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Image quality analysis to reduce dental artifacts in head and neck imaging with dual-source computed tomography.

Ketelsen D, Werner MK, Thomas C, Tsiflikas I, Koitschev A, Reimann A, Claussen CD, Heuschmid M

Abteilung für Diagnostische und Interventionelle Radiologie, Eberhard-Karls-Universität Tübingen. dominik.ketelsen@med.unituebingen.de

PURPOSE: Important oropharyngeal structures can be superimposed by metallic artifacts due to dental implants. The aim of this study was to compare the image quality of multiplanar reconstructions and an angulated spiral in dual-source computed tomography (DSCT) of the neck. MATERIALS AND METHODS: Sixty-two patients were included for neck imaging with DSCT. MPRs from an axial dataset and an additional short spiral parallel to the mouth floor were acquired. Leading anatomical structures were then evaluated with respect to the extent to which they were affected by dental artifacts using a visual scale, ranging from 1 (least artifacts) to 4 (most artifacts). RESULTS: In MPR, 87.1 % of anatomical structures had significant artifacts (3.12 +/- 0.86), while in angulated slices leading anatomical structures of the oropharynx showed negligible artifacts (1.28 +/- 0.46). The diagnostic growth due to primarily angulated slices concerning artifact severity was significant (p < 0.01). CONCLUSION: MPRs are not capable of reducing dental artifacts sufficiently. In patients with dental artifacts overlying the anatomical structures of the oropharynx, an additional short angulated spiral parallel to the floor of the mouth is recommended and should be applied for daily routine. As a result of the static gantry design of DSCT, the use of a flexible head holder is essential.

Published 30 December 2008 in Rofo, 181(1): 54-9.
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