Quantitative assessment of the lumbar intervertebral disc via T2 shows excellent long-term reliability

PLoS One. 2021 Apr 14;16(4):e0249855. doi: 10.1371/journal.pone.0249855. eCollection 2021.

Abstract

Methodologies for the quantitative assessment of the spine tissues, in particular the intervertebral disc (IVD), have not been well established in terms of long-term reliability. This is required for designing prospective studies. 1H water T2 in the IVD ("T2") has attained wider use in assessment of the lumbar intervertebral discs via magnetic resonance imaging. The reliability of IVD T2 measurements are yet to be established. IVD T2 was assessed nine times at regular intervals over 368 days on six anatomical slices centred at the lumbar spine using a spin-echo multi-echo sequence in 12 men. To assess repeatability, intra-class correlation co-efficients (ICCs), standard error of the measurement, minimal detectable difference and co-efficients of variation (CVs) were calculated along with their 95% confidence intervals. Bland-Altman analysis was also performed. ICCs were above 0.93, with the exception of nuclear T2 at L5/S1, where the ICC was 0.88. CVs of the central-slice nucleus sub-region ranged from 4.3% (average of all levels) to 10.1% for L5/S1 and between 2.2% to 3.2% for whole IVD T2 (1.8% for the average of all levels). Averaging between vertebral levels improved reliability. Reliability of measurements was least at L5/S1. ICCs of degenerated IVDs were lower. Test-retest reliability was excellent for whole IVD and good to excellent for IVD subregions. The findings help to establish the long-term repeatability of lumbar IVD T2 for the implementation of prospective studies and determination of significant changes within individuals.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Humans
  • Intervertebral Disc / diagnostic imaging*
  • Lumbar Vertebrae / diagnostic imaging*
  • Magnetic Resonance Imaging / methods
  • Magnetic Resonance Imaging / standards*
  • Male
  • Reproducibility of Results

Grants and funding

DLB: received funding (grant number 50WB1220) from the German Aerospace Center dlr.de (Deutsches Zentrum für Luft- und Raumfahrt). The funders played no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. YL is employed by Imaging at Olympic Park, a commercial entity. Imaging at Olympic Park had no role in any aspect the study nor in the decision to publish.