Quantification of vertebral bone marrow fat content using 3 tesla MR spectroscopy: Reproducibility, vertebral variation, and applications in osteoporosis

Abstract Background Bone-marrow water–fat composition is a useful imaging biomarker. However, the vertebral bone-marrow fat composition in healthy adults of east China is unknown. The aim of this study was to investigate differences in lumbar vertebral bone-marrow fat content between the sexes with age, using iterative decomposition of water and fat with echo asymmetry and least-squares estimation quantitation (IDEAL-IQ). Methods Three-hundred-and-twenty-one healthy volunteers (age range 20–29 years: 32/33 men/women; 30–39 years: 40/37; 40–49 years: 21/45; 50–59 years: 26/37; ≥ 60 years: 15/26) were included in the present study. All subjects underwent IDEAL-IQ sequence imaging on a 3.0-T MR scanner. Bone-marrow fat-fraction ratio (FF%) was calculated for each vertebral body from sagittal lumbar images. Men and women were compared within age-groups by independent-samples t -tests, and different age-groups and vertebral segments were compared by Bonferroni post-hoc test. FF% correlations with age and body mass index (BMI) were analyzed with Spearman’s correlation coefficient. FF% and vertebral segment correlations were assessed by partial correlation analysis, after adjustment for sex and age. Results FF% averaged over L1–L5 was significantly higher in men than in women for the < 40-year age-groups ( P = 0.000). Bone-marrow fatty conversion was accelerated in women compared to men aged 40–49 years, but was similar in women and men aged > 60 years ( P > 0.05). FF% correlation with age was weakly positive in men ( r = 0.253, P = 0.003), and moderately positive in women ( r = 0.581, P < 0.001), but was non-significantly correlated with BMI and vertebral segments ( r = 0.218; r = 0.187, respectively). FF% was higher in the lower than in the upper lumbar segments ( P < 0.05). Conclusion IDEAL-IQ can accurately quantify lumbar bone-marrow fat infiltration. This increases with age, and differs between men and women and between lower and upper lumbar segments.

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The need forT2correction on MRS-based vertebral bone marrow fat quantification: implications for bone marrow fat fraction age dependence

NMR in Biomedicine ◽

10.1002/nbm.3267 ◽

2015 ◽

Vol 28 (4) ◽

pp. 432-439 ◽

Cited By ~ 36

Author(s):

Michael Dieckmeyer ◽

Stefan Ruschke ◽

Christian Cordes ◽

Samuel P. Yap ◽

Hendrik Kooijman ◽

...

Keyword(s):

Bone Marrow ◽

Age Dependence ◽

Marrow Fat ◽

Fat Quantification ◽

Vertebral Bone ◽

Bone Marrow Fat ◽

Fat Fraction ◽

Vertebral Bone Marrow

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Vertebral bone marrow fat fraction changes in postmenopausal women with breast cancer receiving combined aromatase inhibitor and bisphosphonate therapy

BMC Musculoskeletal Disorders ◽

10.1186/s12891-019-2916-2 ◽

2019 ◽

Vol 20 (1) ◽

Cited By ~ 1

Author(s):

Michael Dieckmeyer ◽

Stefan Ruschke ◽

Alexander Rohrmeier ◽

Jan Syväri ◽

Ingo Einspieler ◽

...

Keyword(s):

