Proton Density Fat Fraction Spine MRI for Differentiation of Erosive Vertebral Endplate Degeneration and Infectious Spondylitis
Vertebral Modic type 1 (MT1) degeneration may mimic infectious disease on conventional spine magnetic resonance imaging (MRI), potentially leading to additional costly and invasive investigations. This study evaluated the diagnostic performance of the proton density fat fraction (PDFF) for distingui...
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MDPI AG
2021-12-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/12/1/78 |
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| author | Frederic Carsten Schmeel Asadeh Lakghomi Nils Christian Lehnen Robert Haase Mohammed Banat Johannes Wach Nikolaus Handke Hartmut Vatter Alexander Radbruch Ulrike Attenberger Julian Alexander Luetkens |
| author_facet | Frederic Carsten Schmeel Asadeh Lakghomi Nils Christian Lehnen Robert Haase Mohammed Banat Johannes Wach Nikolaus Handke Hartmut Vatter Alexander Radbruch Ulrike Attenberger Julian Alexander Luetkens |
| author_sort | Frederic Carsten Schmeel |
| collection | DOAJ |
| description | Vertebral Modic type 1 (MT1) degeneration may mimic infectious disease on conventional spine magnetic resonance imaging (MRI), potentially leading to additional costly and invasive investigations. This study evaluated the diagnostic performance of the proton density fat fraction (PDFF) for distinguishing MT1 degenerative endplate changes from infectious spondylitis. A total of 31 and 22 patients with equivocal diagnosis of MT1 degeneration and infectious spondylitis, respectively, were retrospectively enrolled in this IRB-approved retrospective study and examined with a chemical-shift encoding (CSE)-based water-fat 3D six-echo modified Dixon sequence in addition to routine clinical spine MRI. Diagnostic reference standard was established according to histopathology or clinical and imaging follow-up. Intravertebral PDFF [%] and PDFFratio (i.e., vertebral endplate PDFF/normal vertebrae PDFF) were calculated voxel-wise within the single most prominent edematous bone marrow lesion per patient and examined for differences between MT1 degeneration and infectious spondylitis. Mean PDFF and PDFFratio of infectious spondylitis were significantly lower compared to MT1 degenerative changes (mean PDFF, 4.28 ± 3.12% vs. 35.29 ± 17.15% [<i>p</i> < 0.001]; PDFFratio, 0.09 ± 0.06 vs. 0.67 ± 0.37 [<i>p</i> < 0.001]). The areas under the curve (AUC) and diagnostic accuracies were 0.977 (<i>p</i> < 0.001) and 98.1% (cut-off at 12.9%) for PDFF and 0.971 (<i>p</i> < 0.001) and 98.1% (cut-off at 0.27) for PDFFratio. Our data suggest that quantitative evaluation of vertebral PDFF can provide a high diagnostic accuracy for differentiating erosive MT1 endplate changes from infectious spondylitis. |
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| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-10T01:39:07Z |
| publishDate | 2021-12-01 |
| publisher | MDPI AG |
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| series | Diagnostics |
| spelling | doaj.art-23eff8a3ba2e465594b1eab70a2380102023-11-23T13:27:51ZengMDPI AGDiagnostics2075-44182021-12-011217810.3390/diagnostics12010078Proton Density Fat Fraction Spine MRI for Differentiation of Erosive Vertebral Endplate Degeneration and Infectious SpondylitisFrederic Carsten Schmeel0Asadeh Lakghomi1Nils Christian Lehnen2Robert Haase3Mohammed Banat4Johannes Wach5Nikolaus Handke6Hartmut Vatter7Alexander Radbruch8Ulrike Attenberger9Julian Alexander Luetkens10Department of Neuroradiology, University Hospital Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, 53127 Bonn, GermanyDepartment of Neuroradiology, University Hospital Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, 53127 Bonn, GermanyDepartment of Neuroradiology, University Hospital Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, 53127 Bonn, GermanyDepartment of Neuroradiology, University Hospital Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, 53127 Bonn, GermanyDepartment of Neurosurgery, University Hospital Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, 53127 Bonn, GermanyDepartment