Clinical Potential of Digital Linear Tomosynthesis Imaging of Total Joint Arthroplasty

The present study was performed to evaluate the potential for clinical application of digital linear tomosynthesis in imaging hip prostheses. Volumetric x-ray digital linear tomosysnthesis was used to image hip prostheses. The tomosynthesis was compared to metal artifact reduction (MAR) computed tomography (CT), and non-MAR CT scans of a prosthesis case. The effectiveness of this method in enhancing visibility of a prosthesis case was quantified in terms of the signal-to-noise ratio (SNR), and removal of ghosting artifacts in a prosthesis case was quantified in terms of the artifact spread function (ASF). In the near in-focus plane, the contrast is greater in the MAR CT or tomosynthesis relative to the non-MAR CT. The order of ASF performance of the algorithm was as follows: (1) tomosynthesis; (2) MAR-CT; (3) non-MAR CT. The potential usefulness of digital linear tomosynthesis for evaluation of hip prostheses was demonstrated. Further studies are required to determine the ability of digital linear tomosynthesis to quantify the spatial relationships between the metallic components of these devices as well as to identify bony changes with diagnostic consequences.