Japanese Journal of Radiology

, Volume 36, Issue 4, pp 285–294 | Cite as

Utility of second-generation single-energy metal artifact reduction in helical lung computed tomography for patients with pulmonary arteriovenous malformation after coil embolization

  • Yudai Asano
  • Akihiro Tada
  • Takayoshi Shinya
  • Yoshihisa Masaoka
  • Toshihiro Iguchi
  • Shuhei Sato
  • Susumu Kanazawa
Original Article



The quality of images acquired using single-energy metal artifact reduction (SEMAR) on helical lung computed tomography (CT) in patients with pulmonary arteriovenous malformation (PAVM) after coil embolization was retrospectively evaluated.

Materials and methods

CT images were reconstructed with and without SEMAR. Twenty-seven lesions [20 patients (2 males, 18 females), mean age 61.2 ± 11.0 years; number of embolization coils, 9.8 ± 5.0] on contrast-enhanced CT and 18 lesions of non-enhanced lung CT concurrently performed were evaluated. Regions of interest were positioned around the coils and mean standard deviation value was compared as noise index. Two radiologists visually evaluated metallic coil artifacts using a four-point scale: 4 = minimal; 3 = mild; 2 = strong; 1 = extensive.


Noise index was significantly improved with SEMAR versus without SEMAR (median [interquartile range]; 194.4 [161.6–211.9] Hounsfield units [HU] vs. 243.9 [220.4–286.0] HU; p < 0.001). Visual score was significantly improved with SEMAR versus without SEMAR (Reader 1, 3 [3] vs.1 [1]; Reader 2, 3 [3] vs.1 [1]; p < 0.001). Significant differences were similarly demonstrated on lung CT (p < 0.001).


SEMAR provided clear chest CT images in patients who underwent PAVM coil embolization.


Artifact reduction Metal implants CT Pulmonary arteriovenous malformation Single-energy metal artifact reduction algorithm 


Compliance with ethical standards

Conflict of interest

The authors declare no conflicts of interest or funding sources to disclose.

Ethical approval

This study was approved by the ethics committee of the authors’ institution, and requirements for informed consent were waived. Information from this study was presented on the institutional website, and all patients were informed of their right to opt out.


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Copyright information

© Japan Radiological Society 2018

Authors and Affiliations

  1. 1.Department of RadiologyOkayama University HospitalOkayama-cityJapan
  2. 2.Department of Health InformaticsKawasaki University of Medical WelfareOkayamaJapan

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