Skip to main content

Advertisement

SpringerLink
Log in

In vivo quantification of human lumbar disc degeneration using T1ρ-weighted magnetic resonance imaging

  • Original Article
  • Published:
European Spine Journal Aims and scope Submit manuscript

Abstract

Diagnostic methods and biomarkers of early disc degeneration are needed as emerging treatment technologies develop (e.g., nucleus replacement, total disc arthroplasty, cell therapy, growth factor therapy) to serve as an alternative to lumbar spine fusion in treatment of low back pain. We have recently demonstrated in cadaveric human discs an MR imaging and analysis technique, spin-lock T1ρ-weighted MRI, which may provide a quantitative, objective, and non-invasive assessment of disc degeneration. The goal of the present study was to assess the feasibility of using T1ρ MRI in vivo to detect intervertebral disc degeneration. We evaluated ten asymptomatic 40–60-year-old subjects. Each subject was imaged on a 1.5 T whole-body clinical MR scanner. Mean T1ρ values from a circular region of interest in the center of the nucleus pulposus were calculated from maps generated from a series of T1ρ-weighted images. The degenerative grade of each lumbar disc was assessed from conventional T2-weighted images according to the Pfirmann classification system. The T1ρ relaxation correlated significantly with disc degeneration (r=−0.51, P<0.01) and the values were consistent with our previous cadaveric study, in which we demonstrated correlation between T1ρ and proteoglycan content. The technique allows for spatial measurements on a continuous rather than an integer-based scale, minimizes the potential for observer bias, has a greater dynamic range than T2-weighted imaging, and can be implemented on a 1.5 T clinical scanner without significant hardware modifications. Thus, there is a strong potential to use T1ρ in vivo as a non-invasive biomarker of proteoglycan loss and early disc degeneration.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

Similar content being viewed by others

References

  1. Akella SV, Regatte RR, Gougoutas AJ, Borthakur A, Shapiro EM, Kneeland JB, Leigh JS, Reddy R (2001) Proteoglycan-induced changes in T1rho-relaxation of articular cartilage at 4 T. Magn Reson Med 46(3):419–423

    Article  PubMed  CAS  Google Scholar 

  2. Andersson GB (1998) What are the age-related changes in the spine? Baillieres Clin Rheumatol 12(1):161–173

    Article  PubMed  CAS  Google Scholar 

  3. Antoniou J, Demers CN, Beaudoin G, Goswami T, Mwale F, Aebi M, Alini M (2004) Apparent diffusion coefficient of intervertebral discs related to matrix composition and integrity. Magn Reson Imaging 22(7):963–972

    Article  PubMed  Google Scholar 

  4. Antoniou J, Pike GB, Steffen T, Baramki H, Poole AR, Aebi M, Alini M (1998) Quantitative magnetic resonance imaging in the assessment of degenerative disc disease. Magn Reson Med 40(6):900–907

    Article  PubMed  CAS  Google Scholar 

  5. Antoniou J, Steffen T, Nelson F, Winterbottom N, Hollander AP, Poole RA, Aebi M, Alini M (1996) The human lumbar intervertebral disc: evidence for changes in the biosynthesis and denaturation of the extracellular matrix with growth, maturation, ageing, and degeneration. J Clin Invest 98(4):996–1003

    Article  PubMed  CAS  Google Scholar 

  6. Bashir A, Gray ML, Boutin RD, Burstein D (1997) Glycosaminoglycan in articular cartilage: in vivo assessment with delayed Gd(DTPA)(2-)-enhanced MR imaging. Radiology 205(2):551–558

    PubMed  CAS  Google Scholar 

  7. Bashir A, Gray ML, Hartke J, Burstein D (1999) Nondestructive imaging of human cartilage glycosaminoglycan concentration by MRI. Magn Reson Med 41(5):857–865

    Article  PubMed  CAS  Google Scholar 

  8. Benneker LM, Heini PF, Anderson SE, Alini M, Ito K (2005) Correlation of radiographic and MRI parameters to morphological and biochemical assessment of intervertebral disc degeneration. Eur Spine J 14(1):27–35

    Article  PubMed  Google Scholar 

  9. Bertagnoli R, Kumar S (2002) Indications for full prosthetic disc arthroplasty: a correlation of clinical outcome against a variety of indications. Eur Spine J 11(Suppl 2):S131–S136

    PubMed  Google Scholar 

  10. Boden SD, Balderston RA, Heller JG, Hanley EN Jr., Zigler JE (2004) An AOA critical issue. Disc replacements: this time will we really cure low-back and neck pain? J Bone Joint Surg Am 86-A(2):411–422

    PubMed  Google Scholar 

  11. Boos N, Boesch C (1995) Quantitative magnetic resonance imaging of the lumbar spine. Potential for investigations of water content and biochemical composition. Spine 20(21):2358–2365, discussion 2366

