Lumbar Modic Changes—A Comparison Between Findings at Low- and High-Field Magnetic Resonance Imaging

In Brief Study Design. A cross-sectional observational study. Objective. To investigate whether there is a difference in findings of lumbar Modic changes in low-field (0.3 T) magnetic resonance imaging (MRI) compared with high-field (1.5 T). Summary of Background Data. It is a challenge to give patients with low back pain a specific diagnosis. Modic changes as seen on MRI have been reported to be a possible source of pain. However, it is unclear whether the diagnosis is independent on the field strength. Methods. Twenty patients with Modic changes, 11 women and 9 men (mean age, 53.6 yr; range, 29–81 yr), with or without sciatica, seen in a Danish outpatient low back pain clinic were included. All patients obtained MRI scans on both a high-field and a low-field MRI scanner. Two radiologists evaluated all lumbar endplates independently, using a standardized evaluation protocol. Kappa statistics were used to analyze the interobserver reproducibility. We used paired t test to analyze the difference between low- and high-field MRI. Results. The total number of Modic changes diagnosed with high-field MRI was significantly higher than that with low-field MRI. However, 3 to 4 times as many Modic type 1 changes were found with low-field MRI compared with high-field MRI. Contrarily, with high-field MRI type 2 changes were diagnosed twice as often. Conclusion. There was a significant difference between low- and high-field MRI regarding the overall prevalence of any Modic change, but this had opposite directions for types 1 and 2: type 2 dominated in low field and conversely in high field. The type of MRI unit should be taken into consideration when diagnosing patients with Modic changes. In this cross-sectional observational study, 20 patients with lumbar Modic changes were investigated for possible differences between their prevalences across low- and high-field magnetic resonance imaging scanners. There were significant differences both regarding the total number of any Modic changes and reversed differences within the 2 most frequent subgroups.