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January 2015

Future Applications of MRI Imaging in Spinecare

Spinecare of the future will be integrated, predictive, personalized, and preventive all of which will be influenced by diagnostic imaging methods. Magnetic resonance imaging of the spine will likely remain the single best diagnostic imaging study for evaluating the soft tissues of the spine such as the intervertebral disc, the spinal cord, ligaments and spinal muscles. New MRI protocol, software driven data manipulation is allowing us to look at the spine in ways never before achieved with other forms of imaging. Magnetic resonance spectroscopy (MRS), a specialized form of MRI is a non-invasive imaging technique which currently being performed during a routine MRI examination to evaluate the presence of chemicals in the brain as well as other tissues. It is most often used in the field of neurology to help characterize some brain tumors.

In the near future molecular imaging techniques will become routine methods for assessing molecular and cellular processes in spinecare. There are many different imaging techniques which can be used for molecular imaging such as radiotracer imaging/nuclear medicine, magnetic resonance imaging, magnetic resonance spectroscopy, optical imaging, and ultrasound. Dr David Durrant, a board certified chiropractic neurologist and Director of the Chicago Neuroscience Institute states that “MRS will likely emerge as one of the most practical methods of detecting early stage spinal cord compromise (in vivo).â€? He further acklowedges that “MRS may allow us view chemical changes in the spinal cord which might help predict the development of neurological deficits,  a step which will encourage early intervention and reduce the risk for long term disabilityâ€?. Dr. Durrant is a founding member of the American Academy of Spine Physicians (AASP), and is currently a PhD candidate in Health Services with interest in the neurological applications of molecular imaging. MRS allows for the regional evaluation of chemicals in a manner which cannot be detected with the use of routine blood testing.

If some of the current technical challenges are overcome MRS will soon be used to reveal the underlying biology of aging and disease processes in the spine. The findings will help personalize a patient’s care. The combination of MRI with MRS will yield the relationship between structure and molecular biochemistry in ways we can not achieve through other diagnostic methods. MRS is currently being used to assess biomarkers and biochemical relationships within neurological tissue of the brain, brainstem, and in research settings spinal cord regions. In the future it will likely be used to perform “in vivo� chemical mapping of the intervertebral disc, the vertebral body (bone marrow) and for characterizing spinal tumors. MRS can serve as a needless biopsy and help detect disease before structural abnormalities become evident on more routine forms of imaging.

When MRI and MRS studies are performed together we learn more about how the tissue looks and what is going on chemically within the tissue. Dr. Durrant reminds us that “a shift in chemistry often precedes the development of structural pathology; therefore, MRS may be used in the future to help identify early stage pathology and pre-disease states�.


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