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Original research
Clinical evaluation of volume of interest imaging combined with metal artifact reduction reconstruction techniques in coiling and stent assisted coiling during neurointerventional procedures
  1. Qiang Zhang1,2,
  2. Hao Zhao1,
  3. Qi Sun3,
  4. Jingfeng Han3,
  5. Hao Zhang1,
  6. Tonghui Shan1,
  7. Wenlong Pan1,
  8. Chuanqi Gu1,
  9. Ruxiang Xu1,
  10. Gengsheng Mao4
  1. 1 PLA Army General Hospital, Beijing, China
  2. 2 Chaoyang Chinese Traditional and Western Medicine Emergency Medical Center, Beijing, China
  3. 3 Siemens Healthcare Ltd, Beijing, China
  4. 4 General Hospital of Chinese People’s Armed Police Forces, Beijing, China
  1. Correspondence to Professor Ruxiang Xu, PLA Army General Hospital, Beijing, 100700, China; xuruxiang_bjjz{at} and Dr Gengsheng Mao, General Hospital of Chinese People’s Armed Police Forces, Beijing, 100039, China; mclxmgs{at}


Purpose Three-dimensional (3D) scans with flat detector angiographic systems are widely used for neurointerventions by providing detailed vascular information. However, its associated radiation dose and streak metal artifact generated by implanted treatment devices remain issues. This work evaluates the feasibility and clinical value of volume of interest imaging combined with metal artifact reduction (VOI+MAR) to generate high quality 3D images with reduced radiation dose and metal artifacts.

Material and methods Full volume (FV) and VOI scans were acquired in 25 patients with intracranial aneurysms and treated with either endovascular coiling (n=9) or stent assisted coiling (n=16) procedures. FV and VOI scans were reconstructed with conventional syngo DynaCT and VOI +MAR prototype software, respectively.

Results Quantitative evaluation results demonstrated that compared with standard FV syngo DynaCT images, overall image quality was improved in the VOI+MAR reconstructed images, with streak metal artifacts considerably reduced or even removed; details of soft tissue in the vicinity of the metal devices was well preserved or recovered in the majority of cases. Radiation dose to patients calculated by dose area product was found to be significantly reduced using VOI scans.

Conclusion This study confirmed the feasibility of using VOI+MAR prototype software to achieve high image quality of a small volume of clinical interest and to reduce radiation dose. This technique has potential to improve patient safety and treatment outcomes.

  • angiography
  • intervention
  • coil
  • stent

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  • Contributors Guarantor of integrity of the entire study: ZQ, XR, SQ, and MG. Study concepts and design: ZQ, ZH, HJ, SQ, XR, and MG. Literature research: ZQ, HJ, SQ, and ZH. Clinical studies: ZQ, HJ, ZH, PW, ST, and GC. Experimental studies/data analysis: ZQ, ZH, PW, ST, and GC. Statistical analysis: ZQ, ZH, SQ, and HJ. Manuscript preparation: ZQ, ZH, and SQ. Manuscript editing: ZQ, XR, SQ, and MG.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial, or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval The study was approved by the Military General Hospital of Beijing PLA.

  • Provenance and peer review Not commissioned; externally peer reviewed.