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Co M, Dong H, Boulter DJ, Nguyen XV, Khan SN, Raterman B, Klamer B, Kolipaka A, Walter BA. Magnetic Resonance Elastography of Intervertebral Discs: Spin-Echo Echo-Planar Imaging Sequence Validation. J Magn Reson Imaging 2022; 56:1722-1732. [PMID: 35289470 PMCID: PMC9475395 DOI: 10.1002/jmri.28151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 02/23/2022] [Accepted: 02/25/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Magnetic resonance elastography (MRE) is an imaging technique that can noninvasively assess the shear properties of the intervertebral disc (IVD). Unlike the standard gradient recalled echo (GRE) MRE technique, a spin-echo echo-planar imaging (SE-EPI) sequence has the potential to improve imaging efficiency and patient compliance. PURPOSE To validate the use of an SE-EPI sequence for MRE of the IVD compared against the standard GRE sequence. STUDY TYPE Cross-over. SUBJECTS Twenty-eight healthy volunteers (15 males and 13 females, age range: 19-55). FIELD STRENGTH/SEQUENCE 3 T; GRE, SE-EPI with breath holds (SE-EPI-BH) and SE-EPI with free breathing (SE-EPI-FB) MRE sequences. ASSESSMENT MRE-derived shear stiffnesses were calculated via principal frequency analysis. SE-EPI derived shear stiffness and octahedral shear strain signal-to-noise ratios (OSS-SNR) were compared against those derived using the GRE sequence. The reproducibility and repeatability of SE-EPI stiffness measurements were determined. Shear stiffness was evaluated in the nucleus pulposus (NP) and annulus fibrosus (AF) regions of the disc. Scan times between sequences were compared. STATISTICAL TESTS Linear mixed models, Bland-Altman plots, and Lin's concordance correlation coefficients (CCCs) were used with P < 0.05 considered statistically significant. RESULTS Good correlation was observed between shear stiffnesses derived from the SE-EPI sequences with those derived from the GRE sequence with CCC values greater than 0.73 and 0.78 for the NP and AF regions, respectively. OSS-SNR was not significantly different between GRE and SE-EPI sequences (P > 0.05). SE-EPI sequences generated highly reproducible and repeatable stiffness measurements with CCC values greater than 0.97 in the NP and AF regions and reduced scan time by at least 51% compared to GRE. SE-EPI-BH and SE-EPI-FB stiffness measurements were similar with CCC values greater than 0.98 for both regions. DATA CONCLUSION SE-EPI-based MRE-derived stiffnesses were highly reproducible and repeatable and correlated with current standard GRE MRE-derived stiffness estimates while reducing scan times. LEVEL OF EVIDENCE 1 TECHNICAL EFFICACY STAGE: 1.
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Affiliation(s)
- Megan Co
- Department of Biomedical Engineering, The Ohio State University, Columbus, Ohio, USA
| | - Huiming Dong
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Daniel J Boulter
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Xuan V Nguyen
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Safdar N Khan
- Department of Orthopedics, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Brian Raterman
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Brett Klamer
- Center for Biostatistics, The Ohio State University, Columbus, Ohio, USA
| | - Arunark Kolipaka
- Department of Biomedical Engineering, The Ohio State University, Columbus, Ohio, USA
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Benjamin A Walter
- Department of Biomedical Engineering, The Ohio State University, Columbus, Ohio, USA
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
- Spine Research Institute, The Ohio State University, Columbus, Ohio, USA
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Walter BA, Mageswaran P, Mo X, Boulter DJ, Mashaly H, Nguyen XV, Prevedello LM, Thoman W, Raterman BD, Kalra P, Mendel E, Marras WS, Kolipaka A. MR Elastography-derived Stiffness: A Biomarker for Intervertebral Disc Degeneration. Radiology 2017; 285:167-175. [PMID: 28471737 DOI: 10.1148/radiol.2017162287] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Purpose To determine the repeatability of magnetic resonance (MR) elastography-derived shear stiffness measurements of the intervertebral disc (IVD) taken throughout the day and their relationship with IVD degeneration and subject age. Materials and Methods In a cross-sectional study, in vivo lumbar MR elastography was performed once in the morning and once in the afternoon in 47 subjects without current low back pain (IVDs = 230; age range, 20-71 years) after obtaining written consent under approval of the institutional review board. The Pfirrmann degeneration grade and MR elastography-derived shear stiffness of the nucleus pulposus and annulus fibrosus regions of all lumbar IVDs were assessed by means of principal frequency analysis. One-way analysis of variance, paired t tests, concordance and Bland-Altman tests, and Pearson correlations were used to evaluate degeneration, diurnal changes, repeatability, and age effects, respectively. Results There were no significant differences between morning and afternoon shear stiffness across all levels and there was very good technical repeatability between the morning and afternoon imaging results for both nucleus pulposus (R = 0.92) and annulus fibrosus (R = 0.83) regions. There was a significant increase in both nucleus pulposus and annulus fibrosus MR elastography-derived shear stiffness with increasing Pfirrmann degeneration grade (nucleus pulposus grade 1, 12.5 kPa ± 1.3; grade 5, 16.5 kPa ± 2.1; annulus fibrosus grade 1, 90.4 kPa ± 9.3; grade 5, 120.1 kPa ± 15.4), and there were weak correlations between shear stiffness and age across all levels (R ≤ 0.32). Conclusion Our results demonstrate that MR elastography-derived shear stiffness measurements are highly repeatable, weakly correlate with age, and increase with advancing IVD degeneration. These results suggest that MR elastography-derived shear stiffness may provide an objective biomarker of the IVD degeneration process. © RSNA, 2017 Online supplemental material is available for this article.
