Can micro-imaging based analysis methods quantify structural integrity of rat vertebrae with and without metastatic involvement?

This study compares the ability of μCT image-based registration, 2D structural rigidity analyses and multimodal continuum-level finite element (FE) modeling in evaluating the mechanical stability of healthy, osteolytic, and mixed osteolytic/osteoblastic metastatically involved rat vertebrae. μMR and μCT images (loaded and unloaded) were acquired of lumbar spinal motion segments from 15rnu/rnu rats (five per group). Strains were calculated based on image registration of the loaded and unloaded μCT images and via analysis of FE models created from the μCT and μMR data. Predicted yield load was also calculated through 2D structural rigidity analysis of the axial unloaded μCT slices. Measures from the three techniques were compared to experimental yield loads. The ability of these methods to predict experimental yield loads were evaluated and image registration and FE calculated strains were directly compared. Quantitatively for all samples, only limited weak correlations were found between the image-based measures and experimental yield load. In comparison to the experimental yield load, we observed a trend toward a weak negative correlation with median strain calculated using the image-based strain measurement algorithm (r=-0.405, p=0.067), weak significant correlations (p<0.05) with FE based median and 10th percentile strain values (r=-0.454, -0.637, respectively), and a trend toward a weak significant correlation with FE based mean strain (r=-0.366, p=0.09). Individual group analyses, however, yielded more and stronger correlations with experimental results. Considering the image-based strain measurement algorithm we observed moderate significant correlations with experimental yield load (p<0.05) in the osteolytic group for mean and median strain values (r=-0.840, -0.832, respectively), and in the healthy group for median strain values (r=-0.809). Considering the rigidity-based predicted yield load, we observed a strong significant correlation with the experimental yield load in the mixed osteolytic/osteoblastic group (r=0.946) and trend toward a moderate correlation with the experimental yield load in the osteolytic group (r=0.788). Qualitatively, strain patterns in the vertebral bodies generated using image registration and FEA were well matched, yet quantitatively a significant correlation was found only between mean strains in the healthy group (r=0.934). Large structural differences in metastatic vertebrae and the complexity of motion segment loading may have led to varied modes of failure. Improvements in load characterization, material properties assignments and resolution are necessary to yield a more generalized ability for image-based registration, structural rigidity and FE methods to accurately represent stability in healthy and pathologic scenarios.     

A noncontact,nondestructive method for quantifying intratissue deformations and strains

The function of soft connective tissues is frequently characterized by quantifying tissue strain (e.g., during joint motion). Conventional techniques for quantifying tendon and ligament strain typically provide surface measures, using markers, stain lines or instrumentation that may influence the tissue. An alternative approach is to quantify intratendinous strain by applying texture correlation analysis to magnetic resonance (MR) images. This paper reports the accuracy and reproducibility of this approach by (1) assessing the reproducibility of MR images, (2) assessing texture correlation accuracy using simulated displacements, and (3) comparing texture correlation measures of displacement and strain from MR images to conventional techniques.     

Results of automatic image registration are dependent on initial manual registration

Measurement of static alignment of articulating joints is of clinical benefit and can be determined using image-based registration. We propose a method that could potentially improve the outcome of image-based registration by using initial manual registration. Magnetic resonance images of two wrist specimens were acquired in the relaxed position and during simulated grasp. Transformations were determined from voxel-based image registration between the two volumes. The volumes were manually aligned to match as closely as possible before auto-registration, from which standard transformations were obtained. Then, translation/rotation perturbations were applied to the manual registration to obtain altered initial positions, from which altered auto-registration transformations were obtained. Models of the radiolunate joint were also constructed from the images to simulate joint contact mechanics. We compared the sensitivity of transformations (translations and rotations) and contact mechanics to altering the initial registration condition from the defined standard. We observed that with increasing perturbation, transformation errors appeared to increase and values for contact force and contact area appeared to decrease. Based on these preliminary findings, it appears that the final registration outcome is sensitive to the initial registration.     