    Google Scholar 

  12. Borthakur A, Wheaton AJ, Gougoutas AJ, Akella SV, Regatte RR, Charagundla SR, Reddy R (2004) In vivo measurement of T1rho dispersion in the human brain at 1.5 tesla. J Magn Reson Imaging 19(4):403–409

    Article  PubMed  Google Scholar 

  13. Buckwalter JA (1995) Spine update: aging and degeneration of the human intervertebral disc. Spine 20(11):1307–1314

    PubMed  CAS  Google Scholar 

  14. Carl A, Ledet E, Yuan H, Sharan A (2004) New developments in nucleus pulposus eplacement technology. Spine J 4(6 Suppl):325S–329S

    Article  PubMed  Google Scholar 

  15. Chiu EJ, Newitt DC, Segal MR, Hu SS, Lotz JC, Majumdar S (2001) Magnetic resonance imaging measurement of relaxation and water diffusion in the human lumbar intervertebral disc under compression in vitro. Spine 26(19):E437–E444

    Article  PubMed  CAS  Google Scholar 

  16. Devore J (2004) Probablility and statistics for engineering and the sciences, 6th edn. Thomas-Brooks/Cole, Belmont

    Google Scholar 

  17. Erkintalo MO, Salminen JJ, Alanen AM, Paajanen HEK, Kormano MJ (1995) Development of degenerative changes in the lumbar intervertebral disk: results of a prospective MR Imaging study in adolescents with and without low-back pain. Radiology 196:529–533

    PubMed  CAS  Google Scholar 

  18. Hsu EW, Setton LA (1999) Diffusion tensor microscopy of the intervertebral disc anulus fibrosus. Magn Reson Med 41(5):992–999

    Article  PubMed  CAS  Google Scholar 

  19. Ikoma K, Takamiya H, Kusaka Y, Seo Y (2001) (1)H double-quantum filtered MR imaging of joints tissues: bound water specific imaging of tendons, ligaments and cartilage. Magn Reson Imaging 19(10):1287–1296

    Article  PubMed  CAS  Google Scholar 

  20. Johannessen W, Auerbach J, Wheaton AJ, Kurji A, Reddy R, Borthakur A, Elliott DM (2006) Assessment of human disc degeneration and proteoglycan content using T1rho MRI. Spine (in press)

  21. Kerttula L, Kurunlahti M, Jauhiainen J, Koivula A, Oikarinen J, Tervonen O (2001) Apparent diffusion coefficients and T2 relaxation time measurements to evaluate disc degeneration. A quantitative MR study of young patients with previous vertebral fracture. Acta Radiol 42(6):585–591

    PubMed  CAS  Google Scholar 

  22. Keshari KR, Zektzer AS, Swanson MG, Majumdar S, Lotz JC, Kurhanewicz J (2005) Characterization of intervertebral disc degeneration by high-resolution magic angle spinning (HR-MAS) spectroscopy. Magn Reson Med 53(3):519–527

    Article  PubMed  CAS  Google Scholar 

  23. Kettler A, Wilke HJ (2005) Review of existing grading systems for cervical or lumbar disc and facet joint degeneration. Eur Spine J (in press)

  24. Luoma K, Riihimaki H, Luukkonen R, Raininko R, Viikari-Juntura E, Lamminen A (2000) Low back pain in relation to lumbar disc degeneration. Spine 25(4):487–492

    Article  PubMed  CAS  Google Scholar 

  25. Luoma K, Vehmas T, Riihimaki H, Raininko R (2001) Disc height and signal intensity of the nucleus pulposus on magnetic resonance imaging as indicators of lumbar disc degeneration. Spine 26(6):680–686

    Article  PubMed  CAS  Google Scholar 

  26. Masuda K, Oegema TR Jr., An HS (2004) Growth factors and treatment of intervertebral disc degeneration. Spine 29(23):2757–2769

    Article  PubMed  Google Scholar 

  27. Paajanen H, Komu M, Lehto I, Laato M, Haapasalo H (1994) Magnetization transfer imaging of lumbar disc degeneration. Correlation of relaxation parameters with biochemistry. Spine 19(24):2833–2837

    Article  PubMed  CAS  Google Scholar 

  28. Pedowitz D, Auerbach J, Gibson B, Vresilovic EJ, Guerin HL, Johannessen W, Rogers D, Elliott DM (2005) Correlation of MRI and gross morphologic grading of lumbar intervertebral discs. Trans Orthop Res Soc p 378

  29. Pfirrmann CW, Metzdorf A, Zanetti M, Hodler J, Boos N (2001) Magnetic resonance classification of lumbar intervertebral disc degeneration. Spine 26(17):1873–1878

    Article  PubMed  CAS  Google Scholar 

  30. Regatte RR, Akella SV, Borthakur A, Kneeland JB, Reddy R (2002) Proteoglycan depletion-induced changes in transverse relaxation maps of cartilage: comparison of T2 and T1rho. Acad Radiol 9(12):1388–1394

