Quantifying bone marrow fat using standard T1-weighted magnetic resonance images in children with typical development and in children with cerebral palsy
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Updated: Dec 26, 2025
Quantitative Magnetic Resonance Imaging of Skeletal Muscle Disease
Published on: December 18, 2016
Chuan Zhang1, Jill M Slade2, Freeman Miller3
1Department of Kinesiology, University of Georgia, Athens, GA, USA.
Insights
Standard MRI T1-weighted images accurately estimate bone marrow fat volume in children. This method is comparable to the IDEAL technique but less sensitive to variations in bone marrow fat fraction.
Area of Science:
- Biomedical Imaging
- Pediatric Bone Health
- Magnetic Resonance Imaging
Background:
- Excessive bone marrow adiposity can negatively impact bone growth and development in children.
- Assessing bone marrow fat is crucial for understanding bone health, particularly in conditions like cerebral palsy.
Purpose of the Study:
- To evaluate if standard T1-weighted MRI accurately estimates bone marrow fat in children.
- To compare T1-weighted MRI fat estimation with the iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL) technique.
Main Methods:
- T1-weighted MRI and IDEAL techniques were used to acquire fat and water images of the tibia in typically developing children and those with mild spastic cerebral palsy.
- Bone marrow fat volume (BMFV) and fat fraction (BMFF) were determined using both methods (BMFVT1, BMFFT1 and BMFVIDEAL, BMFFIDEAL).
Main Results:
- BMFVT1 strongly correlated with and did not differ from BMFVIDEAL in both groups.
- BMFFT1 moderately correlated with and did not differ from BMFFIDEAL in both groups.
- While BMFV showed no group differences, BMFFIDEAL was higher in children with cerebral palsy, a difference not detected by BMFFT1.
Conclusions:
- Standard T1-weighted MRI provides bone marrow fat volume estimates comparable to the IDEAL technique in children.
- Standard T1-weighted MRI is less sensitive than IDEAL for detecting variations in bone marrow fat fraction, particularly in pediatric populations with conditions like cerebral palsy.
Abstract:
Excess bone marrow adiposity may have a negative effect on bone growth and development. The aim of this study was to determine whether a procedure using standard T1-weighted magnetic resonance images provides an accurate estimate of bone marrow fat in children with typical development and in children with mild spastic cerebral palsy (CP; n = 15/group; 4-11 y). Magnetic resonance imaging was used to acquire T1-weighted images. It was also used to acquire fat and water images using an iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL) technique. Bone marrow fat volume and fat fraction in the middle-third of the tibia were determined using the standard T1-weighted images (BMFVT1 and BMFFT1, respectively) and the fat and water images (BMFVIDEAL and BMFFIDEAL, respectively). In both groups, BMFVT1 was highly correlated with (both r > 0.99, p < 0.001) and not different from (both p > 0.05) BMFVIDEAL. In both groups, BMFFT1 was moderately correlated with (both r = 0.71, p < 0.01) and not different from (both p > 0.05) BMFFIDEAL. There was no group difference in BMFVT1 or BMFVIDEAL (both p > 0.05). BMFFIDEAL was higher in children with CP (p < 0.05), but there was no group difference in BMFFT1 (p > 0.05). We conclude that a procedure using standard T1-weighted magnetic resonance images can produce estimates of bone marrow fat volume similar to estimates from the IDEAL technique in children. However, it is less sensitive to variation in the bone marrow fat fraction.
