Background Latest generations of flat detector (FD) neuroangiography systems are able to obtain CT-like images of the brain parenchyma. Owing to the geometry of the C-arm system, cone beam artifacts are common and reduce image quality, especially at the periphery of the field of view. An advanced reconstruction algorithm (syngo DynaCT Head Clear) tackles these artifacts by using a modified interpolation-based 3D correction algorithm to improve image quality.
Materials and methods Eleven volumetric datasets from FD-CT scans were reconstructed with the standard algorithm as well as with the advanced algorithm. In a two-step data analysis process, two reviewers compared dedicated regions of the skull and brain in both reconstruction modes using a 5-point scale (1, much better; 5, much worse; advanced vs standard algorithm). Both reviewers were blinded to the reconstruction mode. In a second step, two additional observers independently evaluated image quality of the 3D data (non-comparative evaluation) in dedicated regions also using a 5-point scale (1, not diagnostically evaluable; 5, good quality, perfectly usable for diagnosis) for both reconstruction algorithms.
Results Both in the comparative evaluation of dedicated brain regions and in the independent analysis of the FD-CT datasets the observers rated a better image quality if the advanced algorithm was used. The improvement in image quality was statistically significant at both the supraganglionic (p=0.018) and the infratentorial (p=0.002) levels.
Conclusions The advanced reconstruction algorithm reduces typical artifacts in FD-CT images and improves image quality at the periphery of the field of view.
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Contributors SL: data interpretation, manuscript writing and preparation. CR: data analysis and interpretation, critical review of manuscript. MCH: data analysis, critical review of manuscript. LP: critical review of manuscript. SB: critical review of manuscript. KC: statistical analysis. JB: data analysis, critical review of manuscript. MW: concept, design, data analysis and interpretation, manuscript writing and preparation.
Funding There is a permanent scientific cooperation between Siemens Healthcare AG and the Institute of Neuroradiology and travel expenses for presentation of projects are covered by the company.
Competing interests JB: consulting fee or honorarium: proctor for WEB, Sequent Medical, and member of the scientific advisory board of Acandis. There is a permanent scientific cooperation between Siemens Healthcare AG and the Institute of Neuroradiology and travel expenses for presentation of projects are covered by company. The other authors have no personal, financial, or institutional interest in any of the drugs, materials, or devices described in this article.
Ethics approval Ethics approval was obtained from the local ethics committee of the University of Frankfurt.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement All data are included in the study.