    Article  PubMed  Google Scholar 

  31. Regatte RR, Akella SV, Wheaton AJ, Borthakur A, Kneeland JB, Reddy R (2003) T 1 rho-relaxation mapping of human femoral-tibial cartilage in vivo. J Magn Reson Imaging 18(3):336–341

    Article  PubMed  Google Scholar 

  32. Regatte RR, Akella SV, Wheaton AJ, Lech G, Borthakur A, Kneeland JB, Reddy R (2004) 3D-T1rho-relaxation mapping of articular cartilage: in vivo assessment of early degenerative changes in symptomatic osteoarthritic subjects. Acad Radiol 11(7):741–749

    PubMed  Google Scholar 

  33. Risbud MV, Albert TJ, Guttapalli A, Vresilovic EJ, Hillibrand AS, Vaccaro AR, Shapiro IM (2004) Differentiation of mesenchymal stem cells towards a nucleus pulposus-like phenotype in vitro: implications for cell-based transplantation therapy. Spine 29(23):2627–2632

    Article  PubMed  Google Scholar 

  34. Seguin CA, Grynpas MD, Pilliar RM, Waldman SD, Kandel RA (2004) Tissue engineered nucleus pulposus tissue formed on a porous calcium polyphosphate substrate. Spine 29(12):1299–1306; discussion 1306–1297

    Google Scholar 

  35. Shimer AL, Chadderdon RC, Gilbertson LG, Kang JD (2004) Gene therapy approaches for intervertebral disc degeneration. Spine 29(23):2770–2778

    Article  PubMed  Google Scholar 

  36. Sieber AN, Kostuik JP (2004) Concepts in nuclear replacement. Spine J 4(6 Suppl):322S–324S

    Article  PubMed  Google Scholar 

  37. Urban JPG, McMullin JF (1988) Swelling pressure of the lumbar intervertebral discs: influence of age, spinal level, composition, and degeneration. Spine 13(2):179–187

    Article  PubMed  CAS  Google Scholar 

  38. Vanharanta H, Sachs BL, Spivey M, Hochschuler SH, Guyer RD, Rashbaum RF, Ohnmeiss DD, Mooney V (1988) A comparison of CT/discography, pain response and radiographic disc height. Spine 13(3):321–324

    Article  PubMed  CAS  Google Scholar 

  39. Wheaton A, Dodge G, Elliott DM, Nicoll S, Reddy R (2005) Quantification of cartilage biomechanical and biochemical properties via T1-rho magnetic resonance imaging. Magn Reson Med 54:1087–1093

    Article  PubMed  CAS  Google Scholar 

  40. Wheaton AJ, Borthakur A, Dodge GR, Kneeland JB, Schumacher HR, Reddy R (2004) Sodium magnetic resonance imaging of proteoglycan depletion in an in vivo model of osteoarthritis. Acad Radiol 11(1):21–28

    Article  PubMed  Google Scholar 

  41. Wheaton AJ, Borthakur A, Kneeland JB, Regatte RR, Akella SV, Reddy R (2004) In vivo quantification of T1rho using a multislice spin-lock pulse sequence. Magn Reson Med 52(6):1453–1458

    Article  PubMed  Google Scholar 

  42. Wheaton AJ, Borthakur A, Shapiro EM, Regatte RR, Akella SV, Kneeland JB, Reddy R (2004) Proteoglycan loss in human knee cartilage: quantitation with sodium MR imaging—feasibility study. Radiology 231(3):900–905

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

Supported by a grant from the National Institute of Biomedical Imaging and Bioengineering (NIH EB-002425).

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, McKay Orthopaedic Research Laboratory, University of Pennsylvania, 424 Stemmler Hall, Philadelphia, PA, 19104-6081, USA

    Joshua D. Auerbach, Wade Johannessen & Dawn M. Elliott

  2. MMRRCC, Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA

    Arijitt Borthakur, Andrew J. Wheaton & Ravinder Reddy

  3. Department of Radiology, Pennsylvania Hospital, Philadelphia, PA, USA

    Carol A. Dolinskas

  4. Booth, Bartolozzi, and Balderston Orthopaedics, Pennsylvania Hospital, Philadelphia, PA, USA

    Richard A. Balderston

Authors
  1. Joshua D. Auerbach
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Wade Johannessen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Arijitt Borthakur
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Andrew J. Wheaton
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Carol A. Dolinskas
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Richard A. Balderston
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Ravinder Reddy
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Dawn M. Elliott
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Dawn M. Elliott.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Auerbach, J.D., Johannessen, W., Borthakur, A. et al. In vivo quantification of human lumbar disc degeneration using T1ρ-weighted magnetic resonance imaging. Eur Spine J 15 (Suppl 3), 338–344 (2006). https://doi.org/10.1007/s00586-006-0083-2

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00586-006-0083-2

Keywords

Search

Navigation