of Neurosurgery, University Hospital Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, 53127 Bonn, GermanyDepartment of Diagnostic and Interventional Radiology, University Hospital Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, 53127 Bonn, GermanyDepartment of Neurosurgery, University Hospital Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, 53127 Bonn, GermanyDepartment of Neuroradiology, University Hospital Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, 53127 Bonn, GermanyDepartment of Diagnostic and Interventional Radiology, University Hospital Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, 53127 Bonn, GermanyDepartment of Diagnostic and Interventional Radiology, University Hospital Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, 53127 Bonn, GermanyVertebral Modic type 1 (MT1) degeneration may mimic infectious disease on conventional spine magnetic resonance imaging (MRI), potentially leading to additional costly and invasive investigations. This study evaluated the diagnostic performance of the proton density fat fraction (PDFF) for distinguishing MT1 degenerative endplate changes from infectious spondylitis. A total of 31 and 22 patients with equivocal diagnosis of MT1 degeneration and infectious spondylitis, respectively, were retrospectively enrolled in this IRB-approved retrospective study and examined with a chemical-shift encoding (CSE)-based water-fat 3D six-echo modified Dixon sequence in addition to routine clinical spine MRI. Diagnostic reference standard was established according to histopathology or clinical and imaging follow-up. Intravertebral PDFF [%] and PDFFratio (i.e., vertebral endplate PDFF/normal vertebrae PDFF) were calculated voxel-wise within the single most prominent edematous bone marrow lesion per patient and examined for differences between MT1 degeneration and infectious spondylitis. Mean PDFF and PDFFratio of infectious spondylitis were significantly lower compared to MT1 degenerative changes (mean PDFF, 4.28 ± 3.12% vs. 35.29 ± 17.15% [<i>p</i> < 0.001]; PDFFratio, 0.09 ± 0.06 vs. 0.67 ± 0.37 [<i>p</i> < 0.001]). The areas under the curve (AUC) and diagnostic accuracies were 0.977 (<i>p</i> < 0.001) and 98.1% (cut-off at 12.9%) for PDFF and 0.971 (<i>p</i> < 0.001) and 98.1% (cut-off at 0.27) for PDFFratio. Our data suggest that quantitative evaluation of vertebral PDFF can provide a high diagnostic accuracy for differentiating erosive MT1 endplate changes from infectious spondylitis.https://www.mdpi.com/2075-4418/12/1/78spondylitisosteochondrosisintervertebral disc degenerationfat fractionquantitative imaging |
| spellingShingle | Frederic Carsten Schmeel Asadeh Lakghomi Nils Christian Lehnen Robert Haase Mohammed Banat Johannes Wach Nikolaus Handke Hartmut Vatter Alexander Radbruch Ulrike Attenberger Julian Alexander Luetkens Proton Density Fat Fraction Spine MRI for Differentiation of Erosive Vertebral Endplate Degeneration and Infectious Spondylitis Diagnostics spondylitis osteochondrosis intervertebral disc degeneration fat fraction quantitative imaging |
| title | Proton Density Fat Fraction Spine MRI for Differentiation of Erosive Vertebral Endplate Degeneration and Infectious Spondylitis |
| title_full | Proton Density Fat Fraction Spine MRI for Differentiation of Erosive Vertebral Endplate Degeneration and Infectious Spondylitis |
| title_fullStr | Proton Density Fat Fraction Spine MRI for Differentiation of Erosive Vertebral Endplate Degeneration and Infectious Spondylitis |
| title_full_unstemmed | Proton Density Fat Fraction Spine MRI for Differentiation of Erosive Vertebral Endplate Degeneration and Infectious Spondylitis |
| title_short | Proton Density Fat Fraction Spine MRI for Differentiation of Erosive Vertebral Endplate Degeneration and Infectious Spondylitis |
| title_sort | proton density fat fraction spine mri for differentiation of erosive vertebral endplate degeneration and infectious spondylitis |
| topic | spondylitis osteochondrosis intervertebral disc degeneration fat fraction quantitative imaging |
| url | https://www.mdpi.com/2075-4418/12/1/78 |
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