Quantifying metal-induced susceptibility artifacts of the instrumented spine at 1.5T using fast-spin echo and 3D-multispectral MRI

Kaushik, S. Sivaram; Karr, Robin; Runquist, Matthew L.; Marszalkowski, Cathy S.; Sharma, Ashish; Rand, Scott D.; Maiman, Dennis J.; Koch, Kevin M.

doi:10.1002/jmri.25321

Cited by 11 publications

(5 citation statements)

References 23 publications

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“…101 Moreover, multispectral imaging methods achieved improvements in nerve visualization, artifact reduction, and image quality. 87 The benefit of SEMAC for imaging spines with metal hardware was shown in numerous studies, 100,[102][103][104][105][106] and its added value in artifact reduction compared with basic MARS techniques is particularly apparent when dealing with nonfavorable material, such as stainless steel (Fig. 4).…”

Section: Spinementioning

confidence: 99%

Magnetic Resonance Imaging Around Metal at 1.5 Tesla

2021

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During the last decade, metal artifact reduction in magnetic resonance imaging (MRI) has been an area of intensive research and substantial improvement. The demand for an excellent diagnostic MRI scan quality of tissues around metal implants is closely linked to the steadily increasing number of joint arthroplasty (especially knee and hip arthroplasties) and spinal stabilization procedures. Its unmatched soft tissue contrast and cross-sectional nature make MRI a valuable tool in early detection of frequently encountered postoperative complications, such as periprosthetic infection, material wear–induced synovitis, osteolysis, or damage of the soft tissues. However, metal-induced artifacts remain a constant challenge. Successful artifact reduction plays an important role in the diagnostic workup of patients with painful/dysfunctional arthroplasties and helps to improve patient outcome. The artifact severity depends both on the implant and the acquisition technique. The implant's material, in particular its magnetic susceptibility and electrical conductivity, its size, geometry, and orientation in the MRI magnet are critical. On the acquisition side, the magnetic field strength, the employed imaging pulse sequence, and several acquisition parameters can be optimized. As a rule of thumb, the choice of a 1.5-T over a 3.0-T magnet, a fast spin-echo sequence over a spin-echo or gradient-echo sequence, a high receive bandwidth, a small voxel size, and short tau inversion recovery–based fat suppression can mitigate the impact of metal artifacts on diagnostic image quality. However, successful imaging of large orthopedic implants (eg, arthroplasties) often requires further optimized artifact reduction methods, such as slice encoding for metal artifact correction or multiacquisition variable–resonance image combination. With these tools, MRI at 1.5 T is now widely considered the modality of choice for the clinical evaluation of patients with metal implants.

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Section: Spinementioning

confidence: 99%

Magnetic Resonance Imaging Around Metal at 1.5 Tesla

2021

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“…For metal artifact reduced imaging of the spine, the frequency‐encoding direction should be positioned along the long axis of the pedicle screws in sagittal and transverse images (anterior–posterior) . The utility of SEMAC for artifact reduction in spine imaging has been demonstrated in several studies . SEMAC sequences enabled significantly improved periprosthetic visualization of the pedicles, vertebral body, dural sac, and neural foramina .…”

Section: Clinical Applicationmentioning

confidence: 99%

Advances in MRI around metal

Jungmann

Agten

Pfirrmann

et al. 2017

Magnetic Resonance Imaging

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“…1 ). Metal artifact reduction sequences (MARS) have been developed aiming to reduce metal-induced artifacts [ 9 , 15 ]. However, MARS leads to increased scanning time and reduced image resolution and the availability is limited [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical evaluation of vertebral body replacement of carbon fiber–reinforced polyetheretherketone in patients with tumor manifestation of the thoracic and lumbar spine

et al. 2023

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Purpose Radiolucent anterior and posterior implants by carbon fiber–reinforced polyetheretherketone (CFR PEEK) aim to improve treatment of primary and secondary tumors of the spine during the last years. The aim of this study was to evaluate clinical and radiological outcomes after dorsoventral instrumentation using a CFR PEEK implant in a cohort of patients representing clinical reality. Methods A total of 25 patients with tumor manifestation of the thoracic and lumbar spine underwent vertebral body replacement (VBR) using an expandable CFR PEEK implant between January 2021 and January 2022. Patient outcome, complications, and radiographic follow-up were analyzed. Results A consecutive series aged 65.8 ± 14.7 (27.6–91.2) years were treated at 37 vertebrae of tumor manifestation, including two cases (8.0%) of primary tumor as well as 23 cases (92.0%) of spinal metastases. Overall, 26 cages covering a median of 1 level (1–4) were implanted. Duration of surgery was 134 ± 104 (65–576) min, with a blood loss of 792 ± 785 (100–4000) ml. No intraoperative cage revision was required. Surgical complications were reported in three (12.0%) cases including hemothorax in two cases (one intraoperative, one postoperative) and atrophic wound healing disorder in one case. In two cases (8.0%), revision surgery was performed (fracture of the adjacent tumorous vertebrae, progressive construct failure regarding cage subsidence). No implant failure was observed. Conclusion VBR using CFR PEEK cages represents a legitimate surgical strategy which opens a variety of improvements—especially in patients in need of postoperative radiotherapy of the spine and MRI-based follow-up examinations.

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Quantifying metal-induced susceptibility artifacts of the instrumented spine at 1.5T using fast-spin echo and 3D-multispectral MRI

Abstract: 2 J. Magn. Reson. Imaging 2017;45:51-58.

Cited by 11 publications

References 23 publications

Magnetic Resonance Imaging Around Metal at 1.5 Tesla

Magnetic Resonance Imaging Around Metal at 1.5 Tesla

Advances in MRI around metal

Clinical evaluation of vertebral body replacement of carbon fiber–reinforced polyetheretherketone in patients with tumor manifestation of the thoracic and lumbar spine

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