TY - JOUR
T1 - Proton density fat fraction of the spinal column: an MRI cadaver study
AU - Losch, Merle S.
AU - Swamy, Akash
AU - Elmi-Terander, Adrian
AU - Edström, Erik
AU - Hendriks, Benno H. W.
AU - Dankelman, Jenny
N1 - Funding Information: This study was supported by NWO-TTW 17553. Funding Information: The authors very much appreciate the valuable insights into the image acquisition process provided by Stefan Ruschke at the BMRR group of the Technical University of Munich. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. Publisher Copyright: © 2021, The Author(s).
PY - 2021/12/1
Y1 - 2021/12/1
N2 - Background: The increased popularity of minimally invasive spinal surgery calls for a revision of guidance techniques to prevent injuries of nearby neural and vascular structures. Lipid content has previously been proposed as a distinguishing criterion for different bone tissues to provide guidance along the interface of cancellous and cortical bone. This study aims to investigate how fat is distributed throughout the spinal column to confirm or refute the suitability of lipid content for guidance purposes. Results: Proton density fat fraction (PDFF) was assessed over all vertebral levels for six human cadavers between 53 and 92 years of age, based on fat and water MR images. According to their distance to the vertebra contour, the data points were grouped in five regions of interest (ROIs): cortical bone (−1 mm to 0 mm), pre-cortical zone (PCZ) 1–3 (0–1 mm; 1–2 mm; 2–3 mm), and cancellous bone (≥ 3 mm). For PCZ1 vs. PCZ2, a significant difference in mean PDFF of between −7.59 pp and −4.39 pp on average was found. For cortical bone vs. PCZ1, a significant difference in mean PDFF of between −27.09 pp and −18.96 pp on average was found. Conclusion: A relationship between distance from the cortical bone boundary and lipid content could be established, paving the way for guidance techniques based on fat fraction detection for spinal surgery.
AB - Background: The increased popularity of minimally invasive spinal surgery calls for a revision of guidance techniques to prevent injuries of nearby neural and vascular structures. Lipid content has previously been proposed as a distinguishing criterion for different bone tissues to provide guidance along the interface of cancellous and cortical bone. This study aims to investigate how fat is distributed throughout the spinal column to confirm or refute the suitability of lipid content for guidance purposes. Results: Proton density fat fraction (PDFF) was assessed over all vertebral levels for six human cadavers between 53 and 92 years of age, based on fat and water MR images. According to their distance to the vertebra contour, the data points were grouped in five regions of interest (ROIs): cortical bone (−1 mm to 0 mm), pre-cortical zone (PCZ) 1–3 (0–1 mm; 1–2 mm; 2–3 mm), and cancellous bone (≥ 3 mm). For PCZ1 vs. PCZ2, a significant difference in mean PDFF of between −7.59 pp and −4.39 pp on average was found. For cortical bone vs. PCZ1, a significant difference in mean PDFF of between −27.09 pp and −18.96 pp on average was found. Conclusion: A relationship between distance from the cortical bone boundary and lipid content could be established, paving the way for guidance techniques based on fat fraction detection for spinal surgery.
KW - Bone detection
KW - Lipid content
KW - Magnetic resonance imaging
KW - Minimally invasive spine surgery
KW - Screw placement
UR - http://www.scopus.com/inward/record.url?scp=85098884231&partnerID=8YFLogxK
U2 - https://doi.org/10.1186/s12938-020-00846-4
DO - https://doi.org/10.1186/s12938-020-00846-4
M3 - Article
C2 - 33413458
SN - 1475-925X
VL - 20
JO - BioMedical Engineering OnLine
JF - BioMedical Engineering OnLine
IS - 1
M1 - 7
ER -