Novel Application of the Pfirrmann Disc Degeneration Grading System to 9.4T MRI: Higher Reliability Compared to 3T MRI

No Thumbnail Available
File version
Author(s)
Sher, Idrees
Daly, Chris
Oehme, David
Chandra, Ronil
Sher, Mustafa
Ghosh, Peter
Smith, Julian
Goldschlager, Tony
Griffith University Author(s)
Primary Supervisor
Other Supervisors
Editor(s)
Date
2019
Size
File type(s)
Location
License
Abstract

Objective. To evaluate the applicability and reliability of 9.4T magnetic resonance imaging (MRI) in the assessment of degenerative disc disease compared with 3T MRI. Summary of Background Data. MRI is a reliable indicator of biochemical changes in the intervertebral disc (IVD) including hydration status, proteoglycan content, and disc degeneration compared with anatomical and histological studies. High-field 9.4T MRI has been shown to provide superior resolution and anatomical detail. However, it has not been tested against current standard MRI techniques. Methods. Disc degeneration was initiated in 36 skeletally mature ewes 6 months prior to necropsy via validated surgical IVD injury models using either scalpel injury or drill-bit injury techniques at lumbar spine levels L2/3 and L3/4 with L1/2, L4/5, and L5/6 serving as control discs. All ex vivo IVDs were examined with 9.4T MRI and 3T MRI. All scans were analyzed using the Pfirrmann grading system by four independent observers. Intra- and interobserver reliability was assessed using kappa statistics and Spearman correlation. Results. Inter- and intraobserver agreement for 9.4T MRI was excellent, both at k 0.91 (P 0.001). Comparatively, 3T interobserver reliability demonstrated substantial agreement at k 0.61 (P 0.001). Complete agreement was obtained in 92.7% to 100% of discs at 9.4T compared with 69.7% to 83.1% at 3T. A difference of one grade or more occurred in 6.7% at 9.4T and 39.3% at 3T. 9.4T MRI scored 97.3% of discs as grade 1 to 2 compared with 71.3% at 3T. 3T MRI tended to over-score the extent of disc degeneration with 28.6% of discs scored as grade 3 or higher compared with 2.7% at 9.4T MRI. Conclusion. 9.4T MRI study of IVD degeneration using the Pfirrmann grading system demonstrated excellent inter- and intraobserver reliability. Comparatively, 3T MRI demonstrated a tendency to over score the extent of disc degeneration. This improved reliability of 9.4T MRI holds great potential for its clinical applications

Journal Title

Spine

Conference Title
Book Title
Edition
Volume

44

Issue

13

Thesis Type
Degree Program
School
Publisher link
Patent number
Funder(s)
Grant identifier(s)
Rights Statement
Rights Statement
Item Access Status
Note
Access the data
Related item(s)
Subject

Biomedical engineering

Clinical sciences

Science & Technology

Life Sciences & Biomedicine

Clinical Neurology

Orthopedics

Neurosciences & Neurology

Persistent link to this record
Citation

Sher, I; Daly, C; Oehme, D; Chandra, R; Sher, M; Ghosh, P; Smith, J; Goldschlager, T, Novel Application of the Pfirrmann Disc Degeneration Grading System to 9.4T MRI Higher Reliability Compared to 3T MRI, Spine, 2019, 44 (13), pp. E766-E773

Collections