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Affiliation(s)
- Benjamin A Walter
- From the Spine Research Institute (B.A.W., P.M., H.M., W.T., E.M., W.S.M., A.K.), Department of Biomedical Engineering (B.A.W., A.K.), Department of Integrated Systems Engineering (P.M., W.S.M.), and Department of Biomedical Informatics (X.M.), the Ohio State University, 395 W 12th Ave, 4th Floor Radiology, Columbus, OH 43210; and Departments of Radiology (D.J.B., X.V.N., L.M.P., B.D.R., P.K., A.K.) and Neurologic Surgery (H.M., W.T., E.M.), the Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Prasath Mageswaran
- From the Spine Research Institute (B.A.W., P.M., H.M., W.T., E.M., W.S.M., A.K.), Department of Biomedical Engineering (B.A.W., A.K.), Department of Integrated Systems Engineering (P.M., W.S.M.), and Department of Biomedical Informatics (X.M.), the Ohio State University, 395 W 12th Ave, 4th Floor Radiology, Columbus, OH 43210; and Departments of Radiology (D.J.B., X.V.N., L.M.P., B.D.R., P.K., A.K.) and Neurologic Surgery (H.M., W.T., E.M.), the Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Xiaokui Mo
- From the Spine Research Institute (B.A.W., P.M., H.M., W.T., E.M., W.S.M., A.K.), Department of Biomedical Engineering (B.A.W., A.K.), Department of Integrated Systems Engineering (P.M., W.S.M.), and Department of Biomedical Informatics (X.M.), the Ohio State University, 395 W 12th Ave, 4th Floor Radiology, Columbus, OH 43210; and Departments of Radiology (D.J.B., X.V.N., L.M.P., B.D.R., P.K., A.K.) and Neurologic Surgery (H.M., W.T., E.M.), the Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Daniel J Boulter
- From the Spine Research Institute (B.A.W., P.M., H.M., W.T., E.M., W.S.M., A.K.), Department of Biomedical Engineering (B.A.W., A.K.), Department of Integrated Systems Engineering (P.M., W.S.M.), and Department of Biomedical Informatics (X.M.), the Ohio State University, 395 W 12th Ave, 4th Floor Radiology, Columbus, OH 43210; and Departments of Radiology (D.J.B., X.V.N., L.M.P., B.D.R., P.K., A.K.) and Neurologic Surgery (H.M., W.T., E.M.), the Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Hazem Mashaly
- From the Spine Research Institute (B.A.W., P.M., H.M., W.T., E.M., W.S.M., A.K.), Department of Biomedical Engineering (B.A.W., A.K.), Department of Integrated Systems Engineering (P.M., W.S.M.), and Department of Biomedical Informatics (X.M.), the Ohio State University, 395 W 12th Ave, 4th Floor Radiology, Columbus, OH 43210; and Departments of Radiology (D.J.B., X.V.N., L.M.P., B.D.R., P.K., A.K.) and Neurologic Surgery (H.M., W.T., E.M.), the Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Xuan V Nguyen
- From the Spine Research Institute (B.A.W., P.M., H.M., W.T., E.M., W.S.M., A.K.), Department of Biomedical Engineering (B.A.W., A.K.), Department of Integrated Systems Engineering (P.M., W.S.M.), and Department of Biomedical Informatics (X.M.), the Ohio State University, 395 W 12th Ave, 4th Floor Radiology, Columbus, OH 43210; and Departments of Radiology (D.J.B., X.V.N., L.M.P., B.D.R., P.K., A.K.) and Neurologic Surgery (H.M., W.T., E.M.), the Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Luciano M Prevedello
