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Optical Sectioning and Visualization of the Intervertebral Disc from Embryonic Development to Degeneration
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MRI histogram analysis enables objective and continuous classification of intervertebral disc degeneration

Christian Waldenberg1,2, Hanna Hebelka3,4, Helena Brisby3,5

  • 1Department of Medical Physics and Techniques, Sahlgrenska University Hospital, Gothenburg, Sweden. christian.waldenberg@vgregion.se.

European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
|August 20, 2017
PubMed
Abstract

Insights

Magnetic resonance imaging (MRI) histogram analysis offers a new way to grade intervertebral disc (IVD) degeneration objectively. This method captures IVD heterogeneity, improving classification beyond current systems for low back pain.

Area of Science:

  • Radiology
  • Biomedical Imaging
  • Orthopedics

Background:

  • Magnetic resonance imaging (MRI) is optimal for diagnosing low back pain but has limitations in assessing intervertebral disc (IVD) degeneration.
  • Current clinical classification systems for IVD degeneration are coarse and may not fully capture the condition's nuances.
  • MR image histograms offer potential as sensitive biomarkers for IVD degeneration due to their ability to reflect tissue heterogeneity.

Purpose of the Study:

  • To investigate the feasibility of using MR image histogram analysis for objective and continuous grading of IVD degeneration.
  • To explore histogram features as potential imaging biomarkers for IVD degeneration classification.
  • To assess the correlation between histogram features and established clinical grading scales.

Main Methods:

  • Forty-nine IVDs from ten patients with low back pain were analyzed using MRI (T2-weighted images and T2-maps).
  • Semi-automated segmentation was performed on mid-sagittal slices of each IVD.
  • Histogram features were extracted from regions of interest and correlated with the Pfirrmann grade.

Main Results:

  • T2-weighted images and T2-maps yielded similar histogram features.
  • Well-hydrated IVDs showed two distinct peaks in histograms (annulus fibrosus and nucleus pulposus).
  • Degenerated IVDs exhibited reduced peak separation, strongly correlating with Pfirrmann grade (P < 0.05), and varied histogram appearances within the same grade.

Conclusions:

  • IVD histogram analysis demonstrates strong correlation with degeneration, indicating its suitability for objective and continuous grading.
  • Histogram analysis reveals IVD heterogeneity, positioning it as a potential clinical tool for characterizing regional degeneration.
  • Further research comparing histogram features in symptomatic versus asymptomatic individuals is needed to establish clinical utility.
Keywords:
DiagnosisHeterogeneityHistogram analysisIVD classificationMRI

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