Overcoming MRI challenges with metallic implants
Advanced techniques and technologies to minimize scan artifacts
From the white paper:
Total hip and knee arthroplasty procedures are projected to increase by 175% and 673%, respectively, from 2005 to 20301. Likewise, revision surgeries of total knee and total hip replacements are estimated to grow exponentially over the same period. These impressive growth projections require accurate and cost-effective imaging techniques for post-operative surveillance and diagnosis of implant-related complications. Because magnetic resonance (MR) imaging delivers high spatial and contrast resolution of bone and periprosthetic soft tissues, it is well suited for imaging of arthroplasty implants and has great potential for short- and long-term growth of MSK referrals and generation of revenue.
MR imaging of arthroplasty implants can assist physicians in detecting loosening, periprosthetic fractures, tendon tears, nerve injuries, and adverse reactions to metallic implant products with high accuracy2,3,4. However, metal-induced accelerated dephasing and displacement of MRI signals cause spatial distortions and suboptimal fat suppression⁵. The ensuing artifacts can obscure abnormalities and cause diagnostic inaccuracies⁶, which then may lead to delays in diagnosis, appropriate care, and increased expenses.
On-demand Applied Radiology Expert Forum
Overcoming the Challenge of MRI Metal Artifacts around Orthopedic Implants
Jan Fritz, MD, a board-certified and fellowship-trained MSK radiologist attending at Johns Hopkins and a world expert in metal artifact reduction technologies, discusses how he uses the SEMAC technique to reduce metal artifacts and dramatically improve MR image quality of patients with metallic orthopedic and arthroplasty implants.
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*The MRI restrictions (if any) of the metal implant must be considered prior to the patient undergoing an MRI exam. MRIs of patients with metallic implants bring specific risks. However, certain implants are approved by governing regulatory bodies to be MRI conditionally safe. For such implants, the previously mentioned warning may not be applicable. Please contact the implant manufacturer for the specific conditional information. The conditions for MRI safety are the responsibility of the implant manufacturer, not of Siemens Healthineers.
1Kurtz, S. et al. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am. 2007; 89(4): 780-5.
2Fritz J, Lurie B, Miller TT, Potter HG. MR imaging of hip arthroplasty implants. Radiographics. 2014 Jul-Aug;34(4):E106-32.
3Fritz J, Lurie B, Potter HG. MR Imaging of Knee Arthroplasty Implants. Radiographics. 2015 Sep-Oct;35(5):1483-501.
4Ahlawat S, Stern SE, Belzberg AJ, Fritz J. High-resolution metal artifact reduction MR imaging of the lumbosacral plexus in patients with metallic implants. Skeletal Radiol. 2017 Mar 30.
5Fritz J, Lurie B, Miller TT. Imaging of hip arthroplasty. Semin Musculoskelet Radiol. 2013 Jul;17(3):316-27.
6Sutter R, Ulbrich EJ, Jellus V, Nittka M, Pfirrmann CW. Reduction of metal artifacts in patients with total hip arthroplasty with slice encoding metal artifact correction and view-angle tilting MR imaging. Radiology. 2012 Oct;265(1):204-14.