Improving Signal-to-Noise Ratio in Susceptibility Weighted Imaging: A Novel Multicomponent Non-Local Approach

In susceptibility-weighted imaging (SWI), the high resolution required to obtain a proper contrast generation leads to a reduced signal-to-noise ratio (SNR). The application of a denoising filter to produce images with higher SNR and still preserve small structures from excessive blurring is therefore extremely desirable. However, as the distributions of magnitude and phase noise may introduce biases during image restoration, the application of a denoising filter is non-trivial. Taking advantage of the potential multispectral nature of MR images, a multicomponent approach using a Non-Local Means (MNLM) denoising filter may perform better than a component-by-component image restoration method. Here we present a new MNLM-based method (Multicomponent-Imaginary-Real-SWI, hereafter MIR-SWI) to produce SWI images with high SNR and improved conspicuity. Both qualitative and quantitative comparisons of MIR-SWI with the original SWI scheme and previously proposed SWI restoring pipelines showed that MIR-SWI fared consistently better than the other approaches. Noise removal with MIR-SWI also provided improvement in contrast-to-noise ratio (CNR) and vessel conspicuity at higher factors of phase mask multiplications than the one suggested in the literature for SWI vessel imaging. We conclude that a proper handling of noise in the complex MR dataset may lead to improved image quality for SWI data.     

Estimation of the deformations induced by articulated bodies: Registration of the spinal column

We present a new non-rigid registration algorithm estimating the displacement field generated by articulated bodies. Indeed the bony structures between different patient images may rigidly move while other tissues may deform in a more complex way. Our algorithm tracks the displacement induced in the column by a movement of the patient between two acquisitions. The volumetric deformation field in the whole body is then inferred from those displacements using a linear elastic biomechanical finite element model. We demonstrate in this paper that this method provides accurate results on 3D sets of computed tomography (CT), MR and positron emission tomography (PET) images and that the results of the registration algorithm show significant decreases in the mean, min and max errors.     

Quantitative MRI water content mapping of porcine intervertebral disc during uniaxial compression

Background: Intervertebral disc (IVD) diseases are major public health problem in industrialized countries where they affect a large proportion of the population. In particular, IVD degeneration is considered to be one of the leading causes of pain consultation and sick leave. The aim of this study was to develop a new method for assessing the functionality of IVD in order to diagnose IVD degeneration. Methods: For this purpose, we have designed a specific device that enables to mechanically load porcine IVD ex vivo in the 4.7-Tesla horizontal superconducting magnet of a magnetic resonance (MR) scanner. Proton density weighted imaging (ρ_H-MRI) of the samples was acquired. Findings: The post-processing on MR images allowed (1) to reconstruct the 3D deformation under a known mechanical load and (2) to infer the IVD porosity assuming an incompressible poroelastic model. Interpretation: This study demonstrates the ability to follow the change in morphology and hydration of an IVD using MR measurements, thereby providing valued information for a better understanding of IVD function.     

Intensity-based similarity measures evaluation for CT to ultrasound 2D registration

Ultrasound is a non-invasive image modality which allows for real time acquisition. Nevertheless, the low quality of the acquired images makes this a difficult-to-interpret modality during surgical procedures. To overcome this, the registration of ultrasound images with preoperative CT or MR images has been routinely used to fuse complementary information. This work presents the evaluation of eight similarity measures used in the registration of ultrasound and CT images of the left atrium and the pulmonary veins. Each intensity-based similarity measure was evaluated computing its accuracy, capture range, distinctiveness of the optimum, risk and non-convergence and number of minima. The results show that the Woods criterion presents a globally better performance than the other similarity measures. This is especially true for the accuracy and distinctiveness of the optimum indicators. Preprocessing US images does not improve the performance of all similarity measures, except for Woods criterion that shows the optimal accuracy.     

Image Quality Improvement in Adaptive Optics Scanning Laser Ophthalmoscopy Assisted Capillary Visualization Using B-spline-based Elastic Image Registration

Purpose

To investigate the effect of B-spline-based elastic image registration on adaptive optics scanning laser ophthalmoscopy (AO-SLO)-assisted capillary visualization.

Methods

AO-SLO videos were acquired from parafoveal areas in the eyes of healthy subjects and patients with various diseases. After nonlinear image registration, the image quality of capillary images constructed from AO-SLO videos using motion contrast enhancement was compared before and after B-spline-based elastic (nonlinear) image registration performed using ImageJ. For objective comparison of image quality, contrast-to-noise ratios (CNRS) for vessel images were calculated. For subjective comparison, experienced ophthalmologists ranked images on a 5-point scale.

