title: Comparison of apparent diffusion coefficient in spondylarthritis axial active inflammatory lesions and type 1 Modic changes.
abstract: OBJECTIVE
  The goal of this study was to evaluate whether the values of ADC in spondylarthritis axial active inflammatory lesions are different from ADC values in type 1 Modic changes.
  
  
  METHODS
  95 patients with recent lumbar pain, including 46 patients with diagnosed or suspected spondylarthritis and 49 patients with purely degenerative history, underwent spine MRI. T1w, STIR, and diffusion-weighted images (DWI) were obtained. Two musculoskeletal radiologists interpreted the images. Axial active inflammatory lesions from the SpA group and type 1 Modic changes from the degenerative group were identified on T1w and STIR sequences. ADC values from these lesions and from healthy subchondral bone were compared.
  
  
  RESULTS
  All axial active inflammatory lesions (n=27) and type 1 Modic changes (n=22) identified in T1w and STIR images were visible on DWI. ADC values were significantly higher (p<0.05) for axial active inflammatory lesions (median=0.788×10(-3)mm(2)/s, IQR 25-75 [0.7×10(-3)mm(2)/s; 0.9×10(-3)mm(2)/s]) than for type 1 Modic changes (median=0.585×10(-3)mm(2)/s, IQR 25-75 [0.55×10(-3)mm(2)/s; 0.60×10(-3)mm(2)/s]) and normal subchondral bone (median=0.443×10(-3)mm(2)/s, IQR 25-75 [0.40×10(-3)mm(2)/s; 0.50×10(-3)mm(2)/s]). Intra-class correlation coefficients for intra- and inter-reader ADC values comparison were excellent (0.89 and 0.98 respectively).
  
  
  CONCLUSIONS
  DWI is a sensitive and fast sequence that offer the possibility of quantifying diffusion coefficients of the lesions, which could help to discriminate between spondylarthritis axial active inflammatory and type 1 Modic changes.
authors.affiliation: Hôpital Bichat - Claude Bernard, Service de Radiologie, 46, rue Henri Huchard, Paris 75018, France; Hôpital Bichat - Claude Bernard, Inserm U698, 46, rue Henri Huchard, Paris 75018, France; Université Paris Diderot, Paris, France. Electronic address: benjamin.dallaudiere@gmail.com.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Dallaudière
authors.affiliation: Hôpital Bichat - Claude Bernard, Service de Radiologie, 46, rue Henri Huchard, Paris 75018, France; Université Paris Diderot, Paris, France. Electronic address: raphael_dautry@yahoo.fr.
authors.forename: Raphaël
authors.initials: R
authors.lastname: Dautry
authors.affiliation: Faculté de Médecine de Limoges, Unité fonctionelle de recherche clinique et de biostatistique, hôpital Le Cluzeau, 23, avenue Dominique Larrey, 87042 Limges Cedex, France. Electronic address: pierre-marie.preux@unilim.fr.
authors.forename: Pierre-Marie
authors.initials: PM
authors.lastname: Preux
authors.affiliation: Université Paris Diderot, Paris, France; Hôpital Bichat - Claude Bernard, Unité de recherche clinique, 46, rue Henri Huchard, Paris 75018, France. Electronic address: aperozziello@gmail.com.
authors.forename: Anne
authors.initials: A
authors.lastname: Perozziello
authors.affiliation: Hôpital Bichat - Claude Bernard, Service de Radiologie, 46, rue Henri Huchard, Paris 75018, France. Electronic address: julienlincot@gmail.com.
authors.forename: Julien
authors.initials: J
authors.lastname: Lincot
authors.affiliation: Hôpital Bichat - Claude Bernard, Service de Radiologie, 46, rue Henri Huchard, Paris 75018, France; Université Paris Diderot, Paris, France. Electronic address: elisabeth.schouman-claeys@bch.aphp.fr.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Schouman-Claeys
authors.affiliation: Hôpital Bichat - Claude Bernard, Service de Radiologie, 46, rue Henri Huchard, Paris 75018, France; Hôpital Bichat - Claude Bernard, Inserm U698, 46, rue Henri Huchard, Paris 75018, France; Université Paris Diderot, Paris, France. Electronic address: jeanmichelserfatybch@gmail.com.
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Serfaty
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013167:Spondylitis, Ankylosing / Q000145:classification* / Q000473:pathology*
keywords: ADC; ASAS/OMERACT; Apparent diffusion coefficient; Assessment of Spondylarthritis International Society/Outcome Measures in Rheumatoid Arthritis Clinical Trials; DCE-MRI; DWI; Diffusion weighted imaging; Modic change; ROI; SpA; Spondylarthritis; Spondylitis; T1 weighted; T1w; apparent diffusion coefficient; diffusion weighted imaging; dynamic contrast-enhanced MRI; region of interest; spondylarthritis