Assessment of glycosaminoglycan distribution in human lumbar intervertebral discs using chemical exchange saturation transfer

Abstract

OBJECTIVE: Low back pain is a global concern with tremendous socioeconomic implications which may severely diminish functional activity, decrease quality of life, lead to loss of wages, and increase health-care costs [1]. Intervertebral disc (IVD) degeneration is a factor strongly associated with low back pain. Composed of a central nucleus pulposus (NP) rich in proteoglycan (PG) content (protein core with glycosaminoglycans (GAGs)) and an outer fibrous annulus fibrosus (AF), the IVD has been noted to degenerate as characterized by biochemical and morphological changes [2-3]. Loss of GAGs is known as an initiating factor in degenerative disc disease (DDD), followed by the reduction of the osmotic pressure and shrinkage of the disc height as a consequence. As it has been suggested that treatment can only stop disc degeneration but not reverse it, it is essential to diagnose early degenerative changes at the stage of GAGs loss by non-invasively quantifying the GAGs content. This is not possible using the sequences currently used in routine practice. Recent studies have proposed that chemical exchange saturation transfer (CEST) can be specific for ...