ArticleCancers2026
Postoperative MRI Artifact Burden After Carbon Fiber-Reinforced PEEK Versus Titanium Instrumentation in Metastatic Spinal Disease.
Article in Cancers, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
BACKGROUND/
objectivesPatients undergoing surgery for metastatic spinal disease often require instrumented stabilization followed by radiotherapy and postoperative magnetic resonance imaging (MRI) surveillance. Titanium implants may generate artifacts that impair assessment of the operated level, whereas carbon fiber-reinforced polyetheretherketone (CFR-PEEK) constructs may improve MRI assessability. This study compared CFR-PEEK and titanium instrumentation with respect to postoperative MRI artifact burden, early outcomes, and oncological follow-up, and introduced a study-specific artifact grading system.
methodsThis retrospective single-center cohort included 78 patients treated with instrumented stabilization for metastatic spinal disease: 33 with CFR-PEEK and 45 with titanium instrumentation. Postoperative MRI suitable for artifact assessment was available in 47 patients. Implant-related artifacts were evaluated using the Oncologic Spinal Instrumentation MRI Artifact Score (O-SIMAS), a 0-5 anatomy-based grading system. Early postoperative outcomes, local recurrence, progression-free survival, overall survival, and interrater agreement were analyzed.
resultsCFR-PEEK instrumentation was associated with lower postoperative MRI artifact burden than titanium instrumentation, with median O-SIMAS scores of 2.0 versus 3.0, respectively (
conclusionsCFR-PEEK instrumentation was associated with improved postoperative MRI assessability and fewer diagnostically relevant artifacts than titanium instrumentation. No oncological benefit was shown. O-SIMAS may support structured artifact assessment, but requires external validation.
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