Spurious structures created by interpolation-based CT metal artifact reduction

Under normal circumstances the quality of images reconstructed with the classic FBP CT reconstruction algorithm is adequate for medical diagnosis. However, in some special cases the assumptions made by this method are not applicable because of non-linearities in the underlying physical imaging processes. Especially in the presence of metal implants in the field of view, effects like beam hardening, scatter and photon starvation result in serious streaking and banding artifacts around and between these objects. In order to reduce the artifacts, several different types of correction methods were introduced during the last two decades. In one of the most often used approaches, an interpolation scheme is used to replace all corrupted beam data in the shadow of the metal with artificially generated values. Although this leads to a reduction of the most severe artifacts, typically the results are far from being perfect. Instead of removing all artifacts, in most cases new streak artifacts are introduced. In the present work it is shown that the origin of these new artifacts is related to the loss of edge information of the objects by using surrogate data. The application of a more sophisticated artifact reduction method based on a segmentation of a preliminary reconstructed image decreases the number of newly introduced artifacts to a large degree. This is possible, because edge information between air and tissue recovered from the preliminary reconstruction can be included into the correction scheme. It is concluded that a restoration scheme without additionally information is not sufficient for a successful metal artifact reduction method.