Results

All AO-SLO videos were successfully stabilized by elastic image registration. CNR was significantly higher in capillary images stabilized by elastic image registration than in those stabilized without registration. The average ratio of CNR in images with elastic image registration to CNR in images without elastic image registration was 2.10 ± 1.73, with no significant difference in the ratio between patients and healthy subjects. Improvement of image quality was also supported by expert comparison.

Conclusions

Use of B-spline-based elastic image registration in AO-SLO-assisted capillary visualization was effective for enhancing image quality both objectively and subjectively.     

Reduced Radiation Exposure for Face Transplant Surgical Planning Computed Tomography Angiography

Objective

To test the hypothesis that wide area detector face transplant surgical planning CT angiograms with simulated lower radiation dose and iterative reconstruction (AIDR3D) are comparable in image quality to those with standard tube current and filtered back projection (FBP) reconstruction.

Materials and Methods

The sinograms from 320-detector row CT angiography of four clinical candidates for face transplantation were processed utilizing standard FBP, FBP with simulated 75, 62, and 50% tube current, and AIDR3D with corresponding dose reduction. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were measured at muscle, fat, artery, and vein. Image quality for each reconstruction strategy was assessed by two independent readers using a 4-point scale.

Results

Compared to FBP, the median SNR and CNR for AIDR3D images were higher at all sites for all 4 different tube currents. The AIDR3D with simulated 50% tube current achieved comparable SNR and CNR to FBP with standard dose (median muscle SNR: 5.77 vs. 6.23; fat SNR: 6.40 vs. 5.75; artery SNR: 43.8 vs. 45.0; vein SNR: 54.9 vs. 55.7; artery CNR: 38.1 vs. 38.6; vein CNR: 49.0 vs. 48.7; all p-values >0.19). The interobserver agreement in the image quality score was good (weighted κ = 0.7). The overall score and the scores for smaller arteries were significantly lower when FBP with 50% dose reduction was used. The AIDR3D reconstruction images with 4 different simulated doses achieved a mean score ranging from 3.68 to 3.82 that were comparable to the scores from images reconstructed using FBP with original dose (3.68–3.77).

Conclusions

Simulated radiation dose reduction applied to clinical CT angiography for face transplant planning suggests that AIDR3D allows for a 50% reduction in radiation dose, as compared to FBP, while preserving image quality.     

Improving Image Quality of Bronchial Arteries with Virtual Monochromatic Spectral CT Images

Objective

To evaluate the clinical value of using monochromatic images in spectral CT pulmonary angiography to improve image quality of bronchial arteries.

Methods

We retrospectively analyzed the chest CT images of 38 patients who underwent contrast-enhanced spectral CT. These images included a set of 140kVp polychromatic images and the default 70keV monochromatic images. Using the standard Gemstone Spectral Imaging (GSI) viewer on an advanced workstation (AW4.6,GE Healthcare), an optimal energy level (in keV) for obtaining the best contrast-to-noise ratio (CNR) for the artery could be automatically obtained. The signal-to-noise ratio (SNR), CNR and objective image quality score (1–5) for these 3 image sets (140kVp, 70keV and optimal energy level) were obtained and, statistically compared. The image quality score consistency between the two observers was also evaluated using Kappa test.

Results

The optimal energy levels for obtaining the best CNR were 62.58±2.74keV.SNR and CNR from the 140kVp polychromatic, 70keV and optimal keV monochromatic images were (16.44±5.85, 13.24±5.52), (20.79±7.45, 16.69±6.27) and (24.9±9.91, 20.53±8.46), respectively. The corresponding subjective image quality scores were 1.97±0.82, 3.24±0.75, and 4.47±0.60. SNR, CNR and subjective scores had significant difference among groups (all p<0.001). The optimal keV monochromatic images were superior to the 70keV monochromatic and 140kVp polychromatic images, and there was high agreement between the two observers on image quality score (kappa>0.80).

Conclusions

Virtual monochromatic images at approximately 63keV in dual-energy spectral CT pulmonary angiography yielded the best CNR and highest diagnostic confidence for imaging bronchial arteries.     

