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Assessment of glycosaminoglycan content in intervertebral discs using chemical exchange saturation transfer at 3.0 Tesla: preliminary results in patients with low-back pain

  • Musculoskeletal
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Abstract

Objectives

To evaluate glycosaminoglycan-dependent chemical exchange saturation transfer (gagCEST) imaging at 3-T magnetic resonance imaging (MRI) for quantification of glycosaminoglycan (GAG) content in intervertebral discs (IVDs) in patients with low-back pain (LBP).

Methods

Sixteen patients with LBP were examined in this Institutional Review Board-approved study using a clinical whole-body system. The MRI protocol included standard morphological imaging, sagittal T2-mapping and gagCEST imaging. IVD grading according to the Pfirrmann score and region-of-interest analysis of the annulus fibrosus (AF) and the nucleus pulposus (NP) in gagCEST and T2 maps were performed before data were statistically tested for correlations between imaging techniques and quantitative differences between different grades of IVD degeneration.

Results

GagCEST values of the NP were significantly (P < 0.001) lower in degenerative IVDs (Pfirrmann 3 + 4) compared with non-degenerative IVDs (Pfirrmann 1 + 2), but only a weak linear correlation (r = 0.299) with the T2 relaxation times was found. GagCEST values of the NP exhibited a moderate negative correlation with Pfirrmann grades (r = −0.449).

Conclusions

The known loss of GAG in the NP with increasing grade of morphological degeneration can be assessed using gagCEST imaging at 3.0 T. The correlation with single Pfirrmann grades and T2 relaxation times only seems to be moderate, indicating a substantial difference in information provided by the techniques.

Key Points

• 3-T MRI offers new functional data about the degenerating lumbar disc

• GagCEST imaging can assess glycosaminoglycan loss

• GagCEST imaging and T2 mapping provide substantially different information about disc degeneration

• Correlation between glycosaminoglycan loss and grade of morphological degeneration is only moderate

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Abbreviations

AF:

Annulus fibrosus

GAG:

Glycosaminoglycan

gagCEST:

Glycosaminoglycan-dependent chemical exchange saturation transfer

IVD:

Intervertebral disc

LBP:

Low-back pain

NP:

Nucleus pulposus

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Acknowledgements

The study was supported by funding from the Vienna Clinical Imaging Centre (VIACLIC) project as part of the Vienna Spots of Excellence (VSOE) Program and Siemens Healthcare. This study was supported non-financially by the Proof-of-Concept program of Euro-BioImaging.

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Authors and Affiliations

  1. Department of Radiology, Centre for High-Field MR, Medical University of Vienna, Lazarettgasse 14, 1090, Vienna, Austria

    Stefan Haneder, Sebastian R. Apprich, Benjamin Schmitt, Klaus M. Friedrich & Siegfried Trattnig

  2. Institute of Clinical Radiology and Nuclear Medicine, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany

    Stefan Haneder, Henrik J. Michaely & Stefan O. Schoenberg

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  1. Stefan Haneder
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  2. Sebastian R. Apprich
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  3. Benjamin Schmitt
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  4. Henrik J. Michaely
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  5. Stefan O. Schoenberg
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  6. Klaus M. Friedrich
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  7. Siegfried Trattnig
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Correspondence to Benjamin Schmitt.

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Haneder, S., Apprich, S.R., Schmitt, B. et al. Assessment of glycosaminoglycan content in intervertebral discs using chemical exchange saturation transfer at 3.0 Tesla: preliminary results in patients with low-back pain. Eur Radiol 23, 861–868 (2013). https://doi.org/10.1007/s00330-012-2660-6

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  • DOI: https://doi.org/10.1007/s00330-012-2660-6

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