Correlation of bone mineral density with MRI T2* values in quantitative analysis of lumbar osteoporosis

Wu, Hui-Zhao; Zhang, Xiaofei; Han, Shu-Man; Cao, Lei; Wen, Jin-Xu; Wu, Wenjuan; Gao, Bu-Lang

doi:10.1007/s11657-020-0682-2

Cited by 32 publications

(33 citation statements)

References 34 publications

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“…T2* was significantly higher in patients with osteoporosis/osteopenia compared to patients with normal BMD (i.e., >120 mg/cm 3 ). These findings are in line with the previous studies (10,11). As the increase in T2* in patients with lower bone mineral density is presumably caused by rarefication of the trabecular bone structure, we investigated the correlation between T2* and the bone structure in greater detail; we therefore analysed CT-based trabecular bone parameters (TbTh, TbSp, TbN) and their correlation with T2*.…”

Section: Discussionsupporting

confidence: 87%

“…As bone is more diamagnetic than marrow, the trabecular bone and bone marrow interface induce local magnetic field inhomogeneities, which can be measured as a shortening of the effective transverse relaxation time (10). T2* measurements of the vertebra correlated with the bone mineral density inversly in previous studies, suggesting decreased susceptibility due to remodeled and decreased trabecular bone (11).…”

Section: Introductionmentioning

confidence: 81%

“…These local field inhomogeneities shorten the T2* decay of both the water and fat components, which results in a rapid decay of the measured gradient echo signal with increasing echo time (25,31). It has already been shown that T2* of vertebral bone depends on bone density and the microarchitectural trabecular structure, whereas T2* increases with decreasing bone density (11).…”

Section: Discussionmentioning

confidence: 99%

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Vertebral bone marrow T2* mapping using chemical shift encoding-based water-fat separation in the quantitative analysis of lumbar osteoporosis and osteoporotic fractures

Leonhardt

Gassert

Feuerriegel

et al. 2021

Quant Imaging Med Surg

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Background: Chemical shift encoding-based water-fat separation techniques have been used for fat quantification [proton density fat fraction (PDFF)], but they also enable the assessment of bone marrow T2*, which has previously been reported to be a potential biomarker for osteoporosis and may give insight into the cause of vertebral fractures (i.e., osteoporotic vs. traumatic) and the microstructure of the bone when applied to vertebral bone marrow. Methods:The 32 patients (78.1% with low-energy osteopenic/osteoporotic fractures, mean age 72.3±9.8 years, 76% women; 21.9% with high-energy traumatic fractures, 47.3±12.8 years, no women) were frequency-matched for age and sex to subjects without vertebral fractures (n=20). All study patients underwent 3T-MRI of the lumbar spine including sagittally acquired spoiled gradient echo sequences for chemical shift encoding-based water-fat separation, from which T2* values were obtained. Volumetric trabecular bone mineral density (BMD) and trabecular bone parameters describing the three-dimensional structural integrity of trabecular bone were derived from quantitative CT. Associations between T2* measurements, fracture status and trabecular bone parameters were assessed using multivariable linear regression models.Results: Mean T2* values of non fractured vertebrae in all patients showed a significant correlation with BMD (r=−0.65, P<0.001), trabecular number (TbN) (r=−0.56, P<0.001) and trabecular spacing (TbSp) (r=0.61, P<0.001); patients with low-energy osteoporotic vertebral fractures showed significantly higher mean T2* values than those with traumatic fractures (13.6±4.3 vs. 8.4±2.2 ms, P=0.01) as well as a significantly lower TbN (0.69±0.08 vs. 0.93±0.03 mm−1, P<0.01) and a significantly larger trabecular spacing (1.06±0.16 vs. 0.56±0.08 mm, P<0.01). Mean T2* values of osteoporotic patients with and without vertebral fracture showed no significant difference (13.5±3.4 vs. 15.6±3.5 ms, P=0.40). When comparing the mean T2* of the fractured vertebrae, no significant difference could be detected between low-energy osteoporotic fractures and high-energy traumatic fractures (12.6±5.4 vs. 8.1±2.4 ms, P=0.10).Conclusions: T2* mapping of vertebral bone marrow using using chemical shift encoding-based water-fat separation allows for assessing osteoporosis as well as the trabecular microstructure and enables a radiation-

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

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Vertebral bone marrow T2* mapping using chemical shift encoding-based water-fat separation in the quantitative analysis of lumbar osteoporosis and osteoporotic fractures

