Bone cement X‐ray contrast media: A clinically relevant method of measuring their efficacy

Abstract

It is important to compare different contrast media used in bone cement according to their ability to attenuate X-rays and thereby produce image contrast between bone cement and its surroundings in clinical applications. The radiopacity of bone cement is often evaluated by making radiographs of cement in air at an X-ray tube voltage of 40 kV. We have developed a method for ranking contrast media in bone cement simulating the clinical situation, by (1) choosing the same X-ray tube voltage as used in clinical work, and (2) using a water phantom to imitate the effects of the patients' soft tissue on the X-ray photons. In clinical work it is desirable to have low radiation dose, but high image contrast. The voltage chosen is a compromise, because both dose and image contrast decrease with higher voltage. Three contrast media (ZrO 2 , BaSO 4 , and Iodixanol) have been compared for degree of "image contrast." Comparing 10 wt % contrast media samples at an X-ray tube voltage of 40 kV, ZrO 2 produced higher image contrast than the other media. However, at 80 kV, using a water phantom, the results were reversed, ZrO 2 produced lower image contrast than both BaSO 4 and Iodixanol. We conclude that evaluations of contrast media should be made with voltages and phantoms imitating the clinical application.

A Daptomycin-Xylitol-loaded Polymethylmethacrylate Bone Cement: How Much Xylitol Should Be Used?

“…1 for numbers of specimens or replicates used for each type of testing). These determined properties are of clinical relevance [17,25,29,35,41,43,44]. (3) Using our determined values for the cement properties and an optimization method, we determined an appropriate xylitol amount.…”

Production of bone cement composites: effect of fillers, co-monomer and particles properties

“…Due to this incompatibility with the polymeric matrix, the contrast forms a segregated phase and makes mixing of reagents more difficult during the preparation. For this reason, some authors have suggested the use of alternative contrasts, such as iodine (Almén, 1995;Davy et al, 1997;Davenport et al, 1999;Ginebra et al, 2002;Nakamura et al, 2003;Artola et al, 2004;Kjellson et al, 2004;Van Hooy-Corstjensa et al, 2004) and/or bismuth (Rawls et al, 1996;Deb et al, 2002) based compounds. These compounds are chemically linked to specially designed monomers and are thus automatically incorporated into the BC formulation.…”

Effect of iodixanol particle size on the mechanical properties of a PMMA based bone cement

“…Other types of contrast media have previously been investigated to find contrast media which are as effective at providing X-ray attenuation [7] without reducing the mechanical properties or producing abrasive or inflammatory particles. Iohexol and Iodixanol are non-ionic water-soluble contrast media that are used extensively throughout the world, as solutions that are injected into the body for radiographic imaging [8].…”

“…The powder-based opac-ifier iodixanol (IDX) has previously been investigated in PMMA bone cement as an X-ray contrast media. The radiographic contrast study showed that equal concentrations, by weight, of IDX and ZrO 2 produce similar attenuation of X-rays under clinical X-ray measurement situations [7]. The in vitro and in vivo inflammation response was investigated [9] and it was found that the inflammatory response to cement containing IDX is lower than those for cements containing ZrO 2 .…”