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European Radiology
Published in: European Radiology 12/2013

01-12-2013 | Musculoskeletal

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

Authors: Jens-Peter Kühn, Diego Hernando, Peter J. Meffert, Scott Reeder, Norbert Hosten, Rene Laqua, Antje Steveling, Stephan Ender, Henry Schröder, Dirk-Thomas Pillich

Published in: European Radiology | Issue 12/2013

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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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Metadata
Title
Proton-density fat fraction and simultaneous R2* estimation as an MRI tool for assessment of osteoporosis
Authors
Jens-Peter Kühn
Diego Hernando
Peter J. Meffert
Scott Reeder
Norbert Hosten
Rene Laqua
Antje Steveling
Stephan Ender
Henry Schröder
Dirk-Thomas Pillich
Publication date
01-12-2013
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 12/2013
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-013-2950-7

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