Wang ZL, Wu G. Application of streak metal artifact reduction technique in cone-beam computed tomography guided percutaneous transthoracic needle biopsy. World J Radiol 2026; 18(2): 115249 [DOI: 10.4329/wjr.v18.i2.115249]
Corresponding Author of This Article
Ge Wu, PhD, Associate Chief Physician, Department of Interventional Radiology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, No. 55 South Renmin Road, Chengdu 610044, Sichuan Province, China. wuge@scszlyy.org.cn
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Respiratory System
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Retrospective Study
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Feb 28, 2026 (publication date) through Feb 28, 2026
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Publication Name
World Journal of Radiology
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1949-8470
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Wang ZL, Wu G. Application of streak metal artifact reduction technique in cone-beam computed tomography guided percutaneous transthoracic needle biopsy. World J Radiol 2026; 18(2): 115249 [DOI: 10.4329/wjr.v18.i2.115249]
World J Radiol. Feb 28, 2026; 18(2): 115249 Published online Feb 28, 2026. doi: 10.4329/wjr.v18.i2.115249
Application of streak metal artifact reduction technique in cone-beam computed tomography guided percutaneous transthoracic needle biopsy
Zhi-Lin Wang, Ge Wu
Zhi-Lin Wang, Ge Wu, Department of Interventional Radiology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, 610044, Sichuan Province, China
Author contributions: Wang ZL contributed to conceptualization, methodology, investigation, data curation, formal analysis, writing, original draft; Wu G contributed to conceptualization, supervision, project administration, resources, validation, writing, review and editing; all authors have read and agreed to the published version of the manuscript.
Institutional review board statement: This investigation was approved by the Institutional Review Board of Sichuan Cancer Hospital, No. KY-2025-293-01.
Informed consent statement: The need for patient consent was waived due to the retrospective nature of the study.
Conflict-of-interest statement: The authors declare no conflict of interest.
Data sharing statement: Data is available from the corresponding author upon reasonable request.
Corresponding author: Ge Wu, PhD, Associate Chief Physician, Department of Interventional Radiology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, No. 55 South Renmin Road, Chengdu 610044, Sichuan Province, China. wuge@scszlyy.org.cn
Received: October 15, 2025 Revised: December 24, 2025 Accepted: January 16, 2026 Published online: February 28, 2026 Processing time: 136 Days and 0.4 Hours
Abstract
BACKGROUND
Metallic artifacts from coaxial needles can severely interfere with the precision of cone-beam computed tomography (CBCT)-guided percutaneous transthoracic needle biopsy (PTNB), particularly in assessing vital anatomical structures around small lesions.
AIM
To evaluate the clinical application of a streak metal artifact reduction technique (SMART) in CBCT-PTNB procedures.
METHODS
We retrospectively analyzed data from 68 patients (73 CBCT scans) undergoing CBCT-guided PTNB between March 2023 and December 2024. Image quality was compared among original reconstructed CBCT images, those iteratively reconstructed using SMART with a full volume of interest (VOI) (SMART-Full), and those with a small VOI containing only the coaxial needle (SMART-Small). Evaluations focused on artifact types, puncture needle diameter measurements, and density metrics within the region of interest (ROI).
RESULTS
SMART-Full reconstruction significantly reduced radial, streak, and dark stripe artifacts (P < 0.001) compared to original CBCT, with superior performance in puncture needle diameter measurement and ROI minimum and average density indicators (P < 0.001). The incidence of dark streak artifacts decreased from 71 cases in original CBCT to 26 cases in SMART-Full. Additionally, SMART-Full was more effective than SMART-Small in artifact elimination (P < 0.001).
CONCLUSION
SMART technology effectively reduces metal artifacts, enabling clearer visualization of hidden anatomical structures. Through quantitative analysis, this study confirms the clinical value of SMART in CBCT-guided PTNB, providing a technical reference for precise diagnosis and treatment of small pulmonary lesions.
Core Tip: This retrospective study evaluates the application of streak metal artifact reduction technique (SMART) in cone-beam computed tomography (CBCT)-guided percutaneous transthoracic needle biopsy. SMART iterative reconstruction, particularly in full volume-of-interest mode, significantly reduces radial, streak, and dark stripe artifacts caused by metallic coaxial needles compared to original CBCT images. This technology enables clearer visualization of small lung nodules and critical adjacent anatomical structures, such as blood vessels, which is crucial for accurate puncture path planning. The quantitative improvement in image quality confirms the clinical value of SMART in enhancing the precision and safety of biopsies for small pulmonary lesions.
