Keywords: Muscle, Diabetes, Vertebral Bone Quality score, paravertebral muscles; magnetic resonance imaging

Motivation: Patients with T2DM are at an increased risk of vertebral fractures, but the specific risk factors remain unclear. 

Goal(s): Investigate the correlation between changes in lumbar vertebrae and paravertebral muscles observed through MRI and the occurrence and severity of vertebral fractures in T2DM patients.

Approach: Retrospectively collect general information and lumbar spine MRI images of patients diagnosed with T2DM. Develop a diagnostic model based on MRI vertebral body and paravertebral muscle parameters and evaluate the model's diagnostic performance.

Results: Higher VBQ scores, decreased relative CSA of paravertebral muscles, and increased fat infiltration of the paravertebral muscles indicate an elevated risk of fractures.

Impact: The findings of this study could potentially have a significant impact on the management and prevention of vertebral fractures in T2DM patients. By identifying specific MRI-based risk factors, clinicians can improve fracture risk assessment and implement targeted interventions.

Keywords: Muscle, Muscle, Chronic low back pain; Vertebral bone quality

Motivation: The relationship between paraspinal muscles fat infiltration and vertebral body changes remain unclear. So motivation is to explore the relationship between the two and gain new insights about their interaction.

Goal(s): This study is to determine whether there is a correlation between paraspinal muscles fat infiltration and VBQ score and MCs.

Approach: A multimodal magnetic resonance imaging technique was employed to assess paraspinal muscles fat infiltration, VBQ score, and MCs in patients with CLBP

Results: There is no significant difference in paraspinal muscles PDFF between Modic classification. A positive linear relationship is observed between VBQ and total paraspinal muscles PDFF.

Impact: These findings contribute to our understanding of the association between paraspinal muscles fat infiltration and VBQ in CLBP patients. Further research can explore the clinical implications of these findings to improve alleviate CLBP symptoms.

Keywords: Muscle, Diffusion Tensor Imaging, paraspinal muscle, muscle fat infiltration, proton density fat fraction

Motivation: With the rise of aging-related muscle diseases, particularly sarcopenia, there's a pressing need for advanced diagnostic methods to assess muscle health.

Goal(s): Investigate the relationship between DTI imaging parameters and fat infiltration in paraspinal muscle, to identify novel biomarkers for early detection of muscle degeneration.

Approach: Employing DTI on 16 volunteers, we measured fat infiltration using PDFF and conducted a correlational analysis between DTI metrics and fat content across 64 ROIs.

Results: DTI successfully visualized paraspinal muscle fibers and showed significant correlations between FA values and PDFF, MD, AD, and RD values.

Impact: The research underscores the potential of DTI in detecting imaging biomarkers for muscle degeneration, setting the stage for advanced non-invasive assessments of musculoskeletal health.

Keywords: Muscle, Diffusion Tensor Imaging, Low back pain , Muscle fiber

Motivation: The development of discogenic low back pain (DLBP) and myofiber-type transformation in paraspinal muscles are strongly related. However, the impact of diffusion tensor imaging (DTI) in identifying myofiber-type transformation in paraspinal muscles remains uncertain.

Goal(s): Exploring the value of DTI in evaluating myofiber-type transformation in paraspinal muscles, and contributing to improved clinical diagnosis and intervention strategies for DLBP.

Approach: Prospective case-controlled animal experiments and establish the DLBP model in rats. DTI scanning and immunofluorescence of myofibers were performed to assess myofiber-type transformation.

Results: The fractional anisotropy (FA) was identified as a noninvasive imaging marker for detecting myofiber-type transformation in DLBP rats (r=0.4930, P<0.05).

Impact: Detection of myofiber-type in muscle biopsies is challenging. By utilizing DTI, clinicians can diagnose pathological alterations in paraspinal muscles early on, intervene quickly, and alleviate the burden on patients before the pain worsens.

Keywords: Cartilage, MSK, Spine, Lumbar, Endplate, Intervertebral Disc

Motivation: Despite crucial roles in normal function of the lumbar spine, discovertebral junction (DVJ) is seldom evaluated during MRI.   

Goal(s): Using ultrashort echo time (UTE) MRI, evaluate DVJ in subjects with chronic low back pain and asymptomatic controls.

Approach: Disc degeneration was assessed using Pfirrmann grading on the conventional spin echo T2, while DVJ morphology was assess using UTE MRI. Effect of low back pain  on disc degeneration and abnormal DVJ morphology was assessed.

Results: UTE MRI of the DVJ was feasible in vivo. In the symptomatic group, statistically greater prevalence of disc degeneration and abnormal DVJ morphology were found, suggesting a possible pain-correlation.  

Impact: This study advances MR imaging of the lumbar spine, suggesting that DVJ may be implicated in low back pain and the need for wider assessment of DVJ in routine lumbar MRI.

