Gender, BMI and T2 dependencies of glycosaminoglycan chemical exchange saturation transfer in intervertebral discs

Purpose: The purpose was to investigate the dependence of glycosaminoglycan chemical exchange saturation transfer (gagCEST) effect of lumbar intervertebral discs (IVD) on gender, body mass index and T2 value.

Methods: T2 imaging and gagCEST imaging was performed in 34 healthy volunteers (17 males, 17 females) without low back pain at a 3T MRI system (Magnetom Trio, A Tim System, Siemens Healthcare, Erlangen, Germany). The body mass index was determined for each volunteer. The mean and standard deviation of MTRasym and T2 values were calculated for nucleus pulposus (NP) and annulus fibrosus (AF) as descriptive statistics for females and males. An unpaired student's t-test was applied in order to validate obtained differences. Pearson correlation was determined in order to reveal, if gagCEST effect and T2 values decrease with increasing body mass index (BMI). Pearson correlation analysis was additionally performed between gagCEST and T2 values.

Results: GagCEST effect and T2 values were significantly higher in females compared to males [gagCEST effect (nucleus pulposus, females)=3.58±1.49%; gagCEST effect (nucleus pulosus, males)=3.01±1.63%, p-value (gagCEST effect, nucleus pulposus)=0.02); T2 (nucleus pulposus, females)=134.56±30.27 ms, T2 (nucleus pulposus, males)=122.35±27.64 ms, p-value (T2, nucleus pulposus)=0.01)]. Pearson correlation analysis showed a significant negative relation between BMI and gagCEST effect (nucleus pulposus: ρ=-0.16, p=0.03) and between BMI and T2 values (nucleus pulposus: ρ=-0.30, p<0.01). The correlation between gagCEST effect and T2-values was highly significant (nucleus pulposus: ρ=0.59, p<0.01).

Conclusions: Significantly lower gagCEST effects were found in males compared to females and with increased body mass index. The gagCEST effect was highly correlated with quantitative T2 imaging.