Intravoxel Incoherent Motion Factors Affecting Collapse and Nonunion of Osteoporotic Vertebral Fracture

Izaya Ogon; Tsuneo Takebayashi; Hiroyuki Takashima; Yasuhisa Abe; Hiroshi Oguma; Rui Imamura; Yoshihiro Akatsuka; Tomonori Morita; Atsushi Teramoto

doi:10.1177/21925682231167788

Intravoxel Incoherent Motion Factors Affecting Collapse and Nonunion of Osteoporotic Vertebral Fracture

Global Spine J. 2023 Mar 31:21925682231167788. doi: 10.1177/21925682231167788. Online ahead of print.

Authors

Izaya Ogon¹, Tsuneo Takebayashi², Hiroyuki Takashima³, Yasuhisa Abe², Hiroshi Oguma², Rui Imamura¹, Yoshihiro Akatsuka¹, Tomonori Morita¹, Atsushi Teramoto¹

Affiliations

¹ Department of Orthopaedic Surgery, Sapporo Medical University, School of Medicine, Sapporo, Japan.
² Department of Orthopaedic Surgery, Sapporo Maruyama Orthopaedic Hospital, Sapporo, Japan.
³ Faculty of Health Sciences, Hokkaido University, Sapporo, Japan.

PMID: 37001146
DOI: 10.1177/21925682231167788

Abstract

Study design: Longitudinal study.

Objectives: Intravoxel incoherent motion (IVIM), a magnetic resonance imaging (MRI) scanning technique that applies diffusion-weighted imaging (DWI), is effective for the quantitative assessment of malignant tumors of the vertebral bone. We hypothesized that IVIM parameters of vertebral bodies are associated with the prognosis of osteoporotic vertebral fracture (OVF). We aimed to explore the relationships between IVIM parameters for vertebral collapse and non-union after OVF and calculate the cut-off values of these parameters for vertebral collapse and non-union.

Methods: A total of 150 patients with acute OVF (150 women; mean age: 79.1 ± 7.4 years) were included and treated conservatively with bracing. MRI was performed at the time of injury. IVIM parameters, such as apparent diffusion coefficient (ADC), molecular diffusion coefficient (D), and perfusion-related diffusion (D*) were recorded. The patients were classified into 3 groups: low-collapse (height loss of ≤50%), high-collapse (height loss of >50%), and non-union. We compared ADC, D, and D* among the low-collapse, high-collapse, and non-union groups and performed a receiver operating characteristic (ROC) curve analysis to determine the boundary values of the high-collapse and non-union groups.

Results: The low-collapse, high-collapse, and non-union groups had no significant differences in ADC and D. However, D* differed significantly among the 3 groups. ROC analysis revealed cut-off values of 19.0 × 10^-3 mm²/s and 12.3 × 10^-3 mm²/s for the high-collapse and non-union groups, respectively.

Conclusions: D* is a significant prognostic indicator for high-collapse and non-union groups with OVF. This suggests that D* should be considered when assessing OVF.

Keywords: intravoxel incoherent motion; osteoporotic vertebral fracture; perfusion-related diffusion.