Limits...
Diffusion-Weighted Imaging for Pretreatment Evaluation and Prediction of Treatment Effect in Patients Undergoing CT-Guided Injection for Lumbar Disc Herniation.

Niu XK, Bhetuwal A, Yang HF - Korean J Radiol (2015)

Bottom Line: The ADC index and ODI recovery ratio was significantly correlated (r = 0.819, p < 0.001).When using 7.10 as the cut-off value, the ADC index obtained a sensitivity of 86.3% and a specificity of 82.9% for predicting successful response to therapy around the first month of follow-up.This preliminary study demonstrates that the patients with decreased ADC index tend to show poor improvement of clinical symptoms.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Affiliated Hospital of Chengdu University, Chengdu, Sichuan Province 610000, China.

ABSTRACT

Objective: To determine whether a change in apparent diffusion coefficient (ADC) value could predict early response to CT-guided Oxygen-Ozone (O2-O3) injection therapy in patients with unilateral mono-radiculopathy due to lumbar disc herniation.

Materials and methods: A total of 52 patients with unilateral mono-radiculopathy received a single intradiscal (3 mL) and periganglionic (5 mL) injection of an O2-O3 mixture. An ADC index of the involved side to the intact side was calculated using the following formula: pre-treatment ADC index = ([ADC involved side - ADC intact side] / ADC intact side) × 100. We analyzed the relationship between the pre-treatment Oswestry Disability Index (ODI) and the ADC index. In addition, the correlation between ODI recovery ratio and ADC index was investigated. The sensitivity and specificity of the ADC index for predicting response in O2-O3 therapy was determined.

Results: Oswestry Disability Index and the ADC index was not significantly correlated (r = -0.125, p = 0.093). The ADC index and ODI recovery ratio was significantly correlated (r = 0.819, p < 0.001). When using 7.10 as the cut-off value, the ADC index obtained a sensitivity of 86.3% and a specificity of 82.9% for predicting successful response to therapy around the first month of follow-up.

Conclusion: This preliminary study demonstrates that the patients with decreased ADC index tend to show poor improvement of clinical symptoms. The ADC index may be a useful indicator to predict early response to CT-guided O2-O3 injection therapy in patients with unilateral mono-radiculopathy due to lumbar disc herniation.

No MeSH data available.


Related in: MedlinePlus

50-year-old female patient with right-sided sciatica.A. Transaxial diffusion-weighted image at b = 0 s/mm2. B. Transaxial diffusion-weighted image at b = 1000 s/mm2. Measurement of signal intensity in region of interest (red circle).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4499553&req=5

Figure 2: 50-year-old female patient with right-sided sciatica.A. Transaxial diffusion-weighted image at b = 0 s/mm2. B. Transaxial diffusion-weighted image at b = 1000 s/mm2. Measurement of signal intensity in region of interest (red circle).

Mentions: After transferring DWI data to GE advantage workstation 4.4 (GE Healthcare), circular regions of interest (ROIs) were placed in anatomical locations on the most significant levels for spinal disorders, by using b = 0 and b = 1000 images. The mean values from the ROI were measured in each nerve root (Fig. 2). To assess inter-observer variability, two neuroradiologists, each with more than 5 years of experience (7 and 8 years of experience, respectively), independently reviewed the initial and repeat MRI datasets. For both datasets, each rater was instructed to select the image slices that provided maximal transverse cross-sectional area of each nerve root to be measured. ADC was calculated from the mean value of the appropriate ROI using the following formula: ADC = (SIb = 1000 - SIb = 0) / 1000 (SIb = 1000, SIb = 0: mean value in ROI, respectively, indicates b = 1000 and b = 0). The index of the involved side to the intact side of ADC (ADC index) was calculated using the following formula: ADC index = ([ADC involved side - ADC intact side] / ADC intact side) × 100.


Diffusion-Weighted Imaging for Pretreatment Evaluation and Prediction of Treatment Effect in Patients Undergoing CT-Guided Injection for Lumbar Disc Herniation.

Niu XK, Bhetuwal A, Yang HF - Korean J Radiol (2015)

50-year-old female patient with right-sided sciatica.A. Transaxial diffusion-weighted image at b = 0 s/mm2. B. Transaxial diffusion-weighted image at b = 1000 s/mm2. Measurement of signal intensity in region of interest (red circle).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4499553&req=5

Figure 2: 50-year-old female patient with right-sided sciatica.A. Transaxial diffusion-weighted image at b = 0 s/mm2. B. Transaxial diffusion-weighted image at b = 1000 s/mm2. Measurement of signal intensity in region of interest (red circle).
Mentions: After transferring DWI data to GE advantage workstation 4.4 (GE Healthcare), circular regions of interest (ROIs) were placed in anatomical locations on the most significant levels for spinal disorders, by using b = 0 and b = 1000 images. The mean values from the ROI were measured in each nerve root (Fig. 2). To assess inter-observer variability, two neuroradiologists, each with more than 5 years of experience (7 and 8 years of experience, respectively), independently reviewed the initial and repeat MRI datasets. For both datasets, each rater was instructed to select the image slices that provided maximal transverse cross-sectional area of each nerve root to be measured. ADC was calculated from the mean value of the appropriate ROI using the following formula: ADC = (SIb = 1000 - SIb = 0) / 1000 (SIb = 1000, SIb = 0: mean value in ROI, respectively, indicates b = 1000 and b = 0). The index of the involved side to the intact side of ADC (ADC index) was calculated using the following formula: ADC index = ([ADC involved side - ADC intact side] / ADC intact side) × 100.

Bottom Line: The ADC index and ODI recovery ratio was significantly correlated (r = 0.819, p < 0.001).When using 7.10 as the cut-off value, the ADC index obtained a sensitivity of 86.3% and a specificity of 82.9% for predicting successful response to therapy around the first month of follow-up.This preliminary study demonstrates that the patients with decreased ADC index tend to show poor improvement of clinical symptoms.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Affiliated Hospital of Chengdu University, Chengdu, Sichuan Province 610000, China.

ABSTRACT

Objective: To determine whether a change in apparent diffusion coefficient (ADC) value could predict early response to CT-guided Oxygen-Ozone (O2-O3) injection therapy in patients with unilateral mono-radiculopathy due to lumbar disc herniation.

Materials and methods: A total of 52 patients with unilateral mono-radiculopathy received a single intradiscal (3 mL) and periganglionic (5 mL) injection of an O2-O3 mixture. An ADC index of the involved side to the intact side was calculated using the following formula: pre-treatment ADC index = ([ADC involved side - ADC intact side] / ADC intact side) × 100. We analyzed the relationship between the pre-treatment Oswestry Disability Index (ODI) and the ADC index. In addition, the correlation between ODI recovery ratio and ADC index was investigated. The sensitivity and specificity of the ADC index for predicting response in O2-O3 therapy was determined.

Results: Oswestry Disability Index and the ADC index was not significantly correlated (r = -0.125, p = 0.093). The ADC index and ODI recovery ratio was significantly correlated (r = 0.819, p < 0.001). When using 7.10 as the cut-off value, the ADC index obtained a sensitivity of 86.3% and a specificity of 82.9% for predicting successful response to therapy around the first month of follow-up.

Conclusion: This preliminary study demonstrates that the patients with decreased ADC index tend to show poor improvement of clinical symptoms. The ADC index may be a useful indicator to predict early response to CT-guided O2-O3 injection therapy in patients with unilateral mono-radiculopathy due to lumbar disc herniation.

No MeSH data available.


Related in: MedlinePlus