Exploring mean kurtosis in MR diffusion kurtosis imaging for early detection of lumbar spine degeneration: a systematic review

Objectives: Degenerative lumbar spine disease, a leading cause of chronic pain and disability in older adults, results from the progressive degeneration of intervertebral discs. This systematic review evaluates the role of mean kurtosis (MK) as a diffusion kurtosis imaging (DKI) parameter in the early diagnosis of degenerative spine disease and its potential to enhance patient outcomes. Methods: A systematic review was conducted following PRISMA guidelines, with a comprehensive search yielding 7,290 articles. After screening, three studies met the inclusion criteria. Quality assessment was performed using the QUADAS tool, considering studies with a score of ≥10 as high-quality. Data extraction focused on DKI parameters, particularly MK, in assessing early disc degeneration. The study was registered in PROSPERO (CRD42024554902) on June 5, 2024. Results: Findings indicate that MK plays a crucial role in detecting microstructural changes in the intervertebral disc space of the lumbar spine. These changes closely correlate with clinical symptoms and the extent of degeneration observed on conventional MRI. DKI-derived MK appears to offer greater sensitivity in identifying early-stage microstructural degeneration compared to traditional imaging methods Conclusions: MR DKI demonstrates significant potential for detecting subtle, early changes in lumbar spine degeneration. Integrating DKI into clinical practice could enhance diagnostic accuracy, enable earlier interventions, and ultimately improve patient outcomes.