Related Experiment Video
Updated: Jul 26, 2025
![Quantitative [18F]-Naf-PET-MRI Analysis for the Evaluation of Dynamic Bone Turnover in a Patient with Facetogenic Low Back Pain](/_next/image?url=https%3A%2F%2Fcloudfront.jove.com%2FCDNSource%2Fteasers%2F58491.jpg&w=3840&q=50)
Quantitative [18F]-Naf-PET-MRI Analysis for the Evaluation of Dynamic Bone Turnover in a Patient with Facetogenic Low Back Pain
Published on: August 8, 2019
Zero echo time MRI improved detection of erosions and sclerosis in the sacroiliac joint in comparison with LAVA-flex
Churong Lin1, Dong Liu2, Huiquan Wen1
1Department of Radiology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China.
Background:
T1-weighted spoiled 3D Gradient Recalled Echo pulse sequences, exemplified by Liver Acquisition with Volume Acceleration-flexible MRI (LAVA-Flex), are currently the preferred MR sequence for detecting erosions of the sacroiliac joint (SIJ). However, zero echo time MRI (ZTE) is recently reported to provide excellent visualization of the cortical bone.
Purpose:
To directly compare the diagnostic accuracy of ZTE and LAVA-Flex in the detection of structural lesions of the SIJ, including erosions, sclerosis and joint space changes.
Materials And Methods:
Two readers independently reviewed the ldCT, ZTE and LAVA-Flex images of 53 patients diagnosed as axSpA and scored the erosions, sclerosis and joint space changes. Sensitivity, specificity and Cohen's kappa (κ) of ZTE and LAVA-Flex were calculated, while McNemar's test was employed to compare the two sequences for the positivity of detecting the structural lesions.
Results:
Analysis of diagnostic accuracy showed a higher sensitivity of ZTE in comparison with LAVA-Flex in the depiction of erosions (92.5% vs 81.5%, p<0.001), especially first-degree erosions (p<0.001) and second-degree erosions (p<0.001), as well as sclerosis (90.6% vs 71.2%, p<0.001), but not joint space changes (95.2% vs 93.8%, p=0.332). Agreement with ldCT was also higher in ZTE in the detection of erosions than LAVA-Flex as indicated by the κ values (0.73 vs 0.47), as well as in the detection of sclerosis (0.92 vs 0.22).
Conclusion:
With ldCT as the reference standard, ZTE could improve diagnostic accuracy of erosions and sclerosis of the SIJ in patients suspected of axSpA, in comparison with LAVA-Flex.
Insights
Zero echo time MRI (ZTE) shows improved diagnostic accuracy for sacroiliac joint erosions and sclerosis in axSpA patients compared to LAVA-Flex. ZTE offers higher sensitivity and better agreement with CT for these key structural lesions.
Area of Science:
- Radiology and Imaging
- Rheumatology
- Musculoskeletal Imaging
Background:
- T1-weighted spoiled 3D Gradient Recalled Echo (LAVA-Flex) is the standard MRI sequence for sacroiliac joint (SIJ) erosions.
- Zero echo time MRI (ZTE) demonstrates potential for superior cortical bone visualization.
Purpose of the Study:
- To directly compare the diagnostic accuracy of ZTE and LAVA-Flex MRI sequences.
- To evaluate the detection of structural SIJ lesions, including erosions, sclerosis, and joint space changes.
Main Methods:
- Fifty-three patients with axial spondyloarthritis (axSpA) underwent ldCT, ZTE, and LAVA-Flex MRI.
- Two independent readers assessed SIJ erosions, sclerosis, and joint space changes.
- Sensitivity, specificity, and Cohen's kappa (κ) were calculated; McNemar's test compared sequence performance.
Main Results:
- ZTE exhibited significantly higher sensitivity than LAVA-Flex for detecting erosions (92.5% vs 81.5%) and sclerosis (90.6% vs 71.2%).
- ZTE showed improved agreement with ldCT for erosions (κ=0.73 vs 0.47) and sclerosis (κ=0.92 vs 0.22).
- No significant difference was found in detecting joint space changes (ZTE 95.2% vs LAVA-Flex 93.8%).
Conclusions:
- Zero echo time MRI (ZTE) enhances diagnostic accuracy for SIJ erosions and sclerosis in suspected axSpA patients.
- ZTE surpasses LAVA-Flex in detecting these specific structural lesions, using ldCT as the reference standard.
More Related Videos
07:15In vivo Macrophage Imaging Using MR Targeted Contrast Agent for Longitudinal Evaluation of Septic Arthritis
Published on: October 20, 2013
09:32Time-Resolved, Dynamic Computed Tomography Angiography for Characterization of Aortic Endoleaks and Treatment Guidance via 2D-3D Fusion-Imaging
Published on: December 9, 2021
Related Concept Videos
01:25Ultrasound II: Endoscopic Ultrasound and FibroScan
Endoscopic Ultrasound (EUS):
01:17Ultrasonography
During an ultrasonography procedure, a handheld device called...
01:24Magnetic Resonance Imaging
01:30Radiological Investigation II: MRI and Ventilation Perfusion Scan
Magnetic Resonance Imaging (MRI) and Ventilation Perfusion Scans are two radiological investigations that offer detailed diagnostic images of the body, particularly lung structures.
MRI
MRI uses magnetic fields and radiofrequency signals to distinguish between normal and abnormal tissues. This technology provides a more detailed diagnostic image than CT scans, enabling it to characterize pulmonary nodules, stage bronchogenic carcinoma, and evaluate inflammatory activity in...
01:22Imaging Studies VI: Voiding Cystourethrography and Cystography
01:20Imaging Studies for Cardiovascular System II:Types of Echocardiography
Types of Echocardiography
Transthoracic Echocardiography (TTE)
TTE is the most common type of echocardiogram which involves placing a transducer on the patient's chest, emitting sound waves to create heart images. TTE is invaluable for evaluating the heart's size, structure, and motion, making it particularly useful for...