Objective To evaluate the effect of energy spectrum imaging in CT-guided puncture biopsy of spinal lesions to remove puncture needle artifacts.Methods Thirty patients with spinal lesions underwent percutaneousspine biopsy un-der the guidance of Dual-Energy CT.From dual-energy images and virtual monochromatic spectral imaging(VMSI)between 40-140 keV were generated,and nine groups of images were obtained.The image noise(standard deviation,SD),artifact index(AI),and signal-to-noise ratio(SNR)of the region of interest(ROI)in front of the puncture needle in each group of images were measured.Simultaneously,the image quality in front of the puncture needle was scored using Likert scores.Results The consistency of the Likert scores of two observers was good(Kappa=0.904).Additional MAR reconstruction significantly improved the noise adjacent to implants compared to standard single energy CT(P＜0.05).Al and SNR were improved significantly(P＜0.05).The high keV-MAR group(≥ 120 keV)in SD,AI,SNR were significantly higher than those of 120 kVp group and the low keV-MAR group(＜120 keV,all P＜0.05).In subjective evaluation,VMSI with MAR algorithm improved visualization of bone lesions,and the average Likert scores of 120 keV-MAR group and 140 keV-MAR group were more than 3.Average volume-weighted CT dose index(CTDIvol)was 8.61 mGy.Conclusion High keV(≥ 120 keV)virtual monochromatic spectral imaging with MAR algorithm can effectively reduce the metal artifacts in front of the needle tip of the spine biopsy,and improve the overall CT image quality,improve the definition of the fine ana-tomical structure of the target area.
Energy spectrumMetal artifact reductionCT-guided percutaneous spine biopsySpinal lesions
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