Lumbar Spine: Reliability of MR Imaging Findings

Carrino, John A.; Lurie, Jon D.; Tosteson, Anna N.A.; Tosteson, Tor D.; Carragee, Eugene J.; Kaiser, Jay A.; Grove, Margaret R.; Blood, Emily A.; Pearson, Loretta H.; Weinstein, James Neil; Herzog, Richard J.

doi:10.1148/radiol.2493071999

Cited by 171 publications

(138 citation statements)

References 26 publications

(33 reference statements)

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“…Modic changes were evaluated according to the Modic classification system: Type 1-Hypointense T1 signal and hyperintense T2 signal, Type 2-Hyperintense T1 signal and iso or slightly hyperintense T2 signal [9].…”

Section: Magnetic Resonance Imaging (Mri)mentioning

confidence: 99%

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Are Modic changes prognostic for recovery in a cohort of patients with non-specific low back pain?

et al. 2011

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Background There is evidence for an association between Modic type 1 and pain in patients with low back pain (LBP), but little knowledge about its effect on clinical outcomes. Purpose (1) To assess the prevalence of Modic changes, (2) to determine if Modic changes influence the clinical course of LBP, and (3) to identify prognostic factors for recovery. Study design/setting Prospective clinical cohort study, with a 1-year follow-up. The treatment consisted of brief intervention and instruction in stretching. Patient's sample Two hundred and sixty-nine patients with chronic low back pain. Outcome measures Socio-demographic variables, education, profession, self-reported measures, degenerative changes on MRI. Methods Linear growth model and Cox regression analysis.Results Five percent had a normal MRI, 14 and 50% had Modic 1 and Modic 2 changes. Modic changes were not significant covariates for the clinical course of pain, function or fear avoidance beliefs. Education was a strong prognostic factor for recovery. Conclusions Modic changes did not influence the clinical course of back pain and were not prognostic factors for recovery. Education was strongly associated with recovery.

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Section: Magnetic Resonance Imaging (Mri)mentioning

confidence: 99%

“…A posterior HIZ was defined as an area of high signal intensity in the posterior annulus fibrosus that was brighter than nucleus pulposus on T2-weighted images [9].…”

Section: Magnetic Resonance Imaging (Mri)mentioning

confidence: 99%

Are Modic changes prognostic for recovery in a cohort of patients with non-specific low back pain?

et al. 2011

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“…Gorbach et al [23] found the extent of facet joint arthropathy defined anatomically on MRI and CT was not a significant predictor for outcome in a cohort of 42 patients undergoing facet joint blocks (p=0.57-0.95). Carrino et al [25] used weighted Kappa statistics for measuring interobserver agreement between four specialist readers of MR lumbar spine for facet arthropathy in 111 scans and found inter-observer variability of 0.54 (CI 95 %, 0.50-0.57). Inconsistent interobserver variability suggests that the test does not provide an easily interpretable assessment and both MRI and CT reports can be inconclusive regarding the presence or absence of facetal arthropathy.…”

Section: Discussionmentioning

confidence: 99%

Is hybrid imaging (SPECT/CT) a useful adjunct in the management of suspected facet joints arthropathy?

Matar

Navalkissoor

Berovic

et al. 2013

International Orthopaedics (SICOT)

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Purpose The purpose of this study was to assess the value of SPECT/CT imaging in patients with chronic spinal pain. Methods This was a retrospective consecutive study. Patients with chronic neck or back pain from outpatient spinal clinics with clinical features raising the possibility of a facetogenic pain generator and non-conclusive MRI/CT findings were included. Imaging was performed on a dual-headed, hybrid SPECT/CT γ-camera with a low-dose CT transmission scan acquired after the SPECT study. SPECT/CT studies were viewed in the coronal, axial, and sagittal planes and in 3-dimensional mode. Descriptive statistical analysis was performed.Results Seventy-two patients were included (37 females, 35 males, mean age of 53.9 years). There were 25 cervical spine scans and 49 lumbar spine scans. In the cervical spine group, 13 (52 %) patients had scintigraphically active cervical facet joint arthropathy and ten (36 %) had other pathology identified. Two thirds of patients diagnosed with facet joint arthropathy received steroid guided injections following their scans. In the lumbar spine group 34 (69.4 %) patients had scintigraphically active lumbar facet joint arthropathy and eight had other pathology identified. Twenty patients (58.8 %) diagnosed with facet joint arthropathy subsequently received steroid guided injections. Conclusions Hybrid SPECT/CT imaging identified potential pain generators in 92 % of cervical spine scans and 86 % of lumbar spine scans. The scan precisely localised SPECT positive facet joint targets in 65 % of the referral population and a clinical decision to inject was made in 60 % of these cases.

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“…In the clinical practice of radiology, consensus, when interpreting the medical image, is hardly ever reached, especially with diagnostic tests where interpreted components are subjective. Several studies showed substantial observer variability not only among non-specialized radiologists during standard clinical reporting [2,3], but also at the expert level of image interpretation [4,5].…”

Section: Introductionmentioning

confidence: 99%

Consensus Versus Disagreement in Imaging Research: a Case Study Using the LIDC Database

et al. 2011

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Traditionally, image studies evaluating the effectiveness of computer-aided diagnosis (CAD) use a single label from a medical expert compared with a single label produced by CAD. The purpose of this research is to present a CAD system based on Belief Decision Tree classification algorithm, capable of learning from probabilistic input (based on intra-reader variability) and providing probabilistic output. We compared our approach against a traditional decision tree approach with respect to a traditional performance metric (accuracy) and a probabilistic one (area under the distance-threshold curve-AuC dt ). The probabilistic classification technique showed notable performance improvement in comparison with the traditional one with respect to both evaluation metrics. Specifically, when applying crossvalidation technique on the training subset of instances, boosts of 28.26% and 30.28% were noted for the probabilistic approach with respect to accuracy and AuC dt , respectively. Furthermore, on the validation subset of instances, boosts of 20.64% and 23.21% were noted again for the probabilistic approach with respect to the same two metrics. In addition, we compared our CAD system results with diagnostic data available for a small subset of the Lung Image Database Consortium database. We discovered that when our CAD system errs, it generally does so with low confidence. Predictions produced by the system also agree with diagnoses of truly benign nodules more often than radiologists, offering the possibility of reducing the false positives.

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Lumbar Spine: Reliability of MR Imaging Findings

Cited by 171 publications

References 26 publications

Are Modic changes prognostic for recovery in a cohort of patients with non-specific low back pain?

Are Modic changes prognostic for recovery in a cohort of patients with non-specific low back pain?

Is hybrid imaging (SPECT/CT) a useful adjunct in the management of suspected facet joints arthropathy?

Consensus Versus Disagreement in Imaging Research: a Case Study Using the LIDC Database

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