Review Article
Imaging near orthopedic hardware
Matthew F. Koff PhD,
Alissa J. Burge MD,
Kevin M. Koch PhD,
Hollis G. Potter MD,
Corresponding Author
Matthew F. Koff PhD
MRI Laboratory, Hospital for Special Surgery, Department of Radiology and Imaging–MRI, New York, New York, USA
Address reprint requests to: M.F.K., Hospital for Special Surgery, Department of Radiology and Imaging, MRI, 535 E. 70th St., Room BW-08G, New York, NY 10021. E-mail: [email protected]Search for more papers by this authorAlissa J. Burge MD
MRI Laboratory, Hospital for Special Surgery, Department of Radiology and Imaging–MRI, New York, New York, USA
Search for more papers by this authorKevin M. Koch PhD
Medical College of Wisconsin, Department of Radiology, Milwaukee, Wisconsin, USA
Search for more papers by this authorHollis G. Potter MD
MRI Laboratory, Hospital for Special Surgery, Department of Radiology and Imaging–MRI, New York, New York, USA
Search for more papers by this authorMatthew F. Koff PhD,
Alissa J. Burge MD,
Kevin M. Koch PhD,
Hollis G. Potter MD,
Corresponding Author
Matthew F. Koff PhD
MRI Laboratory, Hospital for Special Surgery, Department of Radiology and Imaging–MRI, New York, New York, USA
Address reprint requests to: M.F.K., Hospital for Special Surgery, Department of Radiology and Imaging, MRI, 535 E. 70th St., Room BW-08G, New York, NY 10021. E-mail: [email protected]Search for more papers by this authorAlissa J. Burge MD
MRI Laboratory, Hospital for Special Surgery, Department of Radiology and Imaging–MRI, New York, New York, USA
Search for more papers by this authorKevin M. Koch PhD
Medical College of Wisconsin, Department of Radiology, Milwaukee, Wisconsin, USA
Search for more papers by this authorHollis G. Potter MD
MRI Laboratory, Hospital for Special Surgery, Department of Radiology and Imaging–MRI, New York, New York, USA
Search for more papers by this authorAbstract
Over one million total joint replacement surgeries were performed in the US in 2013 alone, and this number is expected to more than double by 2030. Traditional imaging techniques for postoperative evaluation of implanted devices, such as radiography, computerized tomography, or ultrasound, utilize ionizing radiation, suffer from beam hardening artifact, or lack the inherent high contrast necessary to adequately evaluate soft tissues around the implants, respectively. Magnetic resonance imaging (MRI), due to its ability to generate multiplanar, high-contrast images without the use of ionizing radiation is ideal for evaluating periprosthetic soft tissues but has traditionally suffered from in-plane and through-plane data misregistration due to the magnetic susceptibility of implanted materials. A recent renaissance in the interest of imaging near arthroplasty and implanted orthopedic hardware has led to the development of new techniques that help to mitigate the effects of magnetic susceptibility. This article describes the challenges of performing imaging near implanted orthopedic hardware, how to generate clinically interpretable images when imaging near implanted devices, and how the images may be interpreted for clinical use. We will also describe current developments of utilizing MRI to evaluate implanted orthopedic hardware.
Level of Evidence: 3
Technical Efficacy: Stage 2
J. MAGN. RESON. IMAGING 2017;46:24–39
References
- 1 Murray CJ, Vos T, Lozano R, et al. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012; 380: 2197-2223.
- 2 Koopman WJ. Arthritis and Allied Conditions: A Textbook of Rheumatology. Vol 1. 13th ed. Baltimore: Williams & Wilkins; 1997.
- 3 Centers for Disease Control. Prevalence and most common causes of disability among adults—United States, 2005. Morbid Mortal Wkly Rep 2009; 58: 421–426.
- 4 Agency for Healthcare Research and Quality. HCUPnet, Healthcare Cost and Utilization Project. https://www.hcup-us.ahrq.gov/. Accessed 29 Sept, 2016.
- 5 Kurtz S, Ong K, Lau E, Mowat F, Halpern M. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am 2007; 89: 780–785.
- 6 Font-Rodriguez DE, Scuderi GR, Insall JN. Survivorship of cemented total knee arthroplasty. Clin Orthop Relat Res 1997; 79–86.
- 7 Noble PC, Conditt MA, Cook KF, Mathis KB. The John Insall Award: Patient expectations affect satisfaction with total knee arthroplasty. Clin Orthop Relat Res 2006; 452: 35–43.