Breast Cancer ◽

Bone Marrow ◽

Lumbar Spine ◽

Bone Loss ◽

Marrow Fat ◽

Vertebral Bone ◽

Bone Marrow Fat ◽

Significant Difference ◽

Fat Fraction ◽

Vertebral Bone Marrow

Abstract Background Quantification of vertebral bone marrow (VBM) water–fat composition has been proposed as advanced imaging biomarker for osteoporosis. Estrogen deficiency is the primary reason for trabecular bone loss in postmenopausal women. By reducing estrogen levels aromatase inhibitors (AI) as part of breast cancer therapy promote bone loss. Bisphosphonates (BP) are recommended to counteract this adverse drug effect. The purpose of our study was to quantify VBM proton density fat fraction (PDFF) changes at the lumbar spine using chemical shift encoding-based water-fat MRI (CSE-MRI) and bone mineral density (BMD) changes using dual energy X-ray absorptiometry (DXA) related to AI and BP treatment over a 12-month period. Methods Twenty seven postmenopausal breast cancer patients receiving AI therapy were recruited for this study. 22 subjects completed the 12-month study. 14 subjects received AI and BP (AI+BP), 8 subjects received AI without BP (AI-BP). All subjects underwent 3 T MRI. An eight-echo 3D spoiled gradient-echo sequence was used for CSE-based water-fat separation at the lumbar spine to generate PDFF maps. After manual segmentation of the vertebral bodies L1-L5 PDFF values were extracted for each vertebra and averaged for each subject. All subjects underwent DXA of the lumbar spine measuring the average BMD of L1-L4. Results Baseline age, PDFF and BMD showed no significant difference between the two groups (p > 0.05). There was a relative longitudinal increase in mean PDFF (∆relPDFF) in both groups (AI+BP: 5.93%; AI-BP: 3.11%) which was only significant (p = 0.006) in the AI+BP group. ∆relPDFF showed no significant difference between the two groups (p > 0.05). There was no significant longitudinal change in BMD (p > 0.05). Conclusions Over a 12-month period, VBM PDFF assessed with CSE-MRI significantly increased in subjects receiving AI and BP. The present results contradict previous results regarding the effect of only BP therapy on bone marrow fat content quantified by magnetic resonance spectroscopy and bone biopsies. Future longer-term follow-up studies are needed to further characterize the effects of combined AI and BP therapy.

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Sex hormones are negatively associated with vertebral bone marrow fat

Bone ◽

10.1016/j.bone.2017.12.009 ◽

2018 ◽

Vol 108 ◽

pp. 20-24 ◽

Cited By ~ 7

Author(s):

Swaroop D. Mistry ◽

Gina N. Woods ◽

Sigurdur Sigurdsson ◽

Susan K. Ewing ◽

Trisha F. Hue ◽

...

Keyword(s):

Bone Marrow ◽

Sex Hormones ◽

Marrow Fat ◽

Vertebral Bone ◽

Negatively Associated ◽

Bone Marrow Fat ◽

Vertebral Bone Marrow

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Vertebral bone marrow glucose uptake is inversely associated with bone marrow fat in diabetic and healthy pigs: [18F]FDG-PET and MRI study

Bone ◽

10.1016/j.bone.2013.12.022 ◽

2014 ◽

Vol 61 ◽

pp. 33-38 ◽

Cited By ~ 15

Author(s):

Ville Huovinen ◽

Virva Saunavaara ◽

Riku Kiviranta ◽

Miikka Tarkia ◽

Henri Honka ◽

...

Keyword(s):

Bone Marrow ◽

Glucose Uptake ◽

Fdg Pet ◽

Marrow Fat ◽

Vertebral Bone ◽

Bone Marrow Fat ◽

Vertebral Bone Marrow ◽

18F Fdg ◽

Mri Study

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Assessment of whole spine vertebral bone marrow fat using chemical shift-encoding based water-fat MRI

Journal of Magnetic Resonance Imaging ◽

10.1002/jmri.24854 ◽

2015 ◽

Vol 42 (4) ◽

pp. 1018-1023 ◽

Cited By ~ 54

Author(s):

Thomas Baum ◽

Samuel P. Yap ◽

Michael Dieckmeyer ◽

Stefan Ruschke ◽

Holger Eggers ◽

...

Keyword(s):

Bone Marrow ◽

Chemical Shift ◽

Marrow Fat ◽

Vertebral Bone ◽

Bone Marrow Fat ◽

Vertebral Bone Marrow ◽

Whole Spine

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The contributions of cartilage endplate composition and vertebral bone marrow fat to intervertebral disc degeneration in patients with chronic low back pain

10.1101/2021.10.25.21265485 ◽

2021 ◽

Author(s):

Noah B Bonnheim ◽

Linshanshan Wang ◽

Anne A Lazar ◽

Jiamin Zhou ◽

Ravi Chachad ◽

...

