Does bone scintigraphy show Modic changes associated with increased bone turnover?

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.