An iterative deconvolution algorithm for image recovery in clinical CT: A phantom study

PurposeTo study the feasibility of using an iterative reconstruction algorithm to improve previously reconstructed CT images which are judged to be non-diagnostic on clinical review. A novel rapidly converging, iterative algorithm (RSEMD) to reduce noise as compared with standard filtered back-projection algorithm has been developed.Materials and methodsThe RSEMD method was tested on in-silico, Catphan^®500, and anthropomorphic 4D XCAT phantoms. The method was applied to noisy CT images previously reconstructed with FBP to determine improvements in SNR and CNR. To test the potential improvement in clinically relevant CT images, 4D XCAT phantom images were used to simulate a small, low contrast lesion placed in the liver.ResultsIn all of the phantom studies the images proved to have higher resolution and lower noise as compared with images reconstructed by conventional FBP. In general, the values of SNR and CNR reached a plateau at around 20 iterations with an improvement factor of about 1.5 for in noisy CT images. Improvements in lesion conspicuity after the application of RSEMD have also been demonstrated. The results obtained with the RSEMD method are in agreement with other iterative algorithms employed either in image space or with hybrid reconstruction algorithms.ConclusionsIn this proof of concept work, a rapidly converging, iterative deconvolution algorithm with a novel resolution subsets-based approach that operates on DICOM CT images has been demonstrated. The RSEMD method can be applied to sub-optimal routine-dose clinical CT images to improve image quality to potentially diagnostically acceptable levels.     

Homographic Patch Feature Transform: A Robustness Registration for Gastroscopic Surgery

Image registration is a key component of computer assistance in image guided surgery, and it is a challenging topic in endoscopic environments. In this study, we present a method for image registration named Homographic Patch Feature Transform (HPFT) to match gastroscopic images. HPFT can be used for tracking lesions and augmenting reality applications during gastroscopy. Furthermore, an overall evaluation scheme is proposed to validate the precision, robustness and uniformity of the registration results, which provides a standard for rejection of false matching pairs from corresponding results. Finally, HPFT is applied for processing in vivo gastroscopic data. The experimental results show that HPFT has stable performance in gastroscopic applications.     

Medical image registration using Edgeworth-based approximation of Mutual Information

We propose a new similarity measure for iconic medical image registration, an Edgeworth-based third order approximation of Mutual Information (MI) and named 3-EMI. Contrary to classical Edgeworth-based MI approximations, such as those proposed for independent component analysis, the 3-EMI measure is able to deal with potentially correlated variables. The performance of 3-EMI is then evaluated and compared with the Gaussian and B-Spline kernel-based estimates of MI, and the validation is leaded in three steps. First, we compare the intrinsic behavior of the measures as a function of the number of samples and the variance of an additive Gaussian noise. Then, they are evaluated in the context of multimodal rigid registration, using the RIRE data. We finally validate the use of our measure in the context of thoracic monomodal non-rigid registration, using the database proposed during the MICCAI EMPIRE10 challenge. The results show the wide range of clinical applications for which our measure can perform, including non-rigid registration which remains a challenging problem. They also demonstrate that 3-EMI outperforms classical estimates of MI for a low number of samples or a strong additive Gaussian noise. More generally, our measure gives competitive registration results, with a much lower numerical complexity compared to classical estimators such as the reference B-Spline kernel estimator, which makes 3-EMI a good candidate for fast and accurate registration tasks.     

Interpolated Compressed Sensing for 2D Multiple Slice Fast MR Imaging

Sparse MRI has been introduced to reduce the acquisition time and raw data size by undersampling the k-space data. However, the image quality, particularly the contrast to noise ratio (CNR), decreases with the undersampling rate. In this work, we proposed an interpolated Compressed Sensing (iCS) method to further enhance the imaging speed or reduce data size without significant sacrifice of image quality and CNR for multi-slice two-dimensional sparse MR imaging in humans. This method utilizes the k-space data of the neighboring slice in the multi-slice acquisition. The missing k-space data of a highly undersampled slice are estimated by using the raw data of its neighboring slice multiplied by a weighting function generated from low resolution full k-space reference images. In-vivo MR imaging in human feet has been used to investigate the feasibility and the performance of the proposed iCS method. The results show that by using the proposed iCS reconstruction method, the average image error can be reduced and the average CNR can be improved, compared with the conventional sparse MRI reconstruction at the same undersampling rate.     

Optimization of the balanced steady state free precession (bSSFP) pulse sequence for magnetic resonance imaging of the mouse prostate at 3T

Introduction

MRI can be used to non-invasively monitor tumour growth and response to treatment in mouse models of prostate cancer, particularly for longitudinal studies of orthotopically-implanted models. We have optimized the balanced steady-state free precession (bSSFP) pulse sequence for mouse prostate imaging.