Leonhardt

Gassert

Feuerriegel

et al. 2021

Quant Imaging Med Surg

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“…T2* and quantitative susceptibility mapping), have been used to discriminate benign and malignant compressed vertebras [42,43]. Among recent MRI methods to analyse bone tissue in osteoporosis [44,45], most efforts have been devoting to fat fraction quantification at the spine by analysing bone marrow composition (for review see [46]). However, there are not studies on large cohorts to accomplish the transition of these methods into clinical practice, partially because of limited evidence of their usefulness in predicting fracture risk.…”

Section: Discussionmentioning

confidence: 99%

Fractal lacunarity of trabecular bone in vertebral MRI to predict osteoporotic fracture risk in over-fifties women. The LOTO study

Alimazighi

Rossi

Galeazzi

et al. 2021

BMC Musculoskelet Disord

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Background Osteoporotic fractures are a major cause of morbidity in the elderly. Menopausal women represent the population with the highest risk of early osteoporosis onset, often accompanied by vertebral fractures (VF). Bone mineral density (BMD) is commonly assessed by dual-energy X-ray absorptiometry (DXA) for osteoporosis diagnosis; however, BMD alone does not represent a significant predictor of fracture risk. Bone microarchitecture, instead, arises as a determinant of bone fragility independent of BMD. High-resolution magnetic resonance imaging (MRI) is an effective noninvasive/nonionizing tool for in vivo characterisation of trabecular bone microarchitecture (TBA). We have previously set up an MRI method able to characterise TBA changes in aging and osteoporosis by one parameter, trabecular bone lacunarity parameter β (TBLβ). Fractal lacunarity was used for TBA texture analysis as it describes discontinuity of bone network and size of bone marrow spaces, changes of which increase the risk of bone fracture. This study aims to assess the potential of TBLβ method as a tool for osteoporotic fracture risk. Methods An observational, cross-sectional, and prospective study on over-50s women at risk for VF was designed. TBLβ, our index of osteoporotic fracture risk, is the main outcome measure. It was calculated on lumbar vertebra axial images, acquired by 1.5 T MRI spin-echo technique, from 279 osteopenic/osteoporotic women with/without prior VF. Diagnostic power of TBLβ method, by Receiver Operating Characteristics (ROC) curve and other diagnostic accuracy measurements were compared with lumbar spine DXA-BMD. Results Baseline results show that TBLβ is able to discriminate patients with/without prevalent VF (p = 0.003). AUC (area under the curve from ROC) is 0.63 for TBLβ, statistically higher (p = 0.012) than BMD one (0.53). Contribution of TBLβ to prevalent VF is statistically higher (p < 0.001) than BMD (sensitivity: 66% vs. 52% respectively; OR: 3.20, p < 0.0001 for TBLβ vs. 1.31, p = 0.297 for BMD). Preliminary 1-year prospective results suggest that TBA contribution to incident VF is even higher (sensitivity: 73% for TBLβ vs. 55% for BMD; RR: 3.00, p = 0.002 for TBLβ vs. 1.31, p = 0.380 for BMD). Conclusion Results from this study further highlight the usefulness of TBLβ as a biomarker of TBA degeneration and an index of osteoporotic fracture risk.

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“…As one of the most common fracture occurs in the vertebra (MEHTA; SEBRO, 2020;LÓPEZ et al, 2016), predicting occurrence of this injury is crucial for prevention and early treatment. Bone mineral density (BMD) is one of the reference indicators employed to diagnose osteoporosis, and is associated to an increased risk of fractures, including lumbar and hip fractures (MCCLUNG, 2005;MEHTA;SEBRO, 2020;WU et al, 2020). Among other bone measurements employed to estimate bone strength are the bone geometry, cortical porosity, collagen properties, bone turnover rates, trabecular microarchitecture, and percentage of microdamage, and bone marrow adiposity (MACIEL et al, 2020).…”

Section: Hypothesismentioning

confidence: 99%

Analysis of medical images to support decision-making in the musculoskeletal field

Ramos¹

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Correlation of bone mineral density with MRI T2* values in quantitative analysis of lumbar osteoporosis

Cited by 32 publications

References 34 publications

Vertebral bone marrow T2* mapping using chemical shift encoding-based water-fat separation in the quantitative analysis of lumbar osteoporosis and osteoporotic fractures

Vertebral bone marrow T2* mapping using chemical shift encoding-based water-fat separation in the quantitative analysis of lumbar osteoporosis and osteoporotic fractures

Fractal lacunarity of trabecular bone in vertebral MRI to predict osteoporotic fracture risk in over-fifties women. The LOTO study

Analysis of medical images to support decision-making in the musculoskeletal field

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