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Carbon-fiber-reinforced polyetheretherketone orthopedic implants in musculoskeletal and spinal tumors: imaging and clinical features

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Abstract

Carbon-fiber-reinforced polyetheretherketone (CFR-PEEK) orthopedic implants are gaining popularity in oncologic applications as they offer many potential advantages over traditional metallic implants. From an imaging perspective, this instrumentation allows for improved evaluation of adjacent anatomic structures during radiography, computed tomography (CT), and magnetic resonance imaging (MRI). This results in improved postoperative surveillance imaging quality as well as easier visualization of anatomy for potential image-guided percutaneous interventions (e.g., pain palliation injections, or ablative procedures for local disease control). CFR-PEEK devices are also advantageous in radiation oncology treatment due to their decreased imaging artifact during treatment planning imaging and decreased dose perturbation during radiotherapy delivery. As manufacturing processes for CFR-PEEK materials continue to evolve and improve, potential orthopedic applications in the spine and appendicular skeleton increase. An understanding of the unique properties of CFR-PEEK devices and their impact on imaging is valuable to radiologists delivering care to orthopedic oncology patients in both the diagnostic and interventional settings. This multidisciplinary review aims to provide a comprehensive insight into the radiologic, surgical, and radiation oncology impact of these innovative devices.

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Authors and Affiliations

  1. Department of Radiology, Mayo Clinic Arizona, 5777 East Mayo Boulevard, Phoenix, AZ, 85054, USA

    Jeremiah R. Long & Jonathan A. Flug

  2. Department of Neurosurgery, Mayo Clinic Arizona, 5777 East Mayo Boulevard, Phoenix, AZ, 85054, USA

    Maziyar A. Kalani

  3. Department of Orthopedic Surgery, Mayo Clinic Arizona, 5777 East Mayo Boulevard, Phoenix, AZ, 85054, USA

    Krista A. Goulding

  4. Department of Radiation Oncology, Mayo Clinic Arizona, 5777 East Mayo Boulevard, Phoenix, AZ, 85054, USA

    Jonathan B. Ashman

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  1. Jeremiah R. Long
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  2. Maziyar A. Kalani
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Correspondence to Jeremiah R. Long.

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MAK is a consultant for Carbofix, NuVasive, and Medtronic. The remaining authors declare they have no conflict of interest.

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Key Points

• Carbon-fiber-reinforced polyetheretherketone orthopedic implants have substantially less imaging artifact than metal implants and are available for spine and appendicular applications.

• Implants made from carbon-fiber-reinforced polyetheretherketone may be advantageous for postoperative imaging surveillance and radiation therapy in the oncologic population.

• Familiarity with the physical properties, clinical applications, and imaging appearances of carbon-fiber-reinforced polyetheretherketone implants is valuable for radiologists providing care to oncology patients.

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Long, J.R., Kalani, M.A., Goulding, K.A. et al. Carbon-fiber-reinforced polyetheretherketone orthopedic implants in musculoskeletal and spinal tumors: imaging and clinical features. Skeletal Radiol 52, 393–404 (2023). https://doi.org/10.1007/s00256-022-04069-7

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  • DOI: https://doi.org/10.1007/s00256-022-04069-7

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