Methods

Phase cycling, excitations, flip angle and receiver bandwidth parameters were optimized for signal to noise ratio and contrast to noise ratio of the prostate. The optimized bSSFP sequence was compared to T1- and T2-weighted spin echo sequences.

Results

SNR and CNR increased with flip angle. As bandwidth increased, SNR, CNR and artifacts such as chemical shift decreased. The final optimized sequence was 4 PC, 2 NEX, FA 50°, BW ±62.5 kHz and took 14–26 minutes with 200 µm isotropic resolution. The SNR efficiency of the bSSFP images was higher than for T1WSE and T2WSE. CNR was highest for T1WSE, followed closely by bSSFP, with the T2WSE having the lowest CNR. With the bSSFP images the whole body and organs of interest including renal, iliac, inguinal and popliteal lymph nodes were visible.

Conclusion

We were able to obtain fast, high-resolution, high CNR images of the healthy mouse prostate with an optimized bSSFP sequence.     

Lumbar spine angles and intervertebral disc characteristics with end-range positions in three planes of motion in healthy people using upright MRI

Understanding changes in lumbar spine (LS) angles and intervertebral disc (IVD) behavior in end-range positions in healthy subjects can provide a basis for developing more specific LS models and comparing people with spine pathology. The purposes of this study are to quantify 3D LS angles and changes in IVD characteristics with end-range positions in 3 planes of motion using upright MRI in healthy people, and to determine which intervertebral segments contribute most in each plane of movement. Thirteen people (average age = 24.4 years, range 18–51 years; 9 females; BMI = 22.4 ± 1.8 kg/m²) with no history of low back pain were scanned in an upright MRI in standing, sitting flexion, sitting axial rotation (left, right), prone on elbows, prone extension, and standing lateral bending (left, right). Global and local intervertebral LS angles were measured. Anterior-posterior length of the IVD and location of the nucleus pulposus was measured. For the sagittal plane, lower LS segments contribute most to change in position, and the location of the nucleus pulposus migrated from a more posterior position in sitting flexion to a more anterior position in end-range extension. For lateral bending, the upper LS contributes most to end-range positions. Small degrees of intervertebral rotation (1–2°) across all levels were observed for axial plane positions. There were no systematic changes in IVD characteristics for axial or coronal plane positions.     

Multisegmental image fusion of the spine]

Fusion of medical images is a technique that permits the correlation of homologous anatomical structures in different imaging modalities on the basis of a spatial transformation of the data sets. CT and MRI of the spine provide complementary information of possible relevance for diagnostic and therapeutic decisions. Methods enabling a multisegmental CT-MRI fusion of the spine were developed. These solve the problem of altered spatial relationships of the individual anatomical structures due to differing patient positioning in successive data acquisitions. Routine clinical CT and MRI data of a thoracic section of the spine were obtained and transferred to a PC-workstation. Following segmentation of the CT-data, landmarks for each individual vertebra were defined in the CT and MRI data. For each individual vertebra the algorithm we developed then carried out a rigid registration of the CT information to the MR data. The fused data sets were presented as colour-coded images or on the basis of dynamic variation of transparency. To assess registration precision, fiducial registration errors (FRE) and target registration errors (TRE) were calculated. The algorithm permitted multi-segmental image fusion of the spine. The average time required for defining the landmarks was 22 seconds per landmark for CT, and 34 seconds per landmark for MR. The average FRE was 1.53 mm. The TRE for the vertebrae was less than 2 mm. The colour-coded images were particularly suitable for assessing the contours of the anatomical structures, whereas dynamic variation of the transparency of overlapping CT images enabled a better overall assessment of the spatial relationship of the anatomical structures. The algorithm permits precise multi-segmental fusion of CT and MR of the spine, which was not possible using current fusion-algorithms due to variations in the spatial orientation of the anatomical structures caused by different positioning of the axial skeleton in successive examinations.     

