ArticleJournal of applied clinical medical physics2020
The dosimetric impact of stabilizing spinal implants in radiotherapy treatment planning with protons and photons: standard titanium alloy vs. radiolucent carbon-fiber-reinforced PEEK systems.
Article in Journal of applied clinical medical physics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
36 citing papers in PubMed, 1 synthesis or guideline pooled it, 64 citations in OpenAlex.
- Carbon fiber-reinforced polyetheretherketone implants versus titanium implants for spinal tumors: a systematic review and meta-analysis.Journal of neuro-oncology · 2026Pooled it
- Comparison of Titanium and Carbon Fiber-Reinforced Polyetheretherketone Spinal Implants in Postoperative Spine Stereotactic Body Radiation Therapy: A Comprehensive Review of Current Evidence and Future Perspectives.Advances in radiation oncology · 2026Review
- Carbon fiber-reinforced peek versus titanium implants for the surgical treatment of spinal metastases: Evaluation of local disease control and quality of life.Journal of bone oncology · 2026Article
- Safety and efficacy of carbon fiber-reinforced polyetheretherketone implants in primary and metastatic spinal tumors: a systematic review and meta-analysis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Review
- Biomaterials for vertebral body repair: interior augmentation and total replacement-a literature review of bone fusion outcomes in clinical studies.Journal of spine surgery (Hong Kong) · 2026Review
- Clinical durability of junction-terminating CFR-PEEK constructs in oncologic spine surgery: a single-center retrospective analysis.Journal of neuro-oncology · 2026Article
- Dosimetric impact of endoscopic titanium clips in photon and proton radiotherapy for esophageal cancer.Frontiers in oncology · 2026Article
- Mitigating dosimetric perturbations from large metal implants utilizing spot-scanning proton arc therapy.Medical dosimetry : official journal of the American Association of Medical Dosimetrists · 2026Article
- Use of carbon fiber-reinforced PEEK cages in spinal oncology patients: An institutional experience with emphasis on surgical, complication and imaging characteristics.Acta neurochirurgica · 2025Article
- Differential diagnosis and management of subaxial cervical chondroma: illustrative case.Journal of neurosurgery. Case lessons · 2025Article
- Carbon-fiber-reinforced polyetheretherketone instrumentation in metastatic spine tumor surgery: technical considerations and potential pitfalls to avoid.Asian spine journal · 2025Article
- Advantages of carbon fibre-reinforced polyetheretherketone over titanium implants in spine SBRT: a phantom evaluation.Physical and engineering sciences in medicine · 2025Article
- Advances in Metastatic Disease Spinal Oncology: Novel Technology Without Forgetting the Fundamentals of Surgical Treatment.Neurospine · 2025Article
- Local Control After Adjuvant Radiosurgery for Spinal Metastasis Treated With Decompression and Posterior Segmental Stabilization: A Comparison Between Carbon Fiber/Polyetheretherketone-Based and Metallic Implants.Advances in radiation oncology · 2025Article
- Radiation Treatment Planning After Minimum Metallic Instrumentation for Patients with Spinal Metastases: A Case Series.Medicina (Kaunas, Lithuania) · 2025Article
- Impact of instrumentation material on local recurrence: a case-matched series using carbon fiber-PEEK vs. titanium.Journal of neuro-oncology · 2025Article
- Role of Posterior Carbon Fiber Implants in Spine Tumor Surgery.Global spine journal · 2025Article
- Hybrid therapy and use of carbon-fiber-reinforced polyetheretherketone instrumentation for management of mobile spine chordomas: A case series and review of the literature.Surgical neurology international · 2025Article
- Case Report: Cervical carbon fiber-reinforced PEEK pedicle screw fixation with 3D custom-made template guides for spinal oncology surgery.Frontiers in surgery · 2025Article
- Scoping review of robotics technology in spinal surgery with highlights of the Annual Seattle Science Foundation Course.Annals of translational medicine · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThroughout the last years, carbon-fibre-reinforced PEEK (CFP) pedicle screw systems were introduced to replace standard titanium alloy (Ti) implants for spinal instrumentation, promising improved radiotherapy (RT) treatment planning accuracy. We compared the dosimetric impact of both implants for intensity modulated proton (IMPT) and volumetric arc photon therapy (VMAT), with the focus on uncertainties in Hounsfield unit assignment of titanium alloy.
methodsRetrospective planning was performed on CT data of five patients with Ti and five with CFP implants. Carbon-fibre-reinforced PEEK systems comprised radiolucent pedicle screws with thin titanium-coated regions and titanium tulips. For each patient, one IMPT and one VMAT plan were generated with a nominal relative stopping power (SP) (IMPT) and electron density (ρ) (VMAT) and recalculated onto the identical CT with increased and decreased SP or ρ by ±6% for the titanium components.
resultsRecalculated VMAT dose distributions hardly deviated from the nominal plans for both screw types. IMPT plans resulted in more heterogeneous target coverage, measured by the standard deviation σ inside the target, which increased on average by 7.6 ± 2.3% (Ti) vs 3.4 ± 1.2% (CFP). Larger SPs lead to lower target minimum doses, lower SPs to higher dose maxima, with a more pronounced effect for Ti screws.
conclusionsWhile VMAT plans showed no relevant difference in dosimetric quality between both screw types, IMPT plans demonstrated the benefit of CFP screws through a smaller dosimetric impact of CT-value uncertainties compared to Ti. Reducing metal components in implants will therefore improve dose calculation accuracy and lower the risk for tumor underdosage.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.