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Six-point DIXON and Magnetic Resonance Spectroscopy Techniques in Quantifying Bone Marrow Fat in Sickle Cell Disease
Carolina Freitas Lins1, Carlos Ernesto Garrido Salmon2, Luana Amorim de Souza3
1Bahiana School of Medicine and Public Health Salvador, Bahia, Brasil; Clínica Delfin Medicina Diagnóstica, Salvador, Bahia, Brasil; Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Ribeirão Preto Medical School, USP Ribeirão Preto, Ribeirão Preto, São Paulo, Brasil; Ribeirão Preto Medical School Musculoskeletal Imaging Research Laboratory, São Paulo, Brasil.
Rationale And Objectives:
To compare bone marrow fat quantification using magnetic resonance spectroscopy (MRS) and six-point DIXON (6PD) techniques in patients with sickle cell disease (SCD) and healthy subjects.
Materials And Methods:
Prospective study, with 43 SCD patients (24 homozygous [SS], 19 double heterozygous [SC), and 41 healthy subjects paired by age, weight and sex with SCD patients. All participants underwent magnetic resonance imaging with 6PD and single voxel MRS in the L3 vertebral body. Pearson's correlation, ROC curve, and bland-altman analysis were performed, p-values ≤0.05 were considered statistically significant for all tests.
Results:
Significant linear correlation was found between fat fraction (FF) by 6PD and Total Lipids (TL) (r = 0.932; p < 0.001) and Saturated Lipids (SL) (r = 0.934; p < 0.001), in all subjects. Strong correlations were also identified considering subjects of the SS/SC subgroups. Despite high correlations, no significant difference was observed only between FF and SL in the SS subgroup (Bland-Altman analysis), indicating excellent agreement between the fat estimations in this specific situation. Significant differences were observed in all variables (FF, TL, SL) comparing the SCD and healthy subjects. The ROC curve between SCD and healthy subjects showed the following areas under the curve: FF(0.924) > TL(0.883) > SL(0.892).
Conclusions:
The comparison between fat quantification by the 6PD with MRS demonstrated an excellent correlation in SCD patients, especially in the SS subgroup, which usually has a higher degree of hemolysis. The diagnostic performance of 6PD and MRS is similar, with advantages of shorter imaging processing time and larger studied area with the 6PD.
