T1? MRI AS A QUANTITATIVE BIOMARKER OF DISC DEGENERATION IN VIVO

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. Primary support for the subproject and the subproject's principal investigator may have been provided by other sources, including other NIH sources. The Total Cost listed for the subproject likely represents the estimated amount of Center infrastructure utilized by the subproject, not direct funding provided by the NCRR grant to the subproject or subproject staff. Healthy intervertebral discs rely on diffusion to transport nutrients and waste products between the surrounding blood vessels and the ordered collagen fibers of the annulus fibrosus (AF), to the central gel-like nucleus pulposus (NP). Age related degradation is marked by a loss of the gel-like consistency of the NP including decreased proteoglycan (PG) content and decreased water concentration. Degenerated intervertebral discs are marked by structural failure and accelerated aging, and when painful, are considered to have degenerate disc disease (DDD). The later stages of DDD are characterized by an NP indistinguishable from AF and a collapsed disc space. DDD is a common cause of lower back pain (LBP). Due to the lack of a proper gold standard, the presence of pain in each disc is currently determined by provocative discography. The technique relies on the patients' subjective perception of pain as a needle is inserted into the disc. We believe a more reliable, objective, and non-invasive determinant of pain in degenerate discs will improve patient care. Towards this goal, we evaluated the predictability of disc pain in LBP patients by fusing T1¿ with disc height ratio (DHR) measurements. The DHR, the average disc height normalized by the width of the disc, can be measured from conventional MRI, and provides a measure of disease progression. While disc height (to width) ratio is a measure of disc quality, it may also be a potential predictor of individual disc pain. The non-invasive technique of T1¿ MRI may be advantageous in objectively detecting DDD at an earlier stage than the DHR, since it is sensitive to biochemical changes in the tissue that precede disc height changes.