Quantification of muscle fat in patients with low back pain

Comparison of multi-echo MR imaging with single-voxel MR spectroscopy

Michael A. Fischer, Daniel Nanz, Ann Shimakawa, Timo Schirmer, Roman Guggenberger, Avneesh Chhabra, John A. Carrino, Gustav Andreisek

Research output: Contribution to journalArticle

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Abstract

Purpose: To compare lumbar muscle fat-signal fractions derived from three-dimensional dual gradient-echo magnetic resonance (MR) imaging and multiple gradient-echo MR imaging with fractions from single-voxel MR spectroscopy in patients with low back pain. Materials and This prospective study had institutional review board ap-Methods: proval, and written informed consent was obtained from all study participants. Fifty-six patients (32 women; mean age, 52 years 6 15 [standard deviation]; age range, 20-79 years) with low back pain underwent standard 1.5-T MR imaging, which was supplemented by dual-echo MR imaging, multi-echo MR imaging, and MR spectroscopy to quantify fatty degeneration of bilateral lumbar multifidus muscles in a region of interest at the intervertebral level of L4 through L5. Fat-signal fractions were determined from signal intensities on fat-and water-only images from both imaging data sets (dual-echo and multi-echo fat-signal fractions without T2 * correction) or directly obtained, with additional T2 * correction, from multi-echo MR imaging. The results were compared with MR spectroscopic fractions. The Student t test and Bland-Altman plots were used to quantify agreement between fat-signal fractions derived from imaging and from spectroscopy. Results: In total, 102 spectroscopic measurements were obtained bilaterally (46 of 56) or unilaterally (10 of 56). Mean spectroscopic fat-signal fraction was 19.6 6 11.4 (range, 5.4-63.5). Correlation between spectroscopic and all imaging-based fat-signal fractions was statistically significant (R2 = 0.87-0.92; all P <.001). Mean dual-echo fat-signal fractions not corrected for T2* and multi-echo fat-signal fractions corrected for T2*significantly differed from spectroscopic fractions (both P <.01), but mean multi-echo fractions not corrected for T2* did not (P =.11). There was a small measurement bias of 0.5% (95% limits of agreement:26.0%, 7.2%) compared with spectroscopic fractions. Conclusion: Large-volume image-based (dual-echo and multi-echo MR imaging) and spectroscopic fat-signal fractions agree well, thus allowing fast and accurate quantification of muscle fat content in patients with low back pain.

Original languageEnglish (US)
Pages (from-to)555-563
Number of pages9
JournalRadiology
Volume266
Issue number2
DOIs
StatePublished - Feb 1 2013

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Low Back Pain
Magnetic Resonance Spectroscopy
Fats
Magnetic Resonance Imaging
Muscles
Paraspinal Muscles
Research Ethics Committees
Informed Consent
Spectrum Analysis
Prospective Studies
Students
Water

ASJC Scopus subject areas

  • Medicine(all)
  • Radiology Nuclear Medicine and imaging

Cite this

Quantification of muscle fat in patients with low back pain : Comparison of multi-echo MR imaging with single-voxel MR spectroscopy. / Fischer, Michael A.; Nanz, Daniel; Shimakawa, Ann; Schirmer, Timo; Guggenberger, Roman; Chhabra, Avneesh; Carrino, John A.; Andreisek, Gustav.

In: Radiology, Vol. 266, No. 2, 01.02.2013, p. 555-563.

Research output: Contribution to journalArticle

Fischer, MA, Nanz, D, Shimakawa, A, Schirmer, T, Guggenberger, R, Chhabra, A, Carrino, JA & Andreisek, G 2013, 'Quantification of muscle fat in patients with low back pain: Comparison of multi-echo MR imaging with single-voxel MR spectroscopy', Radiology, vol. 266, no. 2, pp. 555-563. https://doi.org/10.1148/radiol.12120399
Fischer, Michael A. ; Nanz, Daniel ; Shimakawa, Ann ; Schirmer, Timo ; Guggenberger, Roman ; Chhabra, Avneesh ; Carrino, John A. ; Andreisek, Gustav. / Quantification of muscle fat in patients with low back pain : Comparison of multi-echo MR imaging with single-voxel MR spectroscopy. In: Radiology. 2013 ; Vol. 266, No. 2. pp. 555-563.
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abstract = "Purpose: To compare lumbar muscle fat-signal fractions derived from three-dimensional dual gradient-echo magnetic resonance (MR) imaging and multiple gradient-echo MR imaging with fractions from single-voxel MR spectroscopy in patients with low back pain. Materials and This prospective study had institutional review board ap-Methods: proval, and written informed consent was obtained from all study participants. Fifty-six patients (32 women; mean age, 52 years 6 15 [standard deviation]; age range, 20-79 years) with low back pain underwent standard 1.5-T MR imaging, which was supplemented by dual-echo MR imaging, multi-echo MR imaging, and MR spectroscopy to quantify fatty degeneration of bilateral lumbar multifidus muscles in a region of interest at the intervertebral level of L4 through L5. Fat-signal fractions were determined from signal intensities on fat-and water-only images from both imaging data sets (dual-echo and multi-echo fat-signal fractions without T2 * correction) or directly obtained, with additional T2 * correction, from multi-echo MR imaging. The results were compared with MR spectroscopic fractions. The Student t test and Bland-Altman plots were used to quantify agreement between fat-signal fractions derived from imaging and from spectroscopy. Results: In total, 102 spectroscopic measurements were obtained bilaterally (46 of 56) or unilaterally (10 of 56). Mean spectroscopic fat-signal fraction was 19.6 6 11.4 (range, 5.4-63.5). Correlation between spectroscopic and all imaging-based fat-signal fractions was statistically significant (R2 = 0.87-0.92; all P <.001). Mean dual-echo fat-signal fractions not corrected for T2* and multi-echo fat-signal fractions corrected for T2*significantly differed from spectroscopic fractions (both P <.01), but mean multi-echo fractions not corrected for T2* did not (P =.11). There was a small measurement bias of 0.5{\%} (95{\%} limits of agreement:26.0{\%}, 7.2{\%}) compared with spectroscopic fractions. Conclusion: Large-volume image-based (dual-echo and multi-echo MR imaging) and spectroscopic fat-signal fractions agree well, thus allowing fast and accurate quantification of muscle fat content in patients with low back pain.",
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AU - Fischer, Michael A.

