T1ρ Magnetic Resonance Imaging and Discography Pressure as Novel Biomarkers for Disc Degeneration and Low Back Pain

Abstract

Study Design Prospective MRI study of LBP patients requiring discography as part of their routine clinical diagnoses and asymptomatic age-matched volunteers. Objective To determine whether T1ρ MRI and discography opening pressure are quantitative biomarkers of disc degeneration in LBP patients and in asymptomatic volunteers. Summary of Background Data Disc degenerative disease (DDD), a common cause of low back pain (LBP), is related to the patient’s prognosis and serves as a target for therapeutic interventions. However, there are few quantitative measures in the clinical setting. Discography opening pressure (OP) and T1ρ MRI are potential biomarkers of DDD related to biochemical composition the intervertebral disc (IVD). Methods The Institutional Review Board approved all experiments and informed consent was provided by each subject. Patients being treated for LBP (n=17, 68 levels, mean age 44±6 years, range 30–53) and control (CTL) subjects (n=11, 44 levels, mean age 43±17, range 22–76) underwent T1ρ and T2 MRI on a Siemens 3T Tim Trio clinical scanner. The LBP patients also received multi-level provocative discography before their MRI. Opening Pressure (OP) was recorded as the pressure when fluid first enters the nucleus of the IVD. Results T1ρ was significantly lower in the painful discs (55.3ms±3.0 ms, mean ± std. error) from control (92.0±4.9 ms, p<0.001) and non-painful discs (83.6±3.2 ms, p<0.001). Mean OP for the painful discs (11.8±1.0 psi, mean ± std. error) was significantly lower than non-painful discs (19.1±0.7 psi, p<0.001). Both T1ρ and OP correlated moderately with Pfirrmann degenerative grade. ROC area under the curve was 0.91 for T1ρ MRI and 0.84 for OP for predicting painful discs. Conclusions T1ρ and OP are quantitative measures of degeneration that are consistent across both control subjects and LBP patients. A significant and strong correlation exists between T1ρ values and in vivo OP measurements obtained by discography in LBP patients.

T1ρ and T2 Mapping of the Intervertebral Disk: Comparison of Different Methods of Segmentation

“…However, the comparison among results of different studies that used different segmentation methods should be done with caution. 15,27 Our results demonstrate that the use of different segmentation techniques may result in measurement of different values of intervertebral disk relaxation times.…”

RNA Sequencing Reveals a Role of TonEBP Transcription Factor in Regulation of Pro-inflammatory Genes in Response to Hyperosmolarity in Healthy Nucleus Pulposus Cells

“…The matrix-rich nucleus pulposus (NP) 2 at the center of the disc gives the tissue its ability to resist compression through high osmotic swelling pressure (2-4), loss of which correlates with degeneration and back pain (5). Although the high fixed charge density of the aggrecan-rich matrix allows the nucleus pulposus its water-imbibing properties, it also results in a hypertonic environment for NP cells.…”

Quantitative MRI for Scoliosis Follow-Up

“…T2 and ADC turned out to be sensitive parameters in investigating changes in the MR characteristics of the intervertebral disc matrix between morning and evening (Ludescher et al, 2008). A significant and strong correlation was found between in vivo T1ρ values and discography opening pressure measurements suggesting that T1ρ is a quantitative measure of degeneration (Borthakur et al, 2011). A relationship was also found between in vivo MRS spectroscopy (water content, proteoglycan content), imaging parameters (T1ρ, Pfirrmann Grade), and discography results suggesting that MRSquantified water, proteoglycans and MR T1ρ relaxation time may potentially serve as biomarkers of symptomatic intervertebral disc degeneration (Zuo et al, 2011).…”