Signal-inducing bone cements for MRI-guided spinal cementoplasty: evaluation of contrast-agent-based polymethylmethacrylate cements.

OBJECTIVE: The purpose of this work is to evaluate two signal-inducing bone cements for MRI-guided spinal cementoplasty. MATERIALS AND METHODS: The bone cements were made of polymethylmethacrylate (PMMA, 5 ml monomeric, 12 g polymeric) and gadoterate meglumine as a contrast agent (CA, 0-40 µl) with either saline solution (NaCl, 2-4 ml) or hydroxyapatite bone substitute (HA, 2-4 ml). The cement's signal was assessed in an open 1-Tesla MR scanner, with T1W TSE and fast interventional T1W TSE pulse sequences, and the ideal amount of each component was determined. The compressive and bending strength for different amounts of NaCl and HA were evaluated. RESULTS: The cement's MRI signal depended on the concentration of CA, the amount of NaCl or HA, and the pulse sequence. The signal peaks were recorded between 1 and 10 µl CA per ml NaCl or HA, and were higher in fast T1W TSE than in T1W TSE images. The NaCl-PMMA-CA cements had a greater MRI signal intensity and compressive strength; the HA-PMMA-CA cements had a superior bending strength. CONCLUSIONS: Concerning the MR signal and biomechanical properties, these cements would permit MRI-guided cementoplasty. Due to its higher signal and greater compressive strength, the NaCl-PMMA-CA compound appears to be superior to the HA-PMMA-CA compound.

Evaluation of thermometric monitoring for intradiscal laser ablation in an open 1.0 T MR scanner.

PURPOSE: The purpose of this study was to evaluate different methods of magnetic resonance thermometry (MRTh) for the monitoring of intradiscal laser ablation therapy in an open 1.0 Tesla magnetic resonance (MR) scanner. MATERIAL AND METHODS: MRTh methods based on the two endogenous MR temperature indicators of spin-lattice relaxation time T1 and water proton resonance frequency (PRF) shift were optimised and compared in vitro. For the latter, we measured the effective spin-spin relaxation times T2* in intervertebral discs of volunteers. Then we compared four gradient echo-based imaging techniques to monitor laser ablations in human disc specimens. Criteria of assessment were outline of anatomic detail, immunity against needle artefacts, signal-to-noise ratio (SNR) and accuracy of the calculated temperature. RESULTS: T2* decreased in an inverse and almost linear manner with the patients' age (r = 0.9) from 70 to 30 ms (mean of 49 ms). The optimum image quality (anatomic details, needle artefacts, SNR) and temperature accuracy (+/-1.09 degrees C for T1-based and +/-1.11 degrees C for PRF-based MRTh) was achieved with a non-spoiled gradient-echo sequence with an echo time of TE = 10 ms. CONCLUSION: Combination of anatomic and thermometric non-invasive monitoring of laser ablations in the lumbar spine is feasible. The temperature accuracy of the investigated T1- and PRF-based MRTh methods in vitro is high enough and promises to be reliable in vivo as well.