Simultaneous Estimation of the Fat Fraction and R₂ Via T₂ -Corrected 6-Echo Dixon Volumetric Interpolated Breath-hold Examination Imaging for Osteopenia and Osteoporosis Detection: Correlations with Sex, Age, and Menopause

• Published in: Korean journal of radiology Vol. 20; no. 6; pp. 916 - 930
• Main Authors: Kim, Donghyun, Kim, Sung Kwan, Lee, Sun Joo, Choo, Hye Jung, Park, Jung Won, Kim, Kun Yung
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Society of Radiology 01.06.2019; 대한영상의학회
• Subjects: Adipocytes; Age; Back pain; Confidence intervals; Fractures; Magnetic resonance imaging; Menopause; Musculoskeletal Imaging; Osteoporosis; Software; Spectrum analysis; Women; Work stations; 방사선과학; Germany; Bone marrow; Osteoporosis; R; Fat fraction; Magnetic resonance imaging
• ISSN: 1229-6929; 2005-8330; 2005-8330
• DOI: 10.3348/kjr.2018.0032

To investigate the relationships of T₂ -corrected 6-echo Dixon volumetric interpolated breath-hold examination (VIBE) imaging-based fat fraction (FF) and R₂ values with bone mineral density (BMD); determine their associations with sex, age, and menopause; and evaluate the diagnostic performance of the FF and R₂ for predicting osteopenia and osteoporosis. This study included 153 subjects who had undergone magnetic resonance (MR) imaging, including MR spectroscopy (MRS) and T₂ -corrected 6-echo Dixon VIBE imaging. The FF and R₂ were measured at the L4 vertebra. The male and female groups were divided into two subgroups according to age or menopause. Lin's concordance and Pearson's correlation coefficients, Bland-Altman 95% limits of agreement, and the area under the curve (AUC) were calculated. The correlation between the spectroscopic and 6-echo Dixon VIBE imaging-based FF values was statistically significant for both readers (p = 0.940 [reader 1], 0.908 [reader 2]; both < 0.001). A small measurement bias was observed for the MRS-based FF for both readers (mean difference = -0.3% [reader 1], 0.1% [reader 2]). We found a moderate negative correlation between BMD and the FF ( = -0.411 [reader 1], -0.436 [reader 2]; both < 0.001) with younger men and premenopausal women showing higher correlations. R₂ and BMD were more significantly correlated in women than in men, and the highest correlation was observed in postmenopausal women ( = 0.626 [reader 1], 0.644 [reader 2]; both < 0.001). For predicting osteopenia and osteoporosis, the FF had a higher AUC in men and R₂ had a higher AUC in women. The AUC for predicting osteoporosis was highest with a combination of the FF and R₂ in postmenopausal women (AUC = 0.872 [reader 1], 0.867 [reader 2]; both < 0.001). The FF and R₂ measured using T₂ -corrected 6-echo Dixon VIBE imaging can serve as predictors of osteopenia and osteoporosis. R₂ might be useful for predicting osteoporosis, especially in postmenopausal women.