European Radiology

, Volume 29, Issue 12, pp 6443–6446 | Cite as

MRI identifies biochemical alterations of intervertebral discs in patients with low back pain and radiculopathy

  • Tina Pulickal
  • Johannes BoosEmail author
  • Markus Konieczny
  • Lino Morris Sawicki
  • Anja Müller-Lutz
  • Bernd Bittersohl
  • Joachim Gerß
  • Markus Eichner
  • Hans-Jörg Wittsack
  • Gerald Antoch
  • Christoph Schleich
Letter to the Editor

Key Points

Molecular intervertebral disc damage was associated with LBP and radiculopathy.

Patients with radiculopathy and LBP demonstrated a depletion of gagCEST values compared with healthy controls.

GagCEST imaging may be a non-invasive tool for investigation of degeneration processes of lumbar intervertebral discs (IVDs). GagCEST imaging may be an imaging biomarker for biochemical IVD alterations.



Annulus fibrosus


Body mass index


Chemical exchange saturation transfer




Glycosaminoglycan chemical exchange saturation transfer


Intervertebral disc


Lower back pain


Magnetic resonance imaging


Nucleus pulposus




Region of interest


Asymmetric spin-lock ratio


Visual analogue scale


Water Saturation and B1


World Health Organization



We would like to thank Erika Rädisch for the assistance in receiving the MRI scans.


The authors state that this work has not received any funding.

Compliance with ethical standards


The scientific guarantor of this publication is C. Schleich.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

Joachim Gerß (Institute of Biostatistics and Clinical Research, University of Muenster, Muenster, Germany) kindly provided statistical advice for this manuscript.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was obtained.


• prospective

• diagnostic or prognostic study

• performed at one institution

Supplementary material

330_2019_6305_MOESM1_ESM.docx (6.7 mb)
ESM 1 (DOCX 6862 kb)


  1. 1.
    Hoy D, March L, Brooks P et al (2014) The global burden of low back pain: estimates from the Global Burden of Disease 2010 study. Ann Rheum Dis 73:968–974CrossRefGoogle Scholar
  2. 2.
    Bendix T, Kjaer P, Korsholm L (2008) Burned-out discs stop hurting: fact or fiction? Spine (Phila Pa 1976) 33:E962–E967CrossRefGoogle Scholar
  3. 3.
    Videman T, Battié MC, Gibbons LE, Maravilla K, Manninen H, Kaprio J (2003) Associations between back pain history and lumbar MRI findings. Spine (Phila Pa 1976) 28:582–588Google Scholar
  4. 4.
    An HS, Anderson PA, Haughton VM et al (2004) Introduction: disc degeneration: summary. Spine (Phila Pa 1976) 29:2677–2678CrossRefGoogle Scholar
  5. 5.
    Müller-Lutz A, Ljimani A, Stabinska J et al (2018) Comparison of B0 versus B0 and B1 field inhomogeneity correction for glycosaminoglycan chemical exchange saturation transfer imaging. MAGMA.
  6. 6.
    Millecamps M, Stone LS (2018) Delayed onset of persistent discogenic axial and radiating pain following a single level lumbar intervertebral disc injury in mice. Pain 159:1843–1855Google Scholar
  7. 7.
    Munir S, Freidin MB, Rade M, Määttä J, Livshits G, Williams FMK (2018) Endplate defect is heritable, associated with low back pain and triggers intervertebral disc degeneration: a longitudinal study from twins UK. Spine (Phila Pa 1976).
  8. 8.
    Urban JP, Winlove CP (2007) Pathophysiology of the intervertebral disc and the challenges for MRI. J Magn Reson Imaging 25:419–432CrossRefGoogle Scholar
  9. 9.
    Schleich C, Müller-Lutz A, Eichner M et al (2016) Glycosaminoglycan chemical exchange saturation transfer of lumbar intervertebral discs in healthy volunteers. Spine (Phila Pa 1976) 41:146–152CrossRefGoogle Scholar
  10. 10.
    McDonald RJ, McDonald JS, Kallmes DF et al (2017) Gadolinium deposition in human brain tissues after contrast-enhanced MR imaging in adult patients without intracranial abnormalities. Radiology.

Copyright information

© European Society of Radiology 2019

Authors and Affiliations

  • Tina Pulickal
    • 1
  • Johannes Boos
    • 1
    Email author
  • Markus Konieczny
    • 2
  • Lino Morris Sawicki
    • 1
  • Anja Müller-Lutz
    • 1
  • Bernd Bittersohl
    • 2
  • Joachim Gerß
    • 3
  • Markus Eichner
    • 1
  • Hans-Jörg Wittsack
    • 1
  • Gerald Antoch
    • 1
  • Christoph Schleich
    • 1
  1. 1.Medical Faculty, Department of Diagnostic and Interventional RadiologyUniversity DusseldorfDusseldorfGermany
  2. 2.Medical Faculty, Department of OrthopedicsUniversity DusseldorfDusseldorfGermany
  3. 3.Institute of Biostatistics and Clinical ResearchUniversity of MuensterMuensterGermany

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