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Related Experiment Video

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Author Spotlight: An Economic and Efficient Method for Quantitative Evaluation of Bone Microarchitecture in a Murine Osteoporosis Model
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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.

European Journal of Radiology Open
|February 20, 2020
PubMed
Summary

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.

Keywords:
99mTc, 99mTechnetium99mTc-HDP, 99m Technetium-labeled hydroxymethylene diphosphonateBone scintigraphyBone turnoverICC, intraclass correlation coefficientsLBP, low back painM1, Type 1 Modic changeM1/2, Type 1/2 mixed Modic changeM1/3, Type 1/3 mixed Modic changeM2, Type 2 Modic changeM2/3, Type 2/3 mixed Modic changeM3, Type 3 Modic changeMC, Modic changesMRI, magnetic resonance imagingMagnetic resonance imagingModic changesSPECT, single photon emission computed tomographyκ, Cohen’s kappa

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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.