ORIGINAL RESEARCH article
Front. Pediatr.
Sec. Pediatric Surgery
Volume 13 - 2025 | doi: 10.3389/fped.2025.1430160
The Value of Dual-Energy CT Virtual Monoenergetic Imaging and Metal-Artifacts Reduction System after Metal Plate Correction of Congenital Funnel Chest in Child: A Single Center Retrospective Study
Provisionally accepted
- 1Xuzhou Children's Hospital, Xuzhou, Jiangsu Province, China
- 2Huashan Hospital, Fudan University, Shanghai, China
- 3Department of Radiology, the Second Affiliated Hospital of Xuzhou Medical University, Xuzhou, Xuzhou, Jiangsu Province, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Objective: This study aimed to evaluate the utility of virtual monoenergetic (MONO) imaging and a Metal-Artifact Reduction System (MARs) algorithm for enhancing image quality in dual-energy computed tomography (DECT) of children with congenital funnel chest (CFC) following minimally invasive correction with stainless steel plate implantation. Materials and Methods: We retrospectively analyzed children with CFC who underwent thoracoscopic correction at our institution (January 2022 to August 2023). Their postoperative non-contrast chest CT scans were evaluated. Objective metrics (CT numbers, standard deviation-SD) were measured on five image series (120kVp-like, 50keV, 50keV+MARs, 110keV, 110keV+MARs), and the absolute CT difference (|ΔCT|) and artifact index (AI) were calculated. Subjective image quality was scored by two independent radiologists. Given the non-normal distribution of data (Shapiro-Wilk test, P < 0.001), non-parametric tests (Friedman test with Wilcoxon post-hoc analysis) were used for comparisons. Results: A total of 114 children were enrolled. Objective metrics (SD, |ΔCT|, AI) on 110keV images were significantly lower than on 120kVp-like and 50keV images (P < 0.001). The application of MARs further significantly improved image quality at both energy levels (P < 0.005). Subjective scores (presented as median [IQR]) confirmed that the 110keV+MARs series provided the best image quality, which was significantly superior to all other groups (P < 0.001). Conclusions: The high-energy VMI (110keV) of the dual-energy CT can effectively reduce metal artifacts, and the combination of the 110keV and MARs algorithm could further improve the image quality, which provides great assistance for the review and follow-up of children with CFC after metal plate correction.
Keywords: computed tomography, Dual-energy CT, Virtual monoenergetic imaging, Metal artifact reduction, congenital funnel chest, artifact, Child
Received: 09 May 2024; Accepted: 06 Oct 2025.
Copyright: © 2025 Li, Xu, Lu, Dong and Du. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Lina Dong, dln0325@126.com
Peng Du, dupeng0516@126.com
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.