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Balanced Turbo Field Echo MRI as a radiation-free adjunct for spinal bone imaging: A prospective study of 526 patients.
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Soni Abhishek, Joseph Akhil Xavier, S Vidyadhara, T Balamurugan, Acharya Ullas V, Rao Sharath K
Аннотация
STUDY DESIGN: Single-centre, prospective, within-subject observational imaging-quality study with a single experienced reader.
AIMS & OBJECTIVES: To evaluate whether adding a 3D Balanced Turbo Field Echo (BTFE) sequence to routine 3T spine MRI improves visualization of osseous spinal pathology compared with conventional T1/T2-weighted MRI and plain radiographs.
MATERIALS & METHODS: Between March and November 2024, 526 consecutive adults underwent spine imaging including T1/T2-weighted and BTFE MRI on a 3T scanner plus plain radiographs; thin-section CT served as confirmatory reference in a small ligamentum flavum ossification (LFO) subgroup. Six osseous pathologies were scored: disc osteophyte complex, OPLL, LFO, spondylolisthesis, spondylolysis and vertebral fracture. A single senior consultant radiologist ( > 10 years' experience), blinded to other modalities and clinical details, graded visualization on a 3-point ordinal scale in separate, randomized, washed-out sessions. Modalities were compared per pathology with Friedman's test and Holm-corrected Wilcoxon post-hoc tests.
RESULTS: Mean age was 60.2 ± 11.8 years; 297 (56.5%) were female; thoraco-lumbar scans accounted for 454 (86.3%). Disc osteophyte was most common (n = 229, 43.5%). BTFE scored significantly higher than routine MRI and plain radiographs for every pathology (all p < 0.001 ). OPLL was invisible on radiographs but well delineated on BTFE. For LFO, BTFE meaningfully outperformed routine MRI, representing a radiation-free improvement over standard MRI practice.
CONCLUSION: Adding a widely available BTFE sequence to routine 3T spine MRI improved visualization of spinal osseous pathology without ionizing radiation. BTFE should be regarded as a candidate bone-imaging adjunct; head-to-head comparison with CT and with established CT-like MRI sequences (ZTE, FRACTURE, 3D FLASH, T1-spoiled gradient-echo, synthetic CT) is needed.
AIMS & OBJECTIVES: To evaluate whether adding a 3D Balanced Turbo Field Echo (BTFE) sequence to routine 3T spine MRI improves visualization of osseous spinal pathology compared with conventional T1/T2-weighted MRI and plain radiographs.
MATERIALS & METHODS: Between March and November 2024, 526 consecutive adults underwent spine imaging including T1/T2-weighted and BTFE MRI on a 3T scanner plus plain radiographs; thin-section CT served as confirmatory reference in a small ligamentum flavum ossification (LFO) subgroup. Six osseous pathologies were scored: disc osteophyte complex, OPLL, LFO, spondylolisthesis, spondylolysis and vertebral fracture. A single senior consultant radiologist ( > 10 years' experience), blinded to other modalities and clinical details, graded visualization on a 3-point ordinal scale in separate, randomized, washed-out sessions. Modalities were compared per pathology with Friedman's test and Holm-corrected Wilcoxon post-hoc tests.
RESULTS: Mean age was 60.2 ± 11.8 years; 297 (56.5%) were female; thoraco-lumbar scans accounted for 454 (86.3%). Disc osteophyte was most common (n = 229, 43.5%). BTFE scored significantly higher than routine MRI and plain radiographs for every pathology (all p < 0.001 ). OPLL was invisible on radiographs but well delineated on BTFE. For LFO, BTFE meaningfully outperformed routine MRI, representing a radiation-free improvement over standard MRI practice.
CONCLUSION: Adding a widely available BTFE sequence to routine 3T spine MRI improved visualization of spinal osseous pathology without ionizing radiation. BTFE should be regarded as a candidate bone-imaging adjunct; head-to-head comparison with CT and with established CT-like MRI sequences (ZTE, FRACTURE, 3D FLASH, T1-spoiled gradient-echo, synthetic CT) is needed.