, Daniel; Treitl, Marcus
- Abstract
Objectives: Our aim was to develop an aortic stent graft phantom to simulate endoleak treatment and to find a tantalum content (TC) of ethylene-vinyl-alcohol-copolymer that causes fewer computed tomography (CT) beam hardening artefacts, but still allows for fluoroscopic visualization. Methods: Ethylene-vinyl-alcohol-copolymer specimens of different TC (10-50 %, and 100 %) were injected in an aortic phantom bearing a stent graft and endoleak cavities with simulated re-perfusion. Fluoroscopic visibility of the ethylene-vinyl-alcohol-copolymer specimens was analyzed. In addition, six radiologists analyzed endoleak visibility, and artefact intensity of ethylene-vinyl-alcohol-copolymer in CT. Results: Reduction of TC significantly decreased CT artefact intensity of ethylene-vinyl-alcohol-copolymer and increased visibility of endoleak re-perfusion ( p < 0.000). It also significantly decreased fluoroscopic visibility of ethylene-vinyl-alcohol-copolymer ( R = 0.883, p ≤ 0.01), and increased the active embolic volumes prior to visualization (Δ ≥ 40 μl). Ethylene-vinyl-alcohol-copolymer specimens with a TC of 45-50 % exhibited reasonable visibility, a low active embolic volume and a tolerable CT artefact intensity. Conclusions: The developed aortic stent graft phantom allows for a reproducible simulation of embolization of endoleaks. The data suggest a reduction of the TC of ethylene-vinyl-alcohol-copolymer to 45 -50 % of the original, to interfere less with diagnostic imaging in follow-up CT examinations, while still allowing for fluoroscopic visualization. Key Points: • Standard Tantalum- ethylene- vinyl- alcohol- copolymer causes severe beam hardening artefacts, limiting cross- sectional imaging. • Increased peripheral use of Tantalum- ethylene- vinyl- alcohol- copolymer requires a formulation causing fewer artefacts. • Treatment of endoleaks can be simulated with an aortic stent graft phantom. • Tantalum contents of 45- 50 % exhibit sufficient visualization and tolerable low artefacts.
- Subjects
COMPUTED tomography; FLUOROSCOPY; TANTALUM compounds; SURGICAL stents; COMPUTER-assisted image analysis (Medicine)
- Publication
European Radiology, 2015, Vol 25, Issue 3, p597
- ISSN
0938-7994
- Publication type
Article
- DOI
10.1007/s00330-014-3438-9