OPEN ACCESS Jacobs Journal of Medical Diagnosis and Medical Imaging A Tissue-Equivalent Phantom for the X-ray Evaluation of Polymeric Orthopedic Implants with Osseointegrative Coating Francesco Tessarolo 1,2* , Nicola Pace 2 , Gloria Miori 3,4 , Giandomenico Nollo 1,2 , Mauro Recla 5 , Aldo Valentini 3 1 Department of Industrial Engineering, University of Trento, Trento, Italy 2 Healthcare Research and Innovation Program (IRCS-FBK-PAT), Bruno Kessler Foundation, Trento, Italy 3 Department of Health Physics, Azienda Provinciale per i Servizi Sanitari, Trento, Italy 4 School of Medical Physics, University of Roma Tor Vergata, Rome, Italy 5 Division of Diagnostic Radiology, S. Chiara Hospital, Trento, Italy *Corresponding author: Dr. Francesco Tessarolo, Healthcare Research and Innovation Program (IRCS-FBK-PAT), Bruno Kessler Foundation & Department of Industrial Engineering, University Of Trento via delle Regole, 101, I-38123, Mattarello, Trento, Italy, Phone: +39 0461 282775; Fax: +39 0461283659; E-mail: tessaro@science.unitn.it, tessarolo.f@gmail.com Received: 09-13-2016 Accepted: 10-18-2016 Published: 11-03-2016 Copyright: © 2016 Francesco Tessarolo Abstract Purpose Orthopaedics polymeric implants made of ultra-high molecular-weight polyethylene (UHMWPE), polyether-ether-ketone (PEEK) or its carbon-fiber reinforced composite (CFR-PEEK) can be coated with titanium (Ti) or hydroxyapatite (HA) by com- pression-moulding or plasma-spray techniques for bone integration. The coating may also improve the radiological properties of the implanted device. This work aimed at developing a tissue-equivalent phantom for measuring the radiological contrast given by different polymeric materials coated with Ti or HA for orthopedic implant applications. Methods A modular phantom was designed to simulate the human hip, differentiating soft tissue, trabecular and cortical bone. Seven different substrate-coating combinations were considered for X-ray contrast measurement. Substrate thickness was also varied resulting in 28 tested coupons. Radiographic images were obtained by a state-of-the-art clinical radiography unit. Contrast val- ues were compared to a threshold for detectability. Results The tissue equivalent phantom allowed rapid coupon exchange and acquisition of multiple X-rays-images in a short period of time. Coupons contrast ranged from 0.02 to 0.27 depending on the combination of polymer type, substrate thickness, coating composition, thickness and porosity. Eighteen coupons showed a contrast higher than the predefined threshold. Thin titanium coatings resulted in a sufficient contrast when deposited on PEEK or CFR-PEEK thicker than 10 mm. Medium thickness coatings with low porosity and thick coatings with high porosity were above the threshold when associated to polymeric substrates with a thickness of 8 mm or more. Differently, pre-sintered grid made of titanium alloy was clearly distinguished even when associ- ated to only 6 mm thin UHMWPE. Research Article Cite this article: Francesco Tessarolo. A Tissue-Equivalent Phantom for the X-ray Evaluation of Polymeric Orthopedic Implants with Osseointegrative Coating. J J Med Diagnosis and Image. 2016, 2(1): 014. 1 1(1):014.