- 8 Berry DJ, Harmsen WS, Cabanela ME, Morrey BF. Twenty-five-year survivorship of two thousand consecutive primary Charnley total hip replacements: factors affecting survivorship of acetabular and femoral components. J Bone Joint Surg Am 2002; 84–A: 171-177.
- 9 Willert HG, Semlitsch M. Reactions of the articular capsule to wear products of artificial joint prostheses. J Biomed Mater Res 1977; 11: 157–164.
- 10 Holt G, Murnaghan C, Reilly J, Meek RM. The biology of aseptic osteolysis. Clin Orthop Relat Res 2007; 460: 240–252.
- 11 Hamadouche M, Boutin P, Daussange J, Bolander ME, Sedel L. Alumina-on-alumina total hip arthroplasty: a minimum 18.5-year follow-up study. J Bone Joint Surg Am 2002; 84A: 69–77.
- 12 Sieber HP, Rieker CB, Kottig P. Analysis of 118 second-generation metal-on-metal retrieved hip implants. J Bone Joint Surg Br 1999; 81: 46–50.
- 13 D'Antonio JA, Sutton K. Ceramic materials as bearing surfaces for total hip arthroplasty. J Am Acad Orthop Surg 2009; 17: 63–68.
- 14 Jacobs JJ, Hallab NJ, Skipor AK, Urban RM. Metal degradation products: a cause for concern in metal-metal bearings? Clin Orthop Relat Res 2003; 139–147.
- 15 Farahani K, Sinha U, Sinha S, Chiu LC, Lufkin RB. Effect of field strength on susceptibility artifacts in magnetic resonance imaging. Comput Med Imaging Graph 1990; 14: 409–413.
- 16 Lombardi AV Jr, Berend KR, Adams JB. Why knee replacements fail in 2013: patient, surgeon, or implant? Bone Joint J 2014; 96–B: 101-104.
- 17 Australian Orthopaedic Association National Joint Replacement Registry. Annual Report 2014. https://aoanjrr.sahmri.com/annual-reports-2014. Accessed 1 Aug, 2016.
- 18 Dalling JG, Math K, Scuderi GR. Evaluating the progression of osteolysis after total knee arthroplasty. J Am Acad Orthop Surg 2015; 23: 173–180.
- 19 Goldvasser D, Marchie A, Bragdon LK, Bragdon CR, Weidenhielm L, Malchau H. Incidence of osteolysis in total knee arthroplasty: comparison between radiographic and retrieval analysis. J Arthroplasty 2013; 28: 201–206.
- 20 Lonner JH, Siliski JM, Scott RD. Prodromes of failure in total knee arthroplasty. J Arthroplasty 1999; 14: 488–492.
- 21 Walde TA, Weiland DE, Leung SB, et al. Comparison of CT, MRI, and radiographs in assessing pelvic osteolysis: a cadaveric study. Clin Orthop Relat Res 2005; 437: 138–144.
- 22 Kurmis TP, Kurmis AP, Campbell DG, Slavotinek JP. Pre-surgical radiologic identification of peri-prosthetic osteolytic lesions around TKRs: a pre-clinical investigation of diagnostic accuracy. J Orthop Surg Res 2008; 3: 47.
- 23 American College of Radiology. American College of Radiology ACR Appropriateness Critera for Imaging After Total Knee Arthroplasty. https://acsearch.acr.org/docs/69430/Narrative/. Accessed 14 Nov, 2016.
- 24 American College of Radiology. American College of Radiology ACR Appropriateness Critera for Imaging After Total Hip Arthroplasty. https://acsearch.acr.org/docs/3094200/Narrative/. Accessed 14 Nov, 2016.
- 25 Kaza RK, Platt JF, Cohan RH, Caoili EM, Al-Hawary MM, Wasnik A. Dual-energy CT with single- and dual-source scanners: current applications in evaluating the genitourinary tract. Radiographics 2012; 32: 353–369.
- 26 Pessis E, Campagna R, Sverzut JM, et al. Virtual monochromatic spectral imaging with fast kilovoltage switching: reduction of metal artifacts at CT. Radiographics 2013; 33: 573–583.
- 27 Morsbach F, Bickelhaupt S, Wanner GA, Krauss A, Schmidt B, Alkadhi H. Reduction of metal artifacts from hip prostheses on CT images of the pelvis: value of iterative reconstructions. Radiology 2013; 268: 237–244.
- 28 Aliabadi P, Tumeh SS, Weissman BN, McNeil BJ. Cemented total hip prosthesis: radiographic and scintigraphic evaluation. Radiology 1989; 173: 203–206.
- 29 Hart AJ, Sabah S, Henckel J, et al. The painful metal-on-metal hip resurfacing. J Bone Joint Surg Br 2009; 91: 738–744.
