Chemical shift-encoded MRI for assessment of bone marrow adipose tissue fat composition: Pilot study in premenopausal versus postmenopausal women

Martel, D.; Leporq, Benjamin; Bruno, Mary; Regatte, Ravinder R.; Honig, Stephen; Chang, Gregory

doi:10.1016/j.mri.2018.07.001

Cited by 31 publications

(41 citation statements)

References 64 publications

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“…[33][34][35] MRS in Ward's triangle and femoral neck showed similar results to CSE-MRI, with good measurement agreement according to the Bland-Altman method. This result is similar to previous studies, which validated CSE-MRI with: 1) MRS to assess fat quantity and composition in the liver, spine, and bone marrow, 17,18,[20][21][22]36 and 2) more recently, gas chromatography of subcutaneous adipose tissue. 22 Spectral quality was assessed by measurement of the quality factor, methyl protons, and water peak lineshape (reflecting static field homogeneity in the selected voxel).…”

Section: Discussionsupporting

confidence: 91%

“…a). A 3D‐k cluster algorithm was used on fat‐ and water‐only images to semiautomatically separate tissues in the image into soft tissue, muscle, cortical bone, and bone marrow . Briefly, an active contour was used to segment bMAT from the fat‐only central image and used for initializing a second mask to water image to segment cortical bone.…”

Section: Methodsmentioning

confidence: 99%

“…A 3D-k cluster algorithm was used on fat-and water-only images to semiautomatically separate tissues in the image into soft tissue, muscle, cortical bone, and bone marrow. 21 Briefly, an active contour was used to segment bMAT from the fat-only central image and used for initializing a second mask to water image to segment cortical bone. From the 3D bMAT-masked a k-means algorithm (with k = 2) was used on PDFF maps to cluster adipose tissues into rMAT (red marrow adipose tissue) and yMAT (yellow marrow adipose tissue).…”

Section: Image Reconstructionmentioning

confidence: 99%

“…Recent advances in water‐fat imaging methods allows discrimination between different types of fat in terms of their amount of saturation (saturated fat fraction, SFA), poly‐unsaturation (poly‐unsaturated fat fraction, PUFA) and mono‐unsaturation (mono‐unsaturated fat fraction, MUFA). This approach has been validated using MRS in liver, adipose tissue, muscle, bone marrow, and more recently in abdominal adipose tissue using gas chromatography …”

mentioning

confidence: 99%

“…Recent advances in water-fat imaging methods 13,[16][17][18][19] allows discrimination between different types of fat in terms of their amount of saturation (saturated fat fraction, SFA), poly-unsaturation (poly-unsaturated fat fraction, PUFA) and mono-unsaturation (mono-unsaturated fat fraction, MUFA). This approach has been validated using MRS in liver, adipose tissue, muscle, bone marrow, 13,[16][17][18]20,21 and more recently in abdominal adipose tissue using gas chromatography. 22 The purposes of our study were: 1) to use CSE-MRI to assess differences in the quantity and composition of bMAT in the proximal femur of OP compared with GIO patients, and 2) to assess the relationship between CSE-MRI and MRS for fat quantification in bone marrow studies.…”

mentioning

confidence: 99%

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3T chemical shift‐encoded MRI: Detection of altered proximal femur marrow adipose tissue composition in glucocorticoid users and validation with magnetic resonance spectroscopy

Martel

Leporq

Saxena

et al. 2018

Magnetic Resonance Imaging

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Background Osteoporosis (OP) results in weak bone and can ultimately lead to fracture. Drugs such as glucocorticoids can also induce OP (glucocorticoid‐induced osteoporosis [GIO]). Bone marrow adipose tissue composition and quantity may play a role in OP pathophysiology, but has not been thoroughly studied in GIO compared to primary OP. Purpose/Hypothesis Chemical shift‐encoded (CSE) MRI allows detection of subregional differences in bone marrow adipose tissue composition and quantity in the proximal femur of GIO compared to OP subjects and has high agreement with the reference standard of magnetic resonance spectroscopy (MRS). Study Type Prospective. Subjects In all, 18 OP and 13 GIO subjects. Fields Strength 3T. Sequence Multiple gradient‐echo, stimulated echo acquisition mode (STEAM). Assessment Subjects underwent CSE‐MRI in the proximal femurs, and for each parametric map regions of interest (ROIs) were assessed in the femoral head (fHEAD), femoral neck (fNECK), Ward's triangle (fTRIANGLE), and the greater trochanter (GTROCH). In addition, we compared CSE‐MRI against the reference standard of MRS performed in the femoral neck and Ward's triangle. Statistical Tests Differences between OP/GIO were investigated using the Mann–Whitney nonparametric test. Bland–Altman methodology was used to assess measurement agreement between CSE‐MRI and MRS. Results GIO compared with OP subjects demonstrated: decreased monounsaturated fat fraction (MUFA) (–2.1%, P < 0.05) in fHEAD; decreased MUFA (–3.8%, P < 0.05), increased saturated fat fraction (SFA) (5.5%, P < 0.05), and decreased normalT2* (–3.8 msec, P < 0.05) in fNECK; decreased proton density fat fraction (PDFF) (–15.1%, P < 0.05), MUFA (–9.8%, P < 0.05), polyunsaturated fat fraction (PUFA) (–1.8%, P < 0.01), increased SFA (11.6%, P < 0.05), and decreased normalT2* (–5.4 msec, P < 0.05) in fTRIANGLE; and decreased normalT2* (–1.5 msec, P < 0.05) in GTROCH. There was high measurement agreement between MRI and MRS using the Bland–Altman test. Data Conclusion 3T CSE‐MRI may allow reliable assessment of subregional bone marrow adipose tissue (bMAT) quantity and composition in the proximal femur in a clinically reasonable scan time. Glucocorticoids may alter the lipid profile of bMAT and potentially result in reduced bone quality. Level of Evidence: 2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;50:490–496.

