ArticleBMC medical imaging2021
Comparison of different CT metal artifact reduction strategies for standard titanium and carbon-fiber reinforced polymer implants in sheep cadavers.
Article in BMC medical imaging, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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14 citing papers in PubMed, 28 citations in OpenAlex.
- 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
- Impact of Combined Deep Learning Image Reconstruction and Metal Artifact Reduction Algorithm on CT Image Quality in Different Scanning Conditions for Maxillofacial Region with Metal Implants: A Phantom Study.Journal of imaging informatics in medicine · 2025Article
- Preclinical evaluation of lateral interbody fusions using 3D printed PEEK or 3D printed titanium cages.North American Spine Society journal · 2025Article
- A Comparative Finite Element Analysis of Titanium, Autogenous Bone, and Polyetheretherketone (PEEK)-Based Solutions for Mandibular Reconstruction.Materials (Basel, Switzerland) · 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
- Personalized Approaches to Spine Surgery.International journal of spine surgery · 2024Article
- Universal non-circular cone beam CT orbits for metal artifact reduction imaging during image-guided procedures.Scientific reports · 2024Article
- Development and validation of a novel overhead method for anteroposterior radiographs of fractured rat femurs.Scientific reports · 2024Article
- Metal artifact reduction on musculoskeletal CT: a phantom and clinical study.European radiology experimental · 2023Article
- Combining iterative metal artifact reduction and virtual monoenergetic images severely reduces hip prosthesis-associated artifacts in photon-counting detector CT.Scientific reports · 2023Article
- Carbon fiber lumbopelvic reconstruction following sacral giant cell tumor resection: illustrative case.Journal of neurosurgery. Case lessons · 2023Article
- Review
- Accuracy Assessment of Percutaneous Pedicle Screw Placement Using Cone Beam Computed Tomography with Metal Artifact Reduction.Sensors (Basel, Switzerland) · 2022Article
- Comprehensive Evaluation of Carbon-Fiber-Reinforced Polyetheretherketone (CFR-PEEK) Spinal Hardware for Proton and Photon Planning.Technology in cancer research & treatmentArticle
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Authors and funding
6 authors at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCT artifacts induced by orthopedic implants can limit image quality and diagnostic yield. As a number of different strategies to reduce artifact extent exist, the aim of this study was to systematically compare ex vivo the impact of different CT metal artifact reduction (MAR) strategies on spine implants made of either standard titanium or carbon-fiber-reinforced-polyetheretherketone (CFR-PEEK).
methodsSpine surgeons fluoroscopically-guided prepared six sheep spine cadavers with pedicle screws and rods of either titanium or CFR-PEEK. Samples were subjected to single- and dual-energy (DE) CT-imaging. Different tube voltages (80, DE mixed, 120 and tin-filtered 150 kVp) at comparable radiation dose and iterative reconstruction versus monoenergetic extrapolation (ME) techniques were compared. Also, the influence of image reconstruction kernels (soft vs. bone tissue) was investigated. Qualitative (Likert scores) and quantitative parameters (attenuation changes induced by implant artifact, implant diameter and image noise) were evaluated by two independent radiologists. Artifact degree of different MAR-strategies and implant materials were compared by multiple ANOVA analysis.
resultsCFR-PEEK implants induced markedly less artifacts than standard titanium implants (p < .001). This effect was substantially larger than any other tested MAR technique. Reconstruction algorithms had small impact in CFR-PEEK implants and differed significantly in MAR efficiency (p < .001) with best MAR performance for DECT ME 130 keV (bone kernel). Significant differences in image noise between reconstruction kernels were seen (p < .001) with minor impact on artifact degree.
conclusionsCFR-PEEK spine implants induce significantly less artifacts than standard titanium compositions with higher MAR efficiency than any alternate scanning or image reconstruction strategy. DECT ME 130 keV image reconstructions showed least metal artifacts. Reconstruction kernels primarily modulate image noise with minor impact on artifact degree.
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