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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

Relationship between ADC index and ODI recovery ratio.Statistically positive correlation was observed (r = 0.819, p < 0.001). ADC = apparent diffusion coefficient, ODI = Oswestry Disability Index
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Figure 5: Relationship between ADC index and ODI recovery ratio.Statistically positive correlation was observed (r = 0.819, p < 0.001). ADC = apparent diffusion coefficient, ODI = Oswestry Disability Index

Mentions: Inter-observer agreement of confidence levels for each reader was adequate for ADC measurement (ICC = 0.834, 95% confidence interval [CI] = 0.776 to 0.917). Thirty-six patients out of 52 had successful outcomes (responders), whereas sixteen patients showed unsatisfactory outcomes (non-responders) during the follow-up period of first month. The mean ADC index of responders was 13.022 ± 9.946, which was higher than the -14.484 ± 12.756 of non-responders (p = 0.012) (Fig. 3). There was no correlation between the ADC index and ODI (r = -0.125, p = 0.093) (Fig. 4). Figure 5 shows the relationship between ADC index and ODI recovery ratio with procedure, where a statistically positive correlation was observed (r = 0.819, p < 0.001).


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)

Relationship between ADC index and ODI recovery ratio.Statistically positive correlation was observed (r = 0.819, p < 0.001). ADC = apparent diffusion coefficient, ODI = Oswestry Disability Index
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 5: Relationship between ADC index and ODI recovery ratio.Statistically positive correlation was observed (r = 0.819, p < 0.001). ADC = apparent diffusion coefficient, ODI = Oswestry Disability Index
Mentions: Inter-observer agreement of confidence levels for each reader was adequate for ADC measurement (ICC = 0.834, 95% confidence interval [CI] = 0.776 to 0.917). Thirty-six patients out of 52 had successful outcomes (responders), whereas sixteen patients showed unsatisfactory outcomes (non-responders) during the follow-up period of first month. The mean ADC index of responders was 13.022 ± 9.946, which was higher than the -14.484 ± 12.756 of non-responders (p = 0.012) (Fig. 3). There was no correlation between the ADC index and ODI (r = -0.125, p = 0.093) (Fig. 4). Figure 5 shows the relationship between ADC index and ODI recovery ratio with procedure, where a statistically positive correlation was observed (r = 0.819, p < 0.001).

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