- 30 Heffernan EJ, Alkubaidan FO, Nielsen TO, Munk PL. The imaging appearances of metallosis. Skeletal Radiol 2008; 37: 59–62.
- 31 Toms AP, Marshall TJ, Cahir J, et al. MRI of early symptomatic metal-on-metal total hip arthroplasty: a retrospective review of radiological findings in 20 hips. Clin Radiol 2008; 63: 49–58.
- 32 Pandit H, Glyn-Jones S, McLardy-Smith P, et al. Pseudotumours associated with metal-on-metal hip resurfacings. J Bone Joint Surg Br 2008; 90: 847–851.
- 33 Koch KM, Hargreaves BA, Pauly KB, Chen W, Gold GE, King KF. MRI near metal implants. J Magn Reson Imaging 2010; 32: 773–787.
- 34 Koch KM, Lorbiecki JE, Hinks RS, King KF. A multispectral three-dimensional acquisition technique for imaging near metal implants. Magn Reson Med 2009; 61: 381–390.
- 35 Lu W, Pauly KB, Gold GE, Pauly JM, Hargreaves BA. SEMAC: Slice Encoding for Metal Artifact Correction in MRI. Magn Reson Med 2009; 62: 66–76.
- 36 Fritz J, Lurie B, Miller TT, Potter HG. MR imaging of hip arthroplasty implants. Radiographics 2014; 34: E106–132.
- 37 Fritz J, Lurie B, Potter HG. MR imaging of knee arthroplasty implants. Radiographics 2015; 35: 1483–1501.
- 38 Hayter CL, Koff MF, Potter HG. MRI of the postoperative hip. J Magn Reson Imaging 2012; 35: 1013–1025.
- 39 Li A, Sneag DB, Miller TT, Lipman JD, Padgett DE, Potter HG. MRI of polyethylene tibial inserts in total knee arthroplasty: normal and abnormal appearances. AJR Am J Roentgenol 2016; 206: 1264–1271.
- 40 Schenck JF. The role of magnetic susceptibility in magnetic resonance imaging: MRI magnetic compatibility of the first and second kinds. Med Phys 1996; 23: 815–850.
- 41 Bartusek K, Dokoupil Z, Gescheidtova E. Magnetic field mapping around metal implants using an asymmetric spin-echo MRI sequence. Measur Sci Technol 2006; 17: 3293.
- 42 White LM, Kim JK, Mehta M, et al. Complications of total hip arthroplasty: MR imaging-initial experience. Radiology 2000; 215: 254–262.
- 43 Koff MF, Shah P, Koch KM, Potter HG. Quantifying image distortion of orthopedic materials in magnetic resonance imaging. J Magn Reson Imaging 2013; 38: 1083–1091.
- 44 Kuo YT, Chen CY, Liu GC, Wang YM. Development of bifunctional gadolinium-labeled superparamagnetic nanoparticles (Gd-MnMEIO) for in vivo MR imaging of the liver in an animal model. PLoS One 2016; 11: e0148695.
- 45 Berner D, Brehm W, Gerlach K, et al. Longitudinal cell tracking and simultaneous monitoring of tissue regeneration after cell treatment of natural tendon disease by low-field magnetic resonance imaging. Stem Cells Int 2016; 2016: 1207190.
- 46 Laakman RW, Kaufman B, Han JS, et al. MR imaging in patients with metallic implants. Radiology 1985; 157: 711–714.
- 47 Ebraheim NA, Savolaine ER, Zeiss J, Jackson WT. Titanium hip implants for improved magnetic resonance and computed tomography examinations. Clin Orthop Relat Res 1992; 194–198.
- 48 Tormanen J, Tervonen O, Koivula A, Junila J, Suramo I. Image technique optimization in MR imaging of a titanium alloy joint prosthesis. J Magn Reson Imaging 1996; 6: 805–811.
- 49 Lee MJ, Kim S, Lee SA, et al. Overcoming artifacts from metallic orthopedic implants at high-field-strength MR imaging and multi-detector CT. Radiographics 2007; 27: 791–803.
- 50 Suh JS, Jeong EK, Shin KH, et al. Minimizing artifacts caused by metallic implants at MR imaging: experimental and clinical studies. AJR Am J Roentgenol 1998; 171: 1207–1213.
- 51 Port JD, Pomper MG. Quantification and minimization of magnetic susceptibility artifacts on GRE images. J Comput Assist Tomogr 2000; 24: 958–964.
- 52 Eustace S, Jara H, Goldberg R, et al. A comparison of conventional spin-echo and turbo spin-echo imaging of soft tissues adjacent to orthopedic hardware. AJR Am J Roentgenol 1998; 170: 455–458.
