Quantitative imaging techniques for the assessment of osteoporosis and sarcopenia

Abstract

Bone and muscle are two deeply interconnected organs and a strong relationship between them exists in their development and maintenance. The peak of both bone and muscle mass is achieved in early adulthood, followed by a progressive decline after the age of 40. The increase in life expectancy in developed countries resulted in an increase of degenerative diseases affecting the musculoskeletal system. Osteoporosis and sarcopenia represent a major cause of morbidity and mortality in the elderly population and are associated with a significant increase in healthcare costs. Several imaging techniques are currently available for the non-invasive investigation of bone and muscle mass and quality. Conventional radiology, dual energy X-ray absorptiometry (DXA), computed tomography (CT), magnetic resonance imaging (MRI) and ultrasound often play a complementary role in the study of osteoporosis and sarcopenia, depicting different aspects of the same pathology. This paper presents the different imaging modalities currently used for the investigation of bone and muscle mass and quality in osteoporosis and sarcopenia with special emphasis on the clinical applications and limitations of each technique and with the intent to provide interesting insights into recent advances in the field of conventional imaging, novel high-resolution techniques and fracture risk.

Aging and Imaging Assessment of Body Composition: From Fat to Facts

“…From a technical point of view body composition measurement with MRI is based on the different magnetic properties of hydrogen nuclei contained in water and fat. Several MRI sequences have been developed to measure body fat, using variations in radiofrequency pulse to differentiate between adipose tissue and fat-free mass (27). A variety of pulse sequences are thus available to generate contrast between fat and non-adipose tissue (42).…”

“…in terms of radiation exposure), the time required and costs (equipment and personnel) ( Tables 1, 2). Nowadays, Dual-energy X-ray Absorptiometry (DXA) represents a reference method for the assessment of human BC in the research field (22,23), due to its fast acquisition time, low radiation exposure and relatively low cost when compared to other available techniques (24)(25)(26)(27). Within the framework of the European NU-AGE project (conducted from 2011 to 2016) a DXA scan has been carried out in a large number (N = 1,121) of sex-balanced, free-living, apparently healthy older adults aged 65-79 years enrolled in 5 European countries (Italy, France, United Kingdom, Netherlands and Poland) (28) for the first time.…”

MRI‐Derived Biomarkers Related to Sarcopenia: A Systematic Review

“…This can be considered a consequence of the restricted application of MRI in the clinical assessment of sarcopenic patients. In fact, MRI assessment of sarcopenic patients is currently mainly a research field . This condition makes it challenging to retrospectively retrieve datasets regarding large patient cohorts …”

“…In fact, MRI assessment of sarcopenic patients is currently mainly a research field. 3,4 This condition makes it challenging to retrospectively retrieve datasets regarding large patient cohorts. 50 Notably, MRI is the only technique that allows combining body mass composition and muscle quality assessment.…”

“…Together with osteoporosis, sarcopenia represents a major cause of morbidity and mortality in the elderly population and is associated with a significant increase in healthcare costs due to the increased risk of hospitalization and the associated cost of care . Moreover, sarcopenia is associated with frailty, cardiac disease, respiratory disease, cognitive impairment, and an increased risk of falls and fractures .…”