A Novel Prior- and Motion-Based Compressed Sensing Method for Small-Animal Respiratory Gated CT

Low-dose protocols for respiratory gating in cardiothoracic small-animal imaging lead to streak artifacts in the images reconstructed with a Feldkamp-Davis-Kress (FDK) method. We propose a novel prior- and motion-based reconstruction (PRIMOR) method, which improves prior-based reconstruction (PBR) by adding a penalty function that includes a model of motion. The prior image is generated as the average of all the respiratory gates, reconstructed with FDK. Motion between respiratory gates is estimated using a nonrigid registration method based on hierarchical B-splines. We compare PRIMOR with an equivalent PBR method without motion estimation using as reference the reconstruction of high dose data. From these data acquired with a micro-CT scanner, different scenarios were simulated by changing photon flux and number of projections. Methods were evaluated in terms of contrast-to-noise-ratio (CNR), mean square error (MSE), streak artefact indicator (SAI), solution error norm (SEN), and correction of respiratory motion. Also, to evaluate the effect of each method on lung studies quantification, we have computed the Jaccard similarity index of the mask obtained from segmenting each image as compared to those obtained from the high dose reconstruction. Both iterative methods greatly improved FDK reconstruction in all cases. PBR was prone to streak artifacts and presented blurring effects in bone and lung tissues when using both a low number of projections and low dose. Adopting PBR as a reference, PRIMOR increased CNR up to 33% and decreased MSE, SAI and SEN up to 20%, 4% and 13%, respectively. PRIMOR also presented better compensation for respiratory motion and higher Jaccard similarity index. In conclusion, the new method proposed for low-dose respiratory gating in small-animal scanners shows an improvement in image quality and allows a reduction of dose or a reduction of the number of projections between two and three times with respect to previous PBR approaches.     

High resolution MR eye protocol optimization: Comparison between 3D-CISS, 3D-PSIF and 3D-VIBE sequences

PurposeThe purpose of this study was to compare selected MRI pulse sequences and to evaluate their utility for depicting specific anatomic regions in the eye.MethodsA High-Resolution (HR) 0.08 × 0.08 × 0.60 mm³ MRI protocol was developed on a 1.5-T clinical system and applied in the left eye of an albino rabbit, utilizing a small field of view surface coil. The comprehensive MRI protocol consisted of two 3D (T2/T1)w sequences (3D-PSIF and 3D-CISS), and one 3D T1w sequence (3D-VIBE). The T1w 3D-VIBE sequence was acquired, before and after intravenous injection of 0.2 mmol/kgr gadolinium-DTPA. Signal-to-Noise Ratios (SNR) and Contrast-to-Noise Ratios (CNR) amongst specific eye anatomical areas were calculated for each sequence. The presence of artifacts was rated subjectively utilizing a 5 point scale.Results3D-PSIF and 3D-CISS provide better delineation and visualization of the eye as compared with 3D-VIBE sequences. 3D-CISS images present the highest SNR and revealed better discrimination of the ocular surrounding tissues; its basic drawback though is related to ghost artifacts appearing in the anterior chamber and resulting in the lowest image quality. In post-contrast imaging, the T1w 3D-VIBE sequence provided the best overall image quality. Moreover, 3D (T2/T1)w sequences can provide good anatomic depiction of the eye segments. Agreement between the two independent readers was good.ConclusionsOptimization of a comprehensive MR eye imaging protocol is achieved. A higher SNR, a better spatial resolution and a reduction of the total scan time were obtained, thus making clinical MRI systems more reliable in eye imaging.     

Influence of experimental protocols on the mechanical properties of the intervertebral disc in unconfined compression

The lack of standardization in experimental protocols for unconfined compression tests of intervertebral discs (IVD) tissues is a major issue in the quantification of their mechanical properties. Our hypothesis is that the experimental protocols influence the mechanical properties of both annulus fibrosus and nucleus pulposus. IVD extracted from bovine tails were tested in unconfined compression stress-relaxation experiments according to six different protocols, where for each protocol, the initial swelling of the samples and the applied preload were different. The Young's modulus was calculated from a viscoelastic model, and the permeability from a linear biphasic poroviscoelastic model. Important differences were observed in the prediction of the mechanical properties of the IVD according to the initial experimental conditions, in agreement with our hypothesis. The protocol including an initial swelling, a 5% strain preload, and a 5% strain ramp is the most relevant protocol to test the annulus fibrosus in unconfined compression, and provides a permeability of 5.0 ± 4.2e(-14)m(4)/N[middle dot]s and a Young's modulus of 7.6 ± 4.7 kPa. The protocol with semi confined swelling and a 5% strain ramp is the most relevant protocol for the nucleus pulposus and provides a permeability of 10.7 ± 3.1 e(-14)m(4)/N[middle dot]s and a Young's modulus of 6.0 ± 2.5 kPa.