An interdisciplinary research team in the Cedars-Sinai Biomedical Imaging Research Institute, Department of Biomedical Sciences, Regenerative Medicine Institute and Department of Surgery received a grant from the National Institutes of Health (NIH) to develop the first imaging technique used to identify biomarkers that could indicate patients have a painful, degenerative back condition.
Biomarkers are certain body substances, such as proteins or body fluids that can indicate specific health conditions. When noninvasive imaging procedures can identify exactly where the biomarkers are, researchers may alleviate the need for painful and invasive diagnostic procedures and, in the future, provide targeted, stem cell-based therapies to patients with the condition.
More than 85 percent of the United States population suffers from low back pain, much of which is caused by intervertebral disc degeneration. Disc degeneration is a progressive condition, resulting in chronic pain in the back and neck. For some patients, degeneration can occur for years before pain sets in, presenting symptoms, while others are affected almost immediately.
As described in an article in the journal Magnetic Resonance in Medicine, identifying the exact disc that is the source of pain by employing the latest imaging techniques may save patients from painful and invasive diagnostic procedures, such as procedures in which physicians inject a contrast agent or non-toxic dye into patients' spinal discs.
"The goal of our institute is to develop and apply novel imaging techniques that translate to clinical significance," said Debiao Li, PhD, director of the Biomedical Imaging Research Institute, corresponding author of the article and a co-principal investigator on the NIH grant. "This imaging technology may allow us to do just this. By mapping a patient's lower spinal region, we can identify the discs causing discomfort, which allows physicians to then treat accordingly."
In the study, investigators developed various imaging techniques using magnetic resonance imaging, or MRI, which can identify specific biomarkers to potentially provide a noninvasive diagnostic approach to intervertebral disc degeneration. The approach, which has been tested on patients and in the laboratory, enabled investigators to precisely pinpoint the origin of pain and monitor the progression of each patient's condition.
With this imaging technique, investigators in the Regenerative Medicine Institute aim to generate a stem cell-based therapeutic for patients suffering from the degenerative condition.
"Our research team is interested in the role of stem cells in this disease and how we can utilize these cells to regenerate the disc and turn it back into a functional tissue," said Dan Gazit, PhD, co-principal investigator on the grant and director of the Skeletal Regeneration and Stem Cell Therapy Laboratory in the Department of Surgery, the Skeletal Program in the Regenerative Medicine Institute and the Molecular and Micro Imaging Core Facility. "Using this novel imaging technique, we will be able to evaluate the effect of our future stem cell therapies on back pain."
Hyun Bae, MD, medical director of orthopedic spine surgery and director of spine education, who is co-investigator of the study, said, "By understanding where the source of pain comes from, physicians can better utilize surgical and non surgical treatments to help patients live a more normal lifestyle."
Additional investigators working on the project include Qi Liu, a Cedars-Sinai graduate student and first author of the article, Gadi Pelled, PhD, an assistant professor in the Gazit Laboratory, Wafa Tawackoli, PhD, an assistant professor in the Gazit Laboratory and technical director of the Research Imaging Core and Micro/Molecular Imaging, and Zhaoyang Fan, PhD, 3T MRI technical director in the Biomedical Imaging Research Institute.
- Qi Liu, Wafa Tawackoli, Gadi Pelled, Zhaoyang Fan, Ning Jin, Yutaka Natsuaki, Xiaoming Bi, Avrom Gart, Hyun Bae, Dan Gazit, Debiao Li. Detection of low back pain using pH level-dependent imaging of the intervertebral disc using the ratio of R1ρdispersion and −OH chemical exchange saturation transfer (RROC). Magnetic Resonance in Medicine, 2014; DOI: 10.1002/mrm.25186
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