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Observational Study
. 2023 Dec;32(12):4428-4436.
doi: 10.1007/s00586-023-07936-6. Epub 2023 Sep 16.

Predictive value of texture analysis on lumbar MRI in patients with chronic low back pain

Vicente-Jose Climent-Peris  1 , Luís Martí-Bonmatí  2 , Alejandro Rodríguez-Ortega  3 , Julio Doménech-Fernández  4
Affiliations
Free article
Observational Study

Predictive value of texture analysis on lumbar MRI in patients with chronic low back pain

Vicente-Jose Climent-Peris et al. Eur Spine J. 2023 Dec.
Free article

Abstract

Purpose: The aim of this study was to determine whether MRI texture analysis could predict the prognosis of patients with non-specific chronic low back pain.

Methods: A prospective observational study was conducted on 100 patients with non-specific chronic low back pain, who underwent a conventional MRI, followed by rehabilitation treatment, and revisited after 6 months. Sociodemographic variables, numeric pain scale (NPS) value, and the degree of disability as measured by the Roland-Morris disability questionnaire (RMDQ), were collected. The MRI analysis included segmentation of regions of interest (vertebral endplates and intervertebral disks from L3-L4 to L5-S1, paravertebral musculature at the L4-L5 space) to extract texture variables (PyRadiomics software). The classification random forest algorithm was applied to identify individuals who would improve less than 30% in the NPS or would score more than 4 in the RMDQ at the end of the follow-up. Sensitivity, specificity, and the area under the ROC curve were calculated.

Results: The final series included 94 patients. The predictive model for classifying patients whose pain did not improve by 30% or more offered a sensitivity of 0.86, specificity 0.57, and area under the ROC curve 0.71. The predictive model for classifying patients with a RMDQ score 4 or more offered a sensitivity of 0.83, specificity of 0.20, and area under the ROC curve of 0.52.

Conclusion: The texture analysis of lumbar MRI could help identify patients who are more likely to improve their non-specific chronic low back pain through rehabilitation programs, allowing a personalized therapeutic plan to be established.

Keywords: Back pain; MRI; Radiomics; Texture analysis.

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