Comparative evaluation of multiparametric lumbar MRI radiomic models for detecting osteoporosis

Osteoporosis is a serious global public health issue. Currently, there are few studies that explore the use of multiparametric MRI radiomics for osteoporosis detection. The purpose of this study was to compare the performance of radiomics features from multiple MRI sequences (T1WI, T2WI and T1WI combined with T2WI) for detecting osteoporosis in patients.

A retrospective analysis was performed on 160 patients who had undergone dual-energy X-ray absorptiometry(DXA) and lumbar magnetic resonance imaging (MRI) at our hospital. Among them, 86 patients were diagnosed with abnormal bone mass (osteoporosis or low bone mass), and 74 patients were diagnosed with normal bone mass based on the DXA results. Sagittal T1-and T2-weighted images of all patients were imported into the uAI Research Portal (United Imaging Intelligence) for image delineation and radiomics analysis, where a series of radiomic features were obtained. A radiomic model that included T1WI, T2WI, and T1WI+T2WI was established using features selected by LASSO regression. We used ROC curve analysis to evaluate the predictive efficacy of each model for identifying bone abnormalities and conducted decision curve analysis (DCA) to evaluate the net benefit of each model. Finally, we validated the model in a sample of 35 patients from different health care institution.

The T1WI + T2WI radiomics model showed better screening performance for patients with abnormal bone mass. In the training group, the sensitivity was 0.758, the specificity was 0.78, and the accuracy was 0.768 (AUC =0.839, 95% CI=0.757-0.901). In the validation group, the sensitivity was 0.792, the specificity was 0.875, and the accuracy was 0.833 (AUC =0.86, 95% CI=0.73-0.943).The DCA also showed that the combined model had better net benefits. In the external validation group, the sensitivity was 0.764, the specificity was 0.833, and the accuracy was 0.8 (AUC =0.824, 95% CI 0.678-0.969).

Radiomics-based multiparametric MRI can be used for the quantitative analysis of lumbar MRI and for accurately screening patients with abnormal bone mass.