Keywords: Muscle, Quantitative Imaging

Motivation: Chronic low back pain (CLBP) is frequently associated with fatty infiltration and alterations in the cross-sectional area (CSA) of the paravertebral muscles. However, the precise relationship between disc-related changes and paravertebral muscles remains incompletely understood.

Goal(s): Study correlation between lumbar disc herniation, paravertebral muscle fat infiltration, CSA and chronic low back pain.

Approach: MRI images of the lumbar spine were analyzed in patients with chronic low back pain to correlate findings with paraspinal muscle CSA and PDFF.

Results: CLBP patients with disc herniation had lower PDFF in the multifidus muscle at L4/5 and reported higher pain levels (VAS score) than the control group.

Impact: This study provides valuable insights for clinicians, enabling them to implement targeted interventions for CLBP patients based on specific MRI findings and key characteristics of muscle remodeling.

Keywords: Bone, Cartilage

Motivation: Ruptured lumbar disc herniation (RLDH) can lead to severe clinical symptoms, significantly impacting patients' daily lives. 
. Understanding factors influencing disc resorption, particularly Modic change (MC), is crucial for making treatment decisions.

Goal(s):  To investigate the relationship between MC and the occurrence of disc resorption in RLDH patients.

Approach: This longitudinal study examined the presence of MC at baseline and assessed disc resorption at follow-up to determine the potential influence of MC on RLDH resorption.

Results: The study revealed that MC is an independent influencing factor for RLDH resorption failure, highlighting its significance in the management of this condition.

Impact: First, our study validated the efficacy of nonsurgical treatment of RLDH in resorption. Second, we demonstrated that MC is an independent factor hindering resorption, which helps clinicians to forecast resorption in RLDH patients, to select appropriate treatment methods. 

Keywords: Bone, Data Analysis

Motivation: Fractures can be highly detrimental for the elderly population. Assessing bone density alone is insufficient in accurately predicting fracture risk in osteopenia patients with and without fragility fracture. MRI can provide additional information on vertebral strength. 

Goal(s): To develop and validate a three-dimensional texture analysis method based on MRI for quantifying grayscale and distribution information of vertebrae.

Approach: We extracted MR texture features of the L4 vertebra and selected the most relevant features. A logistic regression model was established for fracture risk prediction.

Results: In a comprehensive model, the training and testing set achieved an AUC of 0.84 and 0.80 respectively.
 

Impact: Detecting subtle texture information that is imperceptible to the naked eye during the osteopenia stage. Analyzing these texture features specifically can help slow down the process of bone loss.

Keywords: Skeletal, MR Value

Motivation: Quantifying the extent of bone marrow infiltration or bone destruction plays a key role in assessing tumor burden and evaluating prognosis.

Goal(s): Previous semi-quantitative tumor burden scoring methods had limitations.

Approach: We developed a new whole spinal MRI-based tumor burden scoring method in participants with newly diagnosed multiple myeloma and to explore its prognostic significance by evaluating its role in predicting the early treatment response and its association with the R-ISS.

Results: The tumor burden score was an independent predictor of poor response and the AUC was 0.842. The tumor burden score was higher in R-ISS-III than in R-ISS-I and R-ISS-II.

Impact: This study quantified the extent of bone marrow infiltration or bone destruction in multiple myeloma and showed that high tumor burden scores were associated with poor early treatment response and high R-ISS stage.

Keywords: Skeletal, Skeletal, CT like image

Motivation: There is no consensus on the use of anterior or posterior surgery for ossification of the posterior longitudinal ligament (OPLL). 

Goal(s): The purpose of this study was to evaluate the usefulness of the FRACTURE MRI sequence in comparison to CT in the detection of OPLL of the cervical spine.

Approach: Seven radiological parameters were analyzed though the inter-observer and inter-modality agreement. 

Results: MRI with FRACTURE may be sufficient for the assessment of cervical spine OPLL, with good performance compared to CT in type of OPLL, distribution of OPLL, ossification thickness, canal-occupying ratio, K-line, and dural calcification.

Impact: In the evaluation of ossification of the posterior longitudinal ligament of the cervical spine, FRACTURE sequence might be a useful alternative to conventional CT scan.

Keywords: Cartilage, Cartilage, sodium MRI, 23Na, IVD, lumar Spine, lower pack pain, ex vivo, quantitative imaging

Motivation: The global impact of lumbar back pain requires an understanding of degenerative disc disease. Conventional MRI often misses early changes, necessitating a more sensitive technique for accurate detection.

Goal(s): To determine the efficacy of 3T-MRI with 23Na in accurately assessing degeneration to provide a deeper understanding of the correlation between sodium concentrations and proteoglycan levels in intervertebral discs.

Approach: Examination of human lumbar spine samples ex vivo using a 23Na-surface-coil, which enabled accurate determination of 23Na relaxation times and quantification of tissue sodium concentrations (TSCs).

Results: Results showed a significant correlation between decreasing TSC values and progression of Thompson grading.