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Section: Discussionsupporting

confidence: 91%

Section: Methodsmentioning

confidence: 99%

Section: Image Reconstructionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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3T chemical shift‐encoded MRI: Detection of altered proximal femur marrow adipose tissue composition in glucocorticoid users and validation with magnetic resonance spectroscopy

Martel

Leporq

Saxena

et al. 2018

Magnetic Resonance Imaging

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Bone Marrow Adiposity Alterations in Type 2 Diabetes Are Sex-Specific and Associated with Serum Lipid Levels

Wu,

Joseph,

Saeed

et al. 2023

Journal of Bone and Mineral Research

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Type 2 diabetes (T2D) has negative effects on skeletal health. A proposed mechanism of diabetic bone disease connects hyperlipidemia to increased bone marrow adiposity and decreased bone quality. Previous research on Type 1 diabetes reported positive associations between serum lipid levels and marrow adiposity, but no data exist for T2D. In addition, marrow adiposity is sex‐dependent in healthy populations, but sex has not been addressed adequately in previous reports of marrow adiposity in T2D. The purpose of this study was to quantify associations of marrow adiposity and composition with T2D status, serum lipid levels, and sex. T2D patients and normoglycemic controls (n = 39/37) were included. Single‐voxel magnetic resonance spectroscopy (MRS) was performed at the spine and tibia. Quantitative MRS outcomes of marrow adiposity and composition were calculated. Linear regression models were used to compare MRS outcomes among groups and to evaluate associations of MRS outcomes with serum lipid levels. All analyses were performed on sex‐stratified subgroups. Total, unsaturated, and saturated fat content at the spine were lower in T2D participants compared to controls in age‐adjusted models; these differences were significant in men but not in women. In our study cohort, total cholesterol, low‐density lipoprotein (LDL), and high‐density lipoprotein (HDL) were lower in T2D participants compared to controls. Adjustment for LDL, HDL, and statin use attenuated the association of T2D status with unsaturated fat but not saturated fat in men. Further analysis confirmed significant associations between serum lipid levels and MRS outcomes. Specifically, we found a positive association between LDL cholesterol and total marrow fat in the male T2D group and a negative association between HDL and total marrow fat in the female T2D group. In conclusion, our results suggest that marrow adiposity and composition are associated with lipid levels as well as T2D status, and these relationships are sex‐specific. © 2023 American Society for Bone and Mineral Research (ASBMR).

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MRI‐Based Quantitative Osteoporosis Imaging at the Spine and Femur

Sollmann

Löffler

Kronthaler

et al. 2020

Magnetic Resonance Imaging

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Osteoporosis is a systemic skeletal disease with a high prevalence worldwide, characterized by low bone mass and microarchitectural deterioration, predisposing an individual to fragility fractures. Dual-energy X-ray absorptiometry (DXA) has been the clinical reference standard for diagnosing osteoporosis and for assessing fracture risk for decades. However, other imaging modalities are of increasing importance to investigate the etiology, treatment, and fracture risk. The purpose of this work is to review the available literature on quantitative magnetic resonance imaging (MRI) methods and related findings in osteoporosis at the spine and proximal femur as the clinically most important fracture sites. Trabecular bone microstructure analysis at the proximal femur based on high-resolution MRI allows for a better prediction of osteoporotic fracture risk than DXA-based bone mineral density (BMD) alone. In the 1990s, T 2 * mapping was shown to correlate with the density and orientation of the trabecular bone. Recently, quantitative susceptibility mapping (QSM), which overcomes some of the limitations of T 2 * mapping, has been applied for trabecular bone quantifications at the spine, whereas ultrashort echo time (UTE) imaging provides valuable surrogate markers of cortical bone quantity and quality. Magnetic resonance spectroscopy (MRS) and chemical shift encoding-based water-fat MRI (CSE-MRI) enable the quantitative assessment of the nonmineralized bone compartment through extraction of the bone marrow fat fraction (BMFF). Furthermore, CSE-MRI allows for the differentiation of osteoporotic vs. pathologic fractures, which is of high clinical relevance. Lastly, advanced postprocessing and image analysis tools, particularly considering statistical parametric mapping and region-specific BMFF distributions, have high potential to further improve MRI-based fracture risk assessments at the spine and hip. Level of Evidence: 5 Technical Efficacy Stage: 2

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Chemical shift-encoded MRI for assessment of bone marrow adipose tissue fat composition: Pilot study in premenopausal versus postmenopausal women

Cited by 31 publications

References 64 publications

3T chemical shift‐encoded MRI: Detection of altered proximal femur marrow adipose tissue composition in glucocorticoid users and validation with magnetic resonance spectroscopy

3T chemical shift‐encoded MRI: Detection of altered proximal femur marrow adipose tissue composition in glucocorticoid users and validation with magnetic resonance spectroscopy

Bone Marrow Adiposity Alterations in Type 2 Diabetes Are Sex-Specific and Associated with Serum Lipid Levels

MRI‐Based Quantitative Osteoporosis Imaging at the Spine and Femur

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