Clinical implementation of accelerated T 2 mapping: Quantitative magnetic resonance imaging as a biomarker for annular t
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MUSCULOSKELETAL
Clinical implementation of accelerated T2 mapping: Quantitative magnetic resonance imaging as a biomarker for annular tear and lumbar disc herniation Marcus Raudner 1,2 & Markus M. Schreiner 3 & Tom Hilbert 4,5,6 & Tobias Kober 4,5,6 & Michael Weber 1 & Anna Szelényi 1 & Reinhard Windhager 3 & Vladimir Juras 2,7 & Siegfried Trattnig 1,2 Received: 12 June 2020 / Revised: 20 October 2020 / Accepted: 17 November 2020 # The Author(s) 2020
Abstract Objectives This study evaluates GRAPPATINI, an accelerated T2 mapping sequence combining undersampling and modelbased reconstruction to facilitate the clinical implementation of T2 mapping of the lumbar intervertebral disc. Methods Fifty-eight individuals (26 females, 32 males, age 23.3 ± 8.0 years) were prospectively examined at 3 T. This cohort study consisted of 19 patients, 20 rowers, and 19 volunteers. GRAPPATINI was conducted with the same parameters as a conventional 2D multi-echo spin-echo (MESE) sequence in 02:27 min instead of 13:18 min. Additional T2 maps were calculated after discarding the first echo (T2-WO1ST) and only using even echoes (T2-EVEN). Segmentation was done on the four most central slices. The resulting T2 values were compared for all four measurements. Results T2-GRAPPATINI, T2-MESE, T2-EVEN, and T2-WO1ST of the nucleus pulposus of normal discs differed significantly from those of bulging discs or herniated discs (all p < 0.001). For the posterior annular region, only T2-GRAPPATINI showed a significant difference (p = 0.011) between normal and herniated discs. There was a significant difference between T2-GRAPPATINI, T2-MESE, T2-EVEN, and T2-WO1ST of discs with and without an annular tear for the nucleus pulposus (all p < 0.001). The nucleus pulposus’ T2 at different degeneration states showed significant differences between all group comparisons of Pfirrmann grades for T2GRAPPATINI (p = 0.000–0.018), T2-MESE (p = 0.000–0.015), T2-EVEN (p = 0.000–0.019), and T2-WO1ST (p = 0.000–0.015). Conclusions GRAPPATINI facilitates the use of T2 values as quantitative imaging biomarkers to detect disc pathologies such as degeneration, lumbar disc herniation, and annular tears while simultaneously shortening the acquisition time from 13:18 to 2:27 min. Key Points • T2-GRAPPATINI, T2-MESE, T2-EVEN, and T2-WO1ST of the nucleus pulposus of normal discs differed significantly from those of discs with bulging or herniation (all p < 0.001). • The investigated T2 mapping techniques differed significantly in discs with and without annular tearing (all p < 0.001).
Summary statement GRAPPATINI facilitates T 2 mapping as a quantitative imaging biomarker that can be used for the quantitative assessment of the nucleus pulposus, which correlates with degeneration and lumbar disc herniation and may be associated with annular tears, while shortening the acquisition time from 13:18 to 2:27 min. * Siegfried Trattnig [email protected] 1
2
Department of Biomedical Imaging and Image-guided Therapy, High Field MR Center, Medical University of Vienna,
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