- From the Spine Research Institute (B.A.W., P.M., H.M., W.T., E.M., W.S.M., A.K.), Department of Biomedical Engineering (B.A.W., A.K.), Department of Integrated Systems Engineering (P.M., W.S.M.), and Department of Biomedical Informatics (X.M.), the Ohio State University, 395 W 12th Ave, 4th Floor Radiology, Columbus, OH 43210; and Departments of Radiology (D.J.B., X.V.N., L.M.P., B.D.R., P.K., A.K.) and Neurologic Surgery (H.M., W.T., E.M.), the Ohio State University Wexner Medical Center, Columbus, Ohio
| | - William Thoman
- From the Spine Research Institute (B.A.W., P.M., H.M., W.T., E.M., W.S.M., A.K.), Department of Biomedical Engineering (B.A.W., A.K.), Department of Integrated Systems Engineering (P.M., W.S.M.), and Department of Biomedical Informatics (X.M.), the Ohio State University, 395 W 12th Ave, 4th Floor Radiology, Columbus, OH 43210; and Departments of Radiology (D.J.B., X.V.N., L.M.P., B.D.R., P.K., A.K.) and Neurologic Surgery (H.M., W.T., E.M.), the Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Brian D Raterman
- From the Spine Research Institute (B.A.W., P.M., H.M., W.T., E.M., W.S.M., A.K.), Department of Biomedical Engineering (B.A.W., A.K.), Department of Integrated Systems Engineering (P.M., W.S.M.), and Department of Biomedical Informatics (X.M.), the Ohio State University, 395 W 12th Ave, 4th Floor Radiology, Columbus, OH 43210; and Departments of Radiology (D.J.B., X.V.N., L.M.P., B.D.R., P.K., A.K.) and Neurologic Surgery (H.M., W.T., E.M.), the Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Prateek Kalra
- From the Spine Research Institute (B.A.W., P.M., H.M., W.T., E.M., W.S.M., A.K.), Department of Biomedical Engineering (B.A.W., A.K.), Department of Integrated Systems Engineering (P.M., W.S.M.), and Department of Biomedical Informatics (X.M.), the Ohio State University, 395 W 12th Ave, 4th Floor Radiology, Columbus, OH 43210; and Departments of Radiology (D.J.B., X.V.N., L.M.P., B.D.R., P.K., A.K.) and Neurologic Surgery (H.M., W.T., E.M.), the Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Ehud Mendel
- From the Spine Research Institute (B.A.W., P.M., H.M., W.T., E.M., W.S.M., A.K.), Department of Biomedical Engineering (B.A.W., A.K.), Department of Integrated Systems Engineering (P.M., W.S.M.), and Department of Biomedical Informatics (X.M.), the Ohio State University, 395 W 12th Ave, 4th Floor Radiology, Columbus, OH 43210; and Departments of Radiology (D.J.B., X.V.N., L.M.P., B.D.R., P.K., A.K.) and Neurologic Surgery (H.M., W.T., E.M.), the Ohio State University Wexner Medical Center, Columbus, Ohio
| | - William S Marras
- From the Spine Research Institute (B.A.W., P.M., H.M., W.T., E.M., W.S.M., A.K.), Department of Biomedical Engineering (B.A.W., A.K.), Department of Integrated Systems Engineering (P.M., W.S.M.), and Department of Biomedical Informatics (X.M.), the Ohio State University, 395 W 12th Ave, 4th Floor Radiology, Columbus, OH 43210; and Departments of Radiology (D.J.B., X.V.N., L.M.P., B.D.R., P.K., A.K.) and Neurologic Surgery (H.M., W.T., E.M.), the Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Arunark Kolipaka
- From the Spine Research Institute (B.A.W., P.M., H.M., W.T., E.M., W.S.M., A.K.), Department of Biomedical Engineering (B.A.W., A.K.), Department of Integrated Systems Engineering (P.M., W.S.M.), and Department of Biomedical Informatics (X.M.), the Ohio State University, 395 W 12th Ave, 4th Floor Radiology, Columbus, OH 43210; and Departments of Radiology (D.J.B., X.V.N., L.M.P., B.D.R., P.K., A.K.) and Neurologic Surgery (H.M., W.T., E.M.), the Ohio State University Wexner Medical Center, Columbus, Ohio
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