Carbon fiber intramedullary nails reduce artifact in postoperative advanced imaging Journal Article

  


Authors: Zimel, M. N.; Hwang, S.; Riedel, E. R.; Healey, J. H.
Article Title: Carbon fiber intramedullary nails reduce artifact in postoperative advanced imaging
Abstract: Objective: This study assessed whether radiolucent carbon fiber reinforced-polyetheretherketone (CFR-PEEK) intramedullary nails decreased hardware artifact on magnetic resonance imaging (MRI) and computed tomography (CT) in vitro and in an oncologic patient population. Materials and methods: In vitro and clinical evaluations were done. A qualitative assessment of metal artifact was performed using CFR-PEEK and titanium nail MRI phantoms. Eight patients with a femoral or tibial prophylactic CFR-PEEK nail were retrospectively identified. All patients had postoperative surveillance imaging by MRI, CT, and were followed for a median 20 months (range, 12–28 months). CFR-PEEK images were compared to images from a comparative group of patients with titanium femoral intramedullary nails who had a postoperative MRI or CT. A musculoskeletal-trained radiologist graded visualization of the cortex, corticomedullary junction, and bone–muscle interface, on T1-weighted (T1W), STIR, and contrast-enhanced T1-weighted fat-saturated (T1W FS) sequences of both groups with a five-point scale, performing independent reviews 4 months apart. Statistical analysis used the Wilcoxon rank-sum test and a weighted kappa. Results: Substantially less MRI signal loss occurred in the CFR-PEEK phantom than in the titanium phantom simulation, particularly as the angle increased with respect to direction of the static magnetic field. CFR-PEEK nails had less MRI artifact than titanium nails on scored T1W, STIR, and contrast-enhanced T1W FS MRI sequences (p ≤ 0.03). The mean weighted kappa was 0.64, showing excellent intraobserver reliability between readings. Conclusions: CFR-PEEK intramedullary nail fixation is a superior alternative to minimize implant artifact on MRI or CT imaging for patients requiring long bone fixation. © 2015, ISS.
Keywords: adult; clinical article; controlled study; treatment outcome; treatment response; aged; middle aged; range of motion; cancer localization; postoperative period; nuclear magnetic resonance imaging; follow up; metastasis; computer assisted tomography; image analysis; in vitro study; oncology; retrospective study; preoperative period; clinical evaluation; scoring system; artifact; thyroid carcinoma; nuclear magnetic resonance scanner; radiological parameters; mobilization; intramedullary nailing; carbon fiber; very elderly; human; male; female; priority journal; article; cfr-peek; ct artifact; intramedullary nail; mri artifact; postoperative imaging; carbon fiber reinforced polyetheretherketone intramedullary nail; device comparison; prophylactic surgical procedure; titanium intramedullary nail
Journal Title: Skeletal Radiology
Volume: 44
Issue: 9
ISSN: 0364-2348
Publisher: Springer  
Date Published: 2015-09-01
Start Page: 1317
End Page: 1325
Language: English
DOI: 10.1007/s00256-015-2158-9
PROVIDER: scopus
PUBMED: 25982252
DOI/URL:

http://www.scopus.com/inward/record.url?eid=2-s2.0-84938975032&partnerID=40&md5=2d72f7c92fc2aa0c2338443c3fa8cb8d
Notes: Export Date: 2 September 2015 -- Source: Scopus
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MSK Authors
  1. Elyn Renee Stubblefield
    203 Stubblefield
  2. Sinchun Hwang
    96 Hwang
  3. John H Healey
    547 Healey
  4. Melissa Nicole Zimel
    3 Zimel
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