MR-based proton density fat fraction (PDFF) of the vertebral bone marrow differentiates between patients with and without osteoporotic vertebral fractures.

Gassert, F T; Kufner, A; Gassert, F G; Leonhardt, Y; Kronthaler, S; Schwaiger, B J; Boehm, C; Makowski, M R; Kirschke, J S; Baum, T; Karampinos, D C; Gersing, A S

doi:10.1007/s00198-021-06147-3

2022

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Title:: MR-based proton density fat fraction (PDFF) of the vertebral bone marrow differentiates between patients with and without osteoporotic vertebral fractures.
Document type:: Journal Article
Author(s):: Gassert, F T; Kufner, A; Gassert, F G; Leonhardt, Y; Kronthaler, S; Schwaiger, B J; Boehm, C; Makowski, M R; Kirschke, J S; Baum, T; Karampinos, D C; Gersing, A S
Abstract:: The bone marrow proton density fat fraction (PDFF) assessed with MRI enables the differentiation between osteoporotic/osteopenic patients with and without vertebral fractures. Therefore, PDFF may be a potentially useful biomarker for bone fragility assessment. INTRODUCTION: To evaluate whether magnetic resonance imaging (MRI)-based proton density fat fraction (PDFF) of vertebral bone marrow can differentiate between osteoporotic/osteopenic patients with and without vertebral fractures. METHODS: Of the 52 study patients, 32 presented with vertebral fractures of the lumbar spine (66.4 ± 14.4 years, 62.5% women; acute low-energy osteoporotic/osteopenic vertebral fractures, N = 25; acute high-energy traumatic vertebral fractures, N = 7). These patients were frequency matched for age and sex to patients without vertebral fractures (N = 20, 69.3 ± 10.1 years, 70.0% women). Trabecular bone mineral density (BMD) values were derived from quantitative computed tomography. Chemical shift encoding-based water-fat MRI of the lumbar spine was performed, and PDFF maps were calculated. Associations between fracture status and PDFF were assessed using multivariable linear regression models. RESULTS: Over all patients, mean PDFF and trabecular BMD correlated significantly (r = - 0.51, P < 0.001). In the osteoporotic/osteopenic group, those patients with osteoporotic/osteopenic fractures had a significantly higher PDFF than those without osteoporotic fractures after adjusting for age, sex, weight, height, and trabecular BMD (adjusted mean difference [95% confidence interval], 20.8% [10.4%, 30.7%]; P < 0.001), although trabecular BMD values showed no significant difference between the subgroups (P = 0.63). For the differentiation of patients with and without vertebral fractures in the osteoporotic/osteopenic subgroup using mean PDFF, an area under the receiver operating characteristic (ROC) curve (AUC) of 0.88 (P = 0.006) was assessed. When evaluating all patients with vertebral fractures, those with high-energy traumatic fractures had a significantly lower PDFF than those with low-energy osteoporotic/osteopenic vertebral fractures (P < 0.001). CONCLUSION: MR-based PDFF enables the differentiation between osteoporotic/osteopenic patients with and without vertebral fractures, suggesting the use of PDFF as a potential biomarker for bone fragility.
Journal title abbreviation:: Osteoporos Int
Year:: 2022
Journal volume:: 33
Journal issue:: 2
Pages contribution:: 487-496
Fulltext / DOI:: doi:10.1007/s00198-021-06147-3
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/34537863
Print-ISSN:: 0937-941X
TUM Institution:: Fachgebiet Neuroradiologie (Prof. Zimmer); Institut für Diagnostische und Interventionelle Radiologie
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