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Proton-density fat fraction and simultaneous R2* estimation as an MRI tool for assessment of osteoporosis

  • Musculoskeletal
  • Published:
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Abstract

Objective

To investigate multi-echo chemical shift-encoded MRI-based mapping of proton density fat fraction (PDFF) and fat-corrected R2* in bone marrow as biomarkers for osteoporosis assessment.

Methods

Fifty-one patients (28 female; mean age 69.7 ± 9.0 years) underwent dual energy X-ray absorptiometry (DXA). On the basis of the t score, 173 valid vertebrae bodies were divided into three groups (healthy, osteopenic and osteoporotic). Three echo chemical shift-encoded MRI sequences were acquired at 3 T. PDFF and R2* with correction for multiple-peak fat (R2*MP) were measured for each vertebral body. Kruskal–Wallis test and post hoc analysis were performed to evaluate differences between groups. Further, the area under the curve (AUC) for each technique was calculated using logistic regression analysis.

Results

On the basis of DXA, 92 samples were normal (53 %), 47 osteopenic (27 %) and 34 osteoporotic (20 %). PDFF was increased in osteoporosis compared with healthy (P = 0.007). R2*MP showed significant differences between normal and osteopenia (P = 0.004), and between normal and osteoporosis (P < 0.001). AUC to differentiate between normal and osteoporosis was 0.698 for R2*MP, 0.656 for PDFF and 0.74 for both combined.

Conclusion

PDFF and R2*MP are moderate biomarkers for osteoporosis. PDFF and R2*MP combination might improve the prediction in differentiating healthy subjects from those with osteoporosis.

Key Points

• Magnetic resonance imaging offers new insights into bone composition.

• PDFF and R2* are moderate biomarkers for the assessment of osteoporosis.

• R2* mapping for staging of osteoporosis is affected by bone marrow fat.

• Multi-peak spectral modelling improved the relationship between osteoporosis and R2*.

• PDFF/multi-peak fat-corrected R2* together might improve differentiation between healthy and osteoporotic subjects.

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Acknowledgments

This work is part of the research project Greifswald Approach to Individualized Medicine (GANI_MED). The GANI_MED consortium is funded by the German Federal Ministry of Education and Research (FKZ 03IS2061A) and the Ministry of Cultural Affairs of the Federal State of Mecklenburg West Pomerania (UG 09 033). We also acknowledge the support of the National Institutes of Health (NIH) (R01 DK083380 and R01 DK088925).

We acknowledge the help of the medical technical assistants of the Department of Radiology and Neuroradiology of the University Hospital Greifswald.

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Authors and Affiliations

  1. Department of Diagnostic Radiology and Neuroradiology, Medical University Greifswald, Sauerbruch-Strasse 1, 17489, Greifswald, Germany

    Jens-Peter Kühn, Norbert Hosten & Rene Laqua

  2. Department of Radiology, University of Wisconsin, 1111 Highland Ave, Madison, WI, 53705, USA

    Diego Hernando

  3. Institute for Community Medicine, Medical University Greifswald, Walther-Rathenau-Strasse 48, 17475, Greifswald, Germany

    Peter J. Meffert

  4. Departments of Radiology, Medical Physics, Biomedical Engineering and Medicine, University of Wisconsin, 1111 Highland Ave, Madison, WI, 53705, USA

    Scott Reeder

  5. Department of Medicine, Medical University Greifswald, Sauerbruch-Strasse 1, 17489, Greifswald, Germany

    Antje Steveling

  6. Department of Orthopedics, Medical University Greifswald, Sauerbruch-Strasse 1, 17489, Greifswald, Germany

    Stephan Ender

  7. Department of Neurosurgery, Medical University Greifswald, Sauerbruch-Strasse 1, 17489, Greifswald, Germany

    Henry Schröder & Dirk-Thomas Pillich

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  1. Jens-Peter Kühn
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  2. Diego Hernando
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  3. Peter J. Meffert
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Correspondence to Jens-Peter Kühn.

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Kühn, JP., Hernando, D., Meffert, P.J. et al. Proton-density fat fraction and simultaneous R2* estimation as an MRI tool for assessment of osteoporosis. Eur Radiol 23, 3432–3439 (2013). https://doi.org/10.1007/s00330-013-2950-7

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  • DOI: https://doi.org/10.1007/s00330-013-2950-7

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