Related Experiment Video
Updated: Dec 28, 2025
Author Spotlight: An Economic and Efficient Method for Quantitative Evaluation of Bone Microarchitecture in a Murine Osteoporosis Model
Published on: September 8, 2023
Does bone scintigraphy show Modic changes associated with increased bone turnover?
Jyri Järvinen1,2,3, Jaakko Niinimäki1,2,3, Jaro Karppinen2,4
1Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland.
Purpose:
Our purpose was to evaluate whether Modic changes (MC) revealed in lumbar MRI are associated with increased tracer uptake shown in bone scintigraphy. To our knowledge, this has not previously been studied.
Methods:
We included patients with MC shown in lumbar MRI and bone scintigraphy performed within six months before or after MRI. Exclusion criteria included metastasis and other specific lesions in the area of interest such as discitis, tumors or fractures. We compared the level and type of MC to the degree of tracer uptake shown in bone scintigraphy. Tracer uptake was assessed both visually and quantitatively. We calculated the lesion-to-normal-bone ratios between the MC area with increased tracer uptake and the vertebra with normal tracer uptake. We used linear mixed models in statistical analyses.
Results:
Our study sample consisted of 93 patients (aged 37-86) with 299 MC (28 Type 1 (M1), 50 mixed Type 1/2 (M1/2), 3 mixed Type 1/3 (M1/3), 211 Type 2 (M2), 6 mixed Type 2/3 (M2/3), and 1 Type 3 (M3)). Of all the MC, 26 (93 %) M1, 34 (64 %) in the combined M1/2 and M1/3 group, and 11 (5 %) in the combined M2, M2/3 and M3 group showed increased tracer uptake. The mean lesion-to-normal-bone ratio was higher for lesions with a Type 1 component (M1, M1/2 and M1/3) than for other types, at 1.55 (SD 0.16) for M1; 1.44 (SD 0.21) for combined M1/2 and M1/3; and 1.28 (SD 0.11) for combined M2, M2/3 and M3; p = 0.001).
Conclusion:
In most cases, MC with a Type 1 component showed increased tracer uptake in bone scintigraphy. This indicates that bone turnover is accelerated in the M1 area.
Insights
Modic changes (MC) with a Type 1 component on lumbar MRI show increased tracer uptake on bone scintigraphy, indicating accelerated bone turnover in these areas. This association was not previously studied.
Area of Science:
- Radiology
- Nuclear Medicine
- Spinal Imaging
Background:
- Modic changes (MC) are common findings on lumbar MRI.
- The association between Modic changes and bone scintigraphy findings is not well-established.
- Bone scintigraphy can indicate areas of increased bone turnover.
Purpose of the Study:
- To evaluate the association between Modic changes (MC) on lumbar MRI and increased tracer uptake on bone scintigraphy.
- To determine if specific types of Modic changes correlate with scintigraphic findings.
Main Methods:
- Retrospective study of 93 patients with lumbar MRI and bone scintigraphy within six months.
- Exclusion of patients with metastasis, discitis, tumors, or fractures.
- Visual and quantitative assessment of tracer uptake in Modic changes, including lesion-to-normal-bone ratios.
- Statistical analysis using linear mixed models.
Main Results:
- 299 Modic changes (MC) were analyzed in 93 patients.
- Type 1 MC (M1) and those with a Type 1 component (M1/2, M1/3) showed significantly higher tracer uptake (93%, 64% respectively) compared to Type 2/3 MC (5%).
- Mean lesion-to-normal-bone ratios were higher for Type 1 component MC (1.55 for M1) than for other types (1.28 for M2/M3).
Conclusions:
- Modic changes with a Type 1 component frequently exhibit increased tracer uptake on bone scintigraphy.
- This suggests accelerated bone turnover in Type 1 Modic changes.
- The findings highlight a correlation between specific MRI-detected spinal changes and functional bone activity.
Related Concept Videos
01:31Osteoclasts in Bone Remodeling
01:40Bone Remodeling
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
01:29Bone Disorders
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...