Phantom based qualitative and quantitative evaluation of artifacts in MR images of metallic hip prostheses

Purpose: To develop methods for qualitative and quantitative evaluation of MRI artifacts near metallic prostheses, and to compare the efficiency of different artifact suppression techniques with different types of hip prostheses. Methods: Three hip prostheses of cobalt-chromium, stainless steel, and titanium were embedded in agarose gel together with a rectilinear grid. Coronal MR images of the prostheses were acquired on a 1.5T scanner. Three pulse sequences were evaluated; TSE: a high-bandwidth turbo spin echo; VAT: TSE with view angle tilting, SEMAC: TSE with both VAT and slice distortion correction (6, 10 or 16 z-phase-encoding steps). Through-plane distortions were assessed as the length of visible gridlines, in-plane artifacts as the artifact area, and total artifacts by subtraction of an ideal, undistorted image from the actual image. Results: VAT reduced in-plane artifacts by up to 50% compared to TSE, but did not reduce through-plane artifacts. SEMAC reduced through-plane artifacts by 60-80% compared to TSE and VAT. SEMAC in-plane artifacts were from 20% higher (6 encoding steps) to 50% lower (16 steps) than VAT. Total artifacts were reduced by 60-80% in the best sequence (SEMAC, 16 steps) compared to the worst (TSE). The titanium prosthesis produced 3-4 times lower artifact scores than the other prostheses. Conclusions: A rectilinear grid phantom is useful for qualitative and quantitative evaluation of artifacts provoked by different MRI protocols and prosthesis models. VAT and SEMAC were superior to TSE with high bandwidth. A proper number of z-encoding steps in SEMAC was critical. The titanium prosthesis caused least artifacts. (C) 2014 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.