- 53 Sperling JW, Potter HG, Craig EV, Flatow E, Warren RF. Magnetic resonance imaging of painful shoulder arthroplasty. J Shoulder Elbow Surg 2002; 11: 315–321.
- 54 Gavira S, Cory DG. Sensitivity and resolution of constant-time imaging. J Magn Reson B 1994; 104: 53–61.
- 55 Balcom BJ, Macgregor RP, Beyea SD, Green DP, Armstrong RL, Bremner TW. single-point ramped imaging with T1 enhancement (SPRITE). J Magn Reson A 1996; 123: 131–134.
- 56 Robson MD, Gatehouse PD, Bydder M, Bydder GM. Magnetic resonance: an introduction to ultrashort TE (UTE) imaging. J Comput Assist Tomogr 2003; 27: 825–846.
- 57 Idiyatullin D, Corum C, Park JY, Garwood M. Fast and quiet MRI using a swept radiofrequency. J Magn Reson 2006; 181: 342–349.
- 58 Barger AV, Block WF, Toropov Y, Grist TM, Mistretta CA. Time-resolved contrast-enhanced imaging with isotropic resolution and broad coverage using an undersampled 3D projection trajectory. Magn Reson Med 2002; 48: 297–305.
- 59 Macovski A, Conolly S. Novel approaches to low-cost MRI. Magn Reson Med 1993; 30: 221–230.
- 60 Venook RD, Matter NI, Ramachandran M, et al. Prepolarized magnetic resonance imaging around metal orthopedic implants. Magn Reson Med 2006; 56: 177–186.
- 61 Cho ZH, Kim DJ, Kim YK. Total inhomogeneity correction including chemical shifts and susceptibility by view angle tilting. Med Phys 1988; 15: 7–11.
- 62 Butts K, Pauly JM, Gold GE. Reduction of blurring in view angle tilting MRI. Magn Reson Med 2005; 53: 418–424.
- 63 Koch KM, Brau AC, Chen W, et al. Imaging near metal with a MAVRIC-SEMAC hybrid. Magn Reson Med 2011; 65: 71–82.
- 64 Kaushik SS, Marszalkowski C, Koch KM. External calibration of the spectral coverage for three-dimensional multispectral MRI. Magn Reson Med 2016; 76: 1494–1503.
- 65 Hayter CL, Koff MF, Shah P, Koch KM, Miller TT, Potter HG. MRI after arthroplasty: comparison of MAVRIC and conventional fast spin-echo techniques. Am J Roentgenol 2011; 197: W405–411.
- 66 Koch KM, Koff MF, Shah PH, Kanwischer A, Gui D, Potter HG. Flexible longitudinal magnetization contrast in spectrally overlapped 3D-MSI metal artifact reduction sequences: Technical considerations and clinical impact. Magn Reson Med 2015; 74: 1349–1355.
- 67 Lee YH, Lim D, Kim E, Kim S, Song HT, Suh JS. Feasibility of fat-saturated T2-weighted magnetic resonance imaging with slice encoding for metal artifact correction (SEMAC) at 3T. Magn Reson Imaging 2014; 32: 1001–1005.
- 68 Choi SJ, Koch KM, Hargreaves BA, Stevens KJ, Gold GE. Metal artifact reduction with MAVRIC SL at 3-T MRI in patients with hip arthroplasty. AJR Am J Roentgenol 2015; 204: 140–147.
- 69 Kretzschmar M, Nardo L, Han MM, et al. Metal artefact suppression at 3 T MRI: comparison of MAVRIC-SL with conventional fast spin echo sequences in patients with Hip joint arthroplasty. Eur Radiol 2015; 25: 2403–2411.
- 70 Potter HG, Foo LF. Magnetic resonance imaging of joint arthroplasty. Orthop Clin North Am 2006; 37: 361–373.
- 71 Reeder SB, Pineda AR, Wen Z, et al. Iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL): application with fast spin-echo imaging. Magn Reson Med 2005; 54: 636–644.
- 72 Bley TA, Wieben O, Francois CJ, Brittain JH, Reeder SB. Fat and water magnetic resonance imaging. J Magn Reson Imaging 2010; 31: 4–18.
- 73 Haase A, Frahm J, Hanicke W, Matthaei D. 1H NMR chemical shift selective (CHESS) imaging. Phys Med Biol 1985; 30: 341–344.
- 74 Block W, Pauly J, Kerr A, Nishimura D. Consistent fat suppression with compensated spectral-spatial pulses. Magn Reson Med 1997; 38: 198–206.
