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Updated: Apr 21, 2026

Multilevel Oblique Lumbar Interbody Fusion in Degenerative Lumbar Disc Disease with Instability
Published on: July 25, 2025
Improvement of gagCEST imaging in the human lumbar intervertebral disc by motion correction
Anja Müller-Lutz1, Christoph Schleich, Benjamin Schmitt
1Medical Faculty, Department of Diagnostic and Interventional Radiology, University Dusseldorf, Moorenstrasse 5, 40225, Dusseldorf, Germany.
Objective:
To investigate whether motion correction improves glycosaminoglycan chemical exchange saturation transfer imaging (gagCEST imaging) of intervertebral discs (IVDs).
Materials And Methods:
Magnetic resonance gagCEST imaging of 12 volunteers was obtained in lumbar IVDs at 3 T using a prototype pulse sequence. The data were motion-corrected using a prototype diffeomorphism-based motion compensation technique. For both the data with and that without motion correction (datac, datauc), CEST evaluation was performed using the magnetisation transfer ratio asymmetry (MTRasym) as a means of quantifying CEST effects. MTRasym and the signal-to-noise ratio (SNR) of the MTRasym map in the nucleus pulposus (NP) were compared for datac and datauc. A visual grading analysis was performed by a radiologist in order to subjectively quantify the quality of the MTRasym analysis (score 1: best quality, score 5: worst quality). Furthermore, a landmark analysis was performed in order to objectively quantify the motion between CEST images using the mean landmark distance dmean.
Results:
MTRasym and SNR were significantly higher for the motion-corrected data than for the uncorrected CEST data (MTRasym(datac) = 3.77 % ± 0.95 %, MTRasym(datauc) = 3.41 % ± 1.54 %, p value = 0.001; SNR(datac) = 3.88 ± 2.04, SNR(datauc) = 2.77 ± 1.55, p value < 0.001, number of IVDs = 48). The visual grading analysis revealed a higher reliability for datac (maximum score = 2) compared with datauc (maximum score = 5). The landmark analysis demonstrated the superiority of the motion-corrected data (dmean(datac) = 0.08 mm ± 0.09 mm, dmean(datauc) = 0.36 mm ± 0.09 mm, p value = 0.001).
Conclusion:
Our study showed significant improvements in the ability to quantify CEST imaging in IVDs after the application of motion correction compared with uncorrected datasets.
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