AU - Nanz, Daniel

AU - Shimakawa, Ann

AU - Schirmer, Timo

AU - Guggenberger, Roman

AU - Chhabra, Avneesh

AU - Carrino, John A.

AU - Andreisek, Gustav

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N2 - Purpose: To compare lumbar muscle fat-signal fractions derived from three-dimensional dual gradient-echo magnetic resonance (MR) imaging and multiple gradient-echo MR imaging with fractions from single-voxel MR spectroscopy in patients with low back pain. Materials and This prospective study had institutional review board ap-Methods: proval, and written informed consent was obtained from all study participants. Fifty-six patients (32 women; mean age, 52 years 6 15 [standard deviation]; age range, 20-79 years) with low back pain underwent standard 1.5-T MR imaging, which was supplemented by dual-echo MR imaging, multi-echo MR imaging, and MR spectroscopy to quantify fatty degeneration of bilateral lumbar multifidus muscles in a region of interest at the intervertebral level of L4 through L5. Fat-signal fractions were determined from signal intensities on fat-and water-only images from both imaging data sets (dual-echo and multi-echo fat-signal fractions without T2 * correction) or directly obtained, with additional T2 * correction, from multi-echo MR imaging. The results were compared with MR spectroscopic fractions. The Student t test and Bland-Altman plots were used to quantify agreement between fat-signal fractions derived from imaging and from spectroscopy. Results: In total, 102 spectroscopic measurements were obtained bilaterally (46 of 56) or unilaterally (10 of 56). Mean spectroscopic fat-signal fraction was 19.6 6 11.4 (range, 5.4-63.5). Correlation between spectroscopic and all imaging-based fat-signal fractions was statistically significant (R2 = 0.87-0.92; all P <.001). Mean dual-echo fat-signal fractions not corrected for T2* and multi-echo fat-signal fractions corrected for T2*significantly differed from spectroscopic fractions (both P <.01), but mean multi-echo fractions not corrected for T2* did not (P =.11). There was a small measurement bias of 0.5% (95% limits of agreement:26.0%, 7.2%) compared with spectroscopic fractions. Conclusion: Large-volume image-based (dual-echo and multi-echo MR imaging) and spectroscopic fat-signal fractions agree well, thus allowing fast and accurate quantification of muscle fat content in patients with low back pain.

AB - Purpose: To compare lumbar muscle fat-signal fractions derived from three-dimensional dual gradient-echo magnetic resonance (MR) imaging and multiple gradient-echo MR imaging with fractions from single-voxel MR spectroscopy in patients with low back pain. Materials and This prospective study had institutional review board ap-Methods: proval, and written informed consent was obtained from all study participants. Fifty-six patients (32 women; mean age, 52 years 6 15 [standard deviation]; age range, 20-79 years) with low back pain underwent standard 1.5-T MR imaging, which was supplemented by dual-echo MR imaging, multi-echo MR imaging, and MR spectroscopy to quantify fatty degeneration of bilateral lumbar multifidus muscles in a region of interest at the intervertebral level of L4 through L5. Fat-signal fractions were determined from signal intensities on fat-and water-only images from both imaging data sets (dual-echo and multi-echo fat-signal fractions without T2 * correction) or directly obtained, with additional T2 * correction, from multi-echo MR imaging. The results were compared with MR spectroscopic fractions. The Student t test and Bland-Altman plots were used to quantify agreement between fat-signal fractions derived from imaging and from spectroscopy. Results: In total, 102 spectroscopic measurements were obtained bilaterally (46 of 56) or unilaterally (10 of 56). Mean spectroscopic fat-signal fraction was 19.6 6 11.4 (range, 5.4-63.5). Correlation between spectroscopic and all imaging-based fat-signal fractions was statistically significant (R2 = 0.87-0.92; all P <.001). Mean dual-echo fat-signal fractions not corrected for T2* and multi-echo fat-signal fractions corrected for T2*significantly differed from spectroscopic fractions (both P <.01), but mean multi-echo fractions not corrected for T2* did not (P =.11). There was a small measurement bias of 0.5% (95% limits of agreement:26.0%, 7.2%) compared with spectroscopic fractions. Conclusion: Large-volume image-based (dual-echo and multi-echo MR imaging) and spectroscopic fat-signal fractions agree well, thus allowing fast and accurate quantification of muscle fat content in patients with low back pain.

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