- 75 Bottomley PA, Foster TH, Argersinger RE, Pfeifer LM. A review of normal tissue hydrogen NMR relaxation times and relaxation mechanisms from 1-100 MHz: dependence on tissue type, NMR frequency, temperature, species, excision, and age. Med Phys 1984; 11: 425–448.
- 76 Smith RC, Constable RT, Reinhold C, McCauley T, Lange RC, McCarthy S. Fast spin echo STIR imaging. J Comput Assist Tomogr 1994; 18: 209–213.
- 77 Korb JP, Bryant RG. Magnetic field dependence of proton spin-lattice relaxation times. Magn Reson Med 2002; 48: 21–26.
- 78 Gold GE, Han E, Stainsby J, Wright G, Brittain J, Beaulieu C. Musculoskeletal MRI at 3.0 T: relaxation times and image contrast. AJR Am J Roentgenol 2004; 183: 343–351.
- 79 Del Grande F, Santini F, Herzka DA, et al. Fat-suppression techniques for 3-T MR imaging of the musculoskeletal system. Radiographics 2014; 34: 217–233.
- 80 Burge AJ. Total hip arthroplasty: MR imaging of complications unrelated to metal wear. Semin Musculoskelet Radiol 2015; 19: 31–39.
- 81 Plodkowski AJ, Hayter CL, Miller TT, Nguyen JT, Potter HG. Lamellated hyperintense synovitis: potential MR imaging sign of an infected knee arthroplasty. Radiology 2013; 266: 256–260.
- 82 Lewinnek GE, Lewis JL, Tarr R, Compere CL, Zimmerman JR. Dislocations after total hip-replacement arthroplasties. J Bone Joint Surg Am 1978; 60: 217–220.
- 83 McLawhorn AS, Potter HG, Cross MB, et al. Posterior soft tissue repair after primary THA is durable at mid-term followup: prospective MRI study. Clin Orthop Relat Res 2015; 473: 3183–3189.
- 84 Pellicci PM, Potter HG, Foo LF, Boettner F. MRI shows biologic restoration of posterior soft tissue repairs after THA. Clin Orthop Relat Res 2009; 467: 940–945.
- 85 Nawabi DH, Gold S, Lyman S, Fields K, Padgett DE, Potter HG. MRI predicts ALVAL and tissue damage in MOM hip arthroplasty. Clin Orthop Relat Res 2014; 472: 471–481.
- 86 Burge AJ, Gold SL, Lurie B, et al. MR imaging of adverse local tissue reactions around rejuvenate modular dual-taper stems. Radiology 2015; 277: 142–150.
- 87 Campbell P, Ebramzadeh E, Nelson S, Takamura K, De Smet K, Amstutz HC. Histological features of pseudotumor-like tissues from metal-on-metal hips. Clin Orthop Relat Res 2010; 468: 2321–2327.
- 88 Hart AJ, Sabah SA, Bandi AS, et al. Sensitivity and specificity of blood cobalt and chromium metal ions for predicting failure of metal-on-metal hip replacement. J Bone Joint Surg Br 2011; 93: 1308–1313.
- 89 Anderson H, Toms AP, Cahir JG, Goodwin RW, Wimhurst J, Nolan JF. Grading the severity of soft tissue changes associated with MOM hip replacements: reliability of an MR grading system. Skeletal Radiol 2011; 40: 303–307.
- 90 Hauptfleisch J, Pandit H, Grammatopoulos G, Gill HS, Murray DW, Ostlere S. A MRI classification of periprosthetic soft tissue masses (pseudotumours) associated with metal-on-metal resurfacing hip arthroplasty. Skeletal Radiol 2012; 41: 149–155.
- 91 Matthies AK, Skinner JA, Osmani H, Henckel J, Hart AJ. Pseudotumors are common in well-positioned low-wearing metal-on-metal hips. Clin Orthop Relat Res 2012; 470: 1895–1906.
- 92 Gilbert JL, Sivan S, Liu Y, Kocagoz SB, Arnholt CM, Kurtz SM. Direct in vivo inflammatory cell-induced corrosion of CoCrMo alloy orthopedic implant surfaces. J Biomed Mater Res A 2015; 103: 211–223.
- 93 Murakami AM, Hash TW, Hepinstall MS, Lyman S, Nestor BJ, Potter HG. MRI evaluation of rotational alignment and synovitis in patients with pain after TKR. J Bone Joint Surg Br 2012; 94: 1209–1215.
- 94 Nicholson GP, Strauss EJ, Sherman SL. Scapular notching: Recognition and strategies to minimize clinical impact. Clin Orthop Relat Res 2011; 469: 2521–2530.
