{
  "abstract": "Metal implants can cause substantial artifacts on computed tomography (CT), and the optimal virtual monochromatic (VM) energy for metal artifact reduction (MAR) remains uncertain. This study assessed metal-artifact reduction and overall image quality on low-dose dual-energy computed tomography (DECT) VM images reconstructed with Smart MAR. A multi-energy CT phantom (GPH-75B; Kyoto Kagaku Co., Ltd., Kyoto, Japan) was scanned in DECT mode with a 12-mm titanium rod positioned at the center, right, and superior portions. VM images from 40 to 140 keV were reconstructed with MAR and without MAR (no-MAR). Image quality was assessed according to artifact and structure visibility scores, CT values, standard deviations (SDs), titanium-rod dimensions, structural similarity index (SSIM), peak signal-to-noise ratio (PSNR), and root mean square error (RMSE). MAR and no-MAR measurements were compared via two-sided paired t-tests. Across the three titanium-rod positions, MAR generally reduced artifacts, improved titanium-rod edge visibility, and reduced geometric distortion compared with no-MAR. At every rod position and energy level, MAR yielded higher SSIM and PSNR and lower RMSE compared to no-MAR (all P values <0.05). At the central position, the transverse-to-longitudinal diameter ratio was 0.94-1.03 with MAR and 0.21-0.81 with no-MAR (all P values <0.001), remaining close to 1.0 at energies ≥60 keV with MAR. For MAR images, adjacent-structure clarity was highest at 60 keV. In both groups, SSIM and PSNR increased with increasing energy, whereas RMSE and image noise decreased. MAR consistently improved image quality across titanium-rod positions. In terms of artifact reduction, implant depiction, and adjacent-structure visibility, 60 to 80-keV VM images with MAR provided the most favorable overall performance under the tested low-dose conditions.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.",
    "GE Healthcare, Computed Tomography Research Center, Beijing, China."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 7,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Tingting Qu",
      "orcid": "0009-0000-6064-8659"
    },
    {
      "affs": [
        0
      ],
      "name": "Ganglian Fan"
    },
    {
      "affs": [
        0
      ],
      "name": "Yanan Li"
    },
    {
      "affs": [
        0
      ],
      "name": "Lihong Chen"
    },
    {
      "affs": [
        0
      ],
      "name": "Le Cao"
    },
    {
      "affs": [
        1
      ],
      "name": "Jianying Li"
    },
    {
      "affs": [
        0
      ],
      "name": "Jianxin Guo"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/4q9khx79kgk2s.bib",
  "cited_by": 0,
  "doi": "10.21037/qims-2026-1454",
  "fulltext_url": "https://europepmc.org/articles/PMC13743334",
  "id": "4q9khx79kgk2s",
  "issns": [
    "2223-4292",
    "2223-4306"
  ],
  "landing_url": "https://europepmc.org/article/MED/42997956",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2204|Advanced X-ray and CT Imaging"
    ]
  ],
  "openalex": "W7223196835",
  "pdf_url": "https://europepmc.org/articles/PMC13743334?pdf=render",
  "pmcid": "PMC13743334",
  "pmid": "42997956",
  "published": "2026-10-20",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/4q9khx79kgk2s.ris",
  "sources": [
    {
      "first_seen": "2026-11-09T15:20:41Z",
      "native_id": "MED:42997956",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42997956"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "journal-openalex:2741|Advanced MRI Techniques and Applications",
      "subfield": "imaging"
    }
  ],
  "title": "Evaluation of virtual monochromatic imaging combined with metal artifact reduction in low-dose dual-energy computed tomography: a phantom study.",
  "title_text": "Evaluation of virtual monochromatic imaging combined with metal artifact reduction in low-dose dual-energy computed tomography: a phantom study.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T15:20:41Z",
  "url": "https://research.draconitic.com/paper/4q9khx79kgk2s",
  "venue": "Quantitative imaging in medicine and surgery",
  "versions": []
}