Quantitative diagnosis of osteoporosis using lumbar spine signal intensity in magnetic resonance imaging

Shayganfar, Azin; Khodayi, Maede; Ebrahimian, Shadi; Tabrizi, Zhale

doi:10.1259/bjr.20180774

Cited by 28 publications

(17 citation statements)

References 17 publications

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“…9 Despite the potential utility of the M-score, it is limited by the fact that it relies on signal-to-noise ratios that are specific to the MR system in use. 1,20 The original description by Bandirali et al noted that this limitation of the Mscore would require each center to identify its own set of normalized values, an arduous task that potentially limits the clinical utility of this score. 1 By contrast, the VBQ score described in the current study was implemented using MR volumes acquired by four distinct MR systems with no significant difference in VBQ scores between machines (Supplemental Table 1).…”

Section: Discussionmentioning

confidence: 99%

A novel MRI-based score assessing trabecular bone quality to predict vertebral compression fractures in patients with spinal metastasis

Ehresman¹,

Schilling²,

Pennington³

et al. 2020

Journal of Neurosurgery: Spine

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OBJECTIVEVertebral compression fractures (VCFs) in patients with spinal metastasis can lead to destabilization and often carry a high risk profile. It is therefore important to have tools that enable providers to predict the occurrence of new VCFs. The most widely used tool for bone quality assessment, dual-energy x-ray absorptiometry (DXA), is not often available at a patient’s initial presentation and has limited sensitivity. While the Spinal Instability Neoplastic Score (SINS) has been associated with VCFs, it does not take patients’ baseline bone quality into consideration. To address this, the authors sought to develop an MRI-based scoring system to estimate trabecular vertebral bone quality (VBQ) and to assess this system’s ability to predict the occurrence of new VCFs in patients with spinal metastasis.METHODSCases of adult patients with a diagnosis of spinal metastasis, who had undergone stereotactic body radiation therapy (SBRT) to the spine or neurosurgical intervention at a single institution between 2012 and 2019, were retrospectively reviewed. The novel VBQ score was calculated for each patient by dividing the median signal intensity of the L1–4 vertebral bodies by the signal intensity of cerebrospinal fluid (CSF). Multivariable logistic regression analysis was used to identify associations of demographic, clinical, and radiological data with new VCFs.RESULTSAmong the 105 patients included in this study, 56 patients received a diagnosis of a new VCF and 49 did not. On univariable analysis, the factors associated with new VCFs were smoking status, steroid use longer than 3 months, the SINS, and the novel scoring system—the VBQ score. On multivariable analysis, only the SINS and VBQ score were significant predictors of new VCFs and, when combined, had a predictive accuracy of 89%.CONCLUSIONSAs a measure of bone quality, the novel VBQ score significantly predicted the occurrence of new VCFs in patients with spinal metastases independent of the SINS. This suggests that baseline bone quality is a crucial factor that requires assessment when evaluating these patients’ conditions and that the VBQ score is a novel and simple MRI-based measure to accomplish this.

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Section: Discussionmentioning

confidence: 99%

A novel MRI-based score assessing trabecular bone quality to predict vertebral compression fractures in patients with spinal metastasis

Ehresman¹,

Schilling²,

Pennington³

et al. 2020

Journal of Neurosurgery: Spine

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“…The bone density is high, usually 300~3000HU [18]. Many studies have shown a good correlation between HU value and T score [8][9][10][18][19][20].Similarly, the M-score was the rst MRI-based observation to use adipose tissue with high T1 signal and to assess fat in ltration in cancellous bone by measuring T1 signal in the vertebral body [21].Other study has con rmed this approach and provided evidence for the use of m-scores to assess bone quality [22].However, M-Score is of limited utility because it requires measurements to be taken using the same MRI machine.Using the principle of M-score and avoiding its defects, VBQ score was developed [11]. VBQ score was standardized with L3 space CSF SI as a reference value and could be compared between patients with different MRI machines.…”

Section: Discussionmentioning

confidence: 99%

Hounsfield Units Value is a Better Predictor of Bone Mineral Density Than the Vertebral Bone Quality Score of Magnetic Resonance Imaging in Patients with Lumbar Degenerative Diseases

Zhu

Tong

et al. 2022

Preprint

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Background: Computed tomography Hounsfield unit (HU) and magnetic resonance imaging (MRI)-based vertebral bone quality (VBQ) score are both alternative tool to the dual energy x-ray absorptiometry(DEXA) scan T-score to quantify the bone quality. However, it is not known which method more accurately reflects vertebral bone mineral density. Purpose: To evaluate the best method for evaluating vertebral bone mineral density in patients undergoing lumbar spine surgery.Methods: Eighty-five patients who had at most two vertebrae with severe degeneration at L1–L4 were retrospectively reviewed.HU value was measured by axial CT image, VBQ score was calculated by T1-weighted lumbar MRI image, and L1-L4 T-score and bone mineral density (BMD) were measured by DEXA.The correlation of the vertebral HU value and VBQ score to the T-score was analyzed.Results: There were 52 female and 33 male patients. The average age was 57.18±9.65 years . HU values had a positive correlation with BMD and T-score. The correlation coefficients between HU and T-score was 0.751(<0.001) for L1; 0.699(<0.001) for L2; 0.618(<0.001) for L3; 0.543(<0.001) for L4; and 0.677(<0.001) for L1-4.However,VBQ score had a negative correlation with BMD and T-score. The correlation coefficients between VBQ score and T-score was -0.231(<0.05) for L1; -0.246(<0.05) for L2; -0.268(<0.05) for L3; -0.252(<0.05) for L4; and -0.346(<0.01) for L1-4. The correlation coefficients of HU value at L1–L4 were higher than the correlation coefficients of VBQ score . Conclusions: HU value was a better predictor of vertebral bone mineral density than VBQ score in patients with lumbar degenerative disease.

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“…More recently, opportunistic bone quality screening has been explored using lumbar MRIs, which are obtained at increasing rates due to the high prevalence of low back pain amongst the aging population [13,14,15]. The first such investigation, published by Bandirali et al in 2015, described the M-score, a SI measurement of the lumbar trabecular bone on T1-weighted MRI [13].…”

Section: Discussionmentioning

confidence: 99%

“…Using this logic, the authors evaluated a cohort of 226 women who underwent MRI and DXA scans and found that the M-score better correlated with fracture risk than did DXA scores [13]. Subsequent studies by other groups have validated this methodology, giving credence to the use of MRI for assessing bone quality [14,15]. Despite this, the M-score is limited in its utility as it requires all scores be acquired using the same MRI machine, as the score is standardized to the signal-to-noise ratio (SNR), which is specific to each individual MRI scanner.…”

Section: Discussionmentioning

confidence: 99%

Vertebral bone quality score predicts fragility fractures independently of bone mineral density

et al. 2021

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Quantitative diagnosis of osteoporosis using lumbar spine signal intensity in magnetic resonance imaging

Cited by 28 publications

References 17 publications

A novel MRI-based score assessing trabecular bone quality to predict vertebral compression fractures in patients with spinal metastasis

A novel MRI-based score assessing trabecular bone quality to predict vertebral compression fractures in patients with spinal metastasis

Hounsfield Units Value is a Better Predictor of Bone Mineral Density Than the Vertebral Bone Quality Score of Magnetic Resonance Imaging in Patients with Lumbar Degenerative Diseases

Vertebral bone quality score predicts fragility fractures independently of bone mineral density

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