Keyword(s):

Bone Marrow ◽

Low Back Pain ◽

Disc Degeneration ◽

Relaxation Times ◽

Low Back ◽

Marrow Fat ◽

Vertebral Bone ◽

Cartilage Endplate ◽

Bone Marrow Fat ◽

Vertebral Bone Marrow

Purpose: The composition of the subchondral bone marrow and cartilage endplate (CEP) could affect intervertebral disc health by influencing vertebral perfusion and nutrient diffusion. However, the relative contributions of these factors to disc degeneration in patients with chronic low back pain (cLBP) have not been quantified. The goal of this study was to use compositional biomarkers derived from quantitative MRI to establish how CEP composition (surrogate for permeability) and vertebral bone marrow fat fraction (BMFF, surrogate for perfusion) relate to disc degeneration. Methods: MRI data from 60 patients with cLBP were included in this prospective observational study (28 female, 32 male; age = 40.0 ± 11.9 years, 19–65 [mean ± SD, min–max]). Ultra-short echo-time MRI was used to calculate CEP T2* relaxation times (reflecting biochemical composition), water-fat MRI was used to calculate vertebral BMFF, and T1ρ MRI was used to calculate T1ρ relaxation times in the nucleus pulposus (NP T1ρ, reflecting proteoglycan content and degenerative grade). Univariate linear regression was used to assess the independent effects of CEP T2* and vertebral BMFF on NP T1ρ. Mixed effects multivariable linear regression accounting for age, sex, and BMI was used to assess the combined relationship between variables. Results: CEP T2* and vertebral BMFF were independently associated with NP T1ρ (p = 0.003 and 0.0001, respectively). After adjusting for age, sex, and BMI, NP T1ρ remained significantly associated with CEP T2* (p = 0.0001) but not vertebral BMFF (p = 0.43). Conclusion: Poor CEP composition may play a significant role in disc degeneration severity and can affect disc health both with and without deficits in vertebral perfusion.

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Intervertebral disc degeneration associated with vertebral marrow fat, assessed using quantitative magnetic resonance imaging

Skeletal Radiology ◽

10.1007/s00256-020-03419-7 ◽

2020 ◽

Vol 49 (11) ◽

pp. 1753-1763

Author(s):

Yayun Ji ◽

Weifeng Hong ◽

Mouyuan Liu ◽

Yuying Liang ◽

YongYan Deng ◽

...

Keyword(s):

Bone Marrow ◽

Intervertebral Disc ◽

Disc Degeneration ◽

Intervertebral Disc Degeneration ◽

Fat Deposition ◽

Marrow Fat ◽

Vertebral Bone ◽

Bone Marrow Fat ◽

Fat Fraction ◽

Vertebral Bone Marrow

Abstract Objective To investigate the potential clinical application of quantitative MRI in assessing the correlation between lumbar vertebrae bone marrow fat deposition and intervertebral disc degeneration. Materials and methods A total of 104 chronic lower-back pain volunteers underwent 3.0-T MRI with T2-weighted imaging, T2 mapping, and iterative decomposition of water and fat with echo asymmetry and least squares estimation (IDEAL-IQ) between August 2018 and June 2019. Each disc was assessed with T2 value by T2 mapping, and the L1-S1 vertebral bone marrow fat fraction was assessed by IDEAL-IQ. The differences and relationship between T2 value and the adjacent vertebral bone marrow fat fraction values within the five Pfirrmann groups, five age groups, and five lumbar levels were statistically analyzed. Results The vertebral bone marrow fat fraction had a significant negative correlation with T2 values of nucleus pulposus’ T2 values (p < 0.001). However, the significant negative correlation was only found between T2 values of nucleus pulposus and adjacent vertebral bone marrow fat in Pfirrmann II–III, L1/2-L5/S1 level, and 40–49 years’ age groups. Pfirrmann grades of the intervertebral disc were positively correlated with adjacent vertebrae bone marrow fat fraction (p < 0.05). Conclusion Lumbar bone marrow fat deposition significantly increases during the early stages of intervertebral disc degeneration. Quantitative measurements of bone marrow fat deposition and water content of intervertebral discs have a predictive value and are an important supplement to the qualitative traditional classification strategies for the early stages of intervertebral disc degeneration.

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