Impact: This exciting research represents a significant advance in the field of lumbar disc degeneration assessment and promises to be an important part of a paradigm shift in diagnostic approaches and treatment strategies for patients with lumbar back pain.

Keywords: Other Musculoskeletal, Elastography, slip interface imaging, myofascial tissue, myofascial mobility, muscle, muscle function

Motivation: Investigating abnormal myofascial adhesion is crucial for understanding chronic low back pain in myofascial pain syndrome (MPS), necessitating objective, non-invasive imaging methods to characterize myofascial mobility in the lower back.  

Goal(s): To evaluate the efficacy of MR-Elastography (MRE)-based slip interface imaging (SII) technique for visualizing myofascial mobility in the lower back of healthy volunteers. 

Approach: A custom-built MRE driver and a new SII biomarker (D_norm) were introduced for detecting slip interfaces across thoracolumbar fascia and inter-muscular myofascial interfaces. 

Results: The D_norm map at a lower MRE frequency successfully provided clear visualization of lumbar slip interfaces, indicating unrestricted mobility in healthy volunteers. 

Impact: The new SII biomarker enhances visualization of the interface mobility in thoracolumbar fascia and other inter-muscular interfaces in the lower back. This may benefit assessment of myofascial mobility differences between healthy individuals and patients with MPS.

Keywords: Other Musculoskeletal, PET/MR, back pain, molecular imaging

Motivation: Diagnosis of chronic low back pain remains a challenge with conventional diagnostic methods leading to unsatisfactory treatment in a vast majority of patients.

Goal(s): To investigate the use of sigma-1 receptor (S1R) radioligand, [¹⁸F] FTC-146 in conjunction with positron emission tomography/magnetic resonance imaging (PET/MRI) for identifying the pain generator in chronic low back pain.

Approach: Correlation of [¹⁸F] FTC-146 PET-MRI imaging in patients with unresolved chronic low back pain to clinical findings. 

Results: S1R PET/MRI imaging matched the clinical diagnosis in all cases. Additionally, it offered benefit over traditional MRI by identifying additional “functional” findings both within and outside the spine.

Impact: Future clinical implementation of S1R-PET/MR can potentially help reveal previously unidentified pain generator in patients with chronic low back pain that have exhausted standard clinical care leading to better-targeted treatment. 

Keywords: Neurography, MSK

Motivation: DTI based on single-shot EPI is established method to evaluate lumbar nerve roots compression, but EPI-DTI has a high geometric distortion. 

Goal(s): To improve the image quality of the lumbar nerve roots, thereby improving the accuracy of tractography visualization and quantitative measurements.

Approach: To reduce distortion, we developed a method to reduce the number of phase encodes per acquisition by combining iZoom 2D RF excitation, IRIS and LIPO (SSGR) only fat suppression.

Results: Compared to the conventional EPI-DTI, LION iZoom IRIS-DTI improves the tractography image quality. LION iZoom IRIS-DTI was superior to the EPI-DTI, in accuracy of FA values measurement and ICC.

Impact: LION iZoom IRIS-DTI is effective in reducing image distortion and might improve the accuracy and reproducibility of FA measurements of lumbar nerve roots.

Keywords: Skeletal, Skeletal

Motivation: Could lumbar fat and water MRI be as an opportunistic screening tool?

Goal(s): To develop autoML radiomics-Based Classification for osteoporosis prediction using lumbar fat and water MRI.

Approach: A TPOP-radiomics classification model was trained using lumbar fat and water images obtained through the IDEAL-IQ method in normal and osteoporosis patients identified by DeXA. Three datasets of radiomics features were used, categorized based on their dimension (2D, 3D, and projection map)

Results: Our results indicate that the best model from the AutoML process demonstrated mean sensitivity of 0.745 and mean specificity of 0.758 in distinguishing between normal and osteroporosis.

Impact: Because osteoporosis is often considered a 'silent' disease, routine IDEAL-IQ lumbar scans have the potential to serve as an opportunistic screening tool for reducing the risk of fragility fractures, which are associated with morbidity and mortality.

Keywords: Other Musculoskeletal, Degenerative

Motivation: Lumbar disc degeneration (LDD) is a major cause of lower back pain, but the relationship of LDD and adjacent structures, especially bone mineral density (BMD), is unclear, which confuses clinicians in estimating condition.

Goal(s): To investigate the relationship between LDD and BMD in a non-specific low back pain (NSLBP) population.

Approach: We assessed the relationship between the extent of LDD, obtained from MRI, and BMD of vertebral bodies, measured using quantitative CT, in NSLBP patients. 

Results: Our results showed that LDD was negatively correlated with vertebra BMD in NSLBP patients, with L2/3 disc degeneration serving as an independent influencing factor for vBMD.

Impact: L2/3 intervertebral disc degeneration is an independent influencing factor for vBMD. Further investigation can explore if the degree of L2/3 intervertebral disc degeneration through MRI can predict OP, thereby reducing the occurrence of complications such as osteoporotic fractures.