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Volume 12
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10.3390/diagnostics12010078
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Article

Proton Density Fat Fraction Spine MRI for Differentiation of Erosive Vertebral Endplate Degeneration and Infectious Spondylitis

by
Frederic Carsten Schmeel
1,*,
Asadeh Lakghomi
1,
Nils Christian Lehnen
1,
Robert Haase
1,
Mohammed Banat
2,
Johannes Wach
2,
Nikolaus Handke
3,
Hartmut Vatter
2,
Alexander Radbruch
1,
Ulrike Attenberger
3 and
Julian Alexander Luetkens
3
1
Department of Neuroradiology, University Hospital Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, 53127 Bonn, Germany
2
Department of Neurosurgery, University Hospital Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, 53127 Bonn, Germany
3
Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, 53127 Bonn, Germany
*
Author to whom correspondence should be addressed.
Diagnostics 2022, 12(1), 78; https://doi.org/10.3390/diagnostics12010078
Submission received: 8 December 2021 / Revised: 27 December 2021 / Accepted: 28 December 2021 / Published: 30 December 2021
(This article belongs to the Special Issue Spine Imaging: Novel Image Acquisition Techniques and Analysis Tools)
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Abstract

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% [p < 0.001]; PDFFratio, 0.09 ± 0.06 vs. 0.67 ± 0.37 [p < 0.001]). The areas under the curve (AUC) and diagnostic accuracies were 0.977 (p < 0.001) and 98.1% (cut-off at 12.9%) for PDFF and 0.971 (p < 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.
Keywords: spondylitis; osteochondrosis; intervertebral disc degeneration; fat fraction; quantitative imaging spondylitis; osteochondrosis; intervertebral disc degeneration; fat fraction; quantitative imaging

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MDPI and ACS Style

Schmeel, F.C.; Lakghomi, A.; Lehnen, N.C.; Haase, R.; Banat, M.; Wach, J.; Handke, N.; Vatter, H.; Radbruch, A.; Attenberger, U.; et al. Proton Density Fat Fraction Spine MRI for Differentiation of Erosive Vertebral Endplate Degeneration and Infectious Spondylitis. Diagnostics 2022, 12, 78. https://doi.org/10.3390/diagnostics12010078

AMA Style

Schmeel FC, Lakghomi A, Lehnen NC, Haase R, Banat M, Wach J, Handke N, Vatter H, Radbruch A, Attenberger U, et al. Proton Density Fat Fraction Spine MRI for Differentiation of Erosive Vertebral Endplate Degeneration and Infectious Spondylitis. Diagnostics. 2022; 12(1):78. https://doi.org/10.3390/diagnostics12010078

Chicago/Turabian Style

Schmeel, Frederic Carsten, Asadeh Lakghomi, Nils Christian Lehnen, Robert Haase, Mohammed Banat, Johannes Wach, Nikolaus Handke, Hartmut Vatter, Alexander Radbruch, Ulrike Attenberger, and et al. 2022. "Proton Density Fat Fraction Spine MRI for Differentiation of Erosive Vertebral Endplate Degeneration and Infectious Spondylitis" Diagnostics 12, no. 1: 78. https://doi.org/10.3390/diagnostics12010078

APA Style

Schmeel, F. C., Lakghomi, A., Lehnen, N. C., Haase, R., Banat, M., Wach, J., Handke, N., Vatter, H., Radbruch, A., Attenberger, U., & Luetkens, J. A. (2022). Proton Density Fat Fraction Spine MRI for Differentiation of Erosive Vertebral Endplate Degeneration and Infectious Spondylitis. Diagnostics, 12(1), 78. https://doi.org/10.3390/diagnostics12010078

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