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Quantitative [18F]-Naf-PET-MRI Analysis for the Evaluation of Dynamic Bone Turnover in a Patient with Facetogenic Low Back Pain
Published on: August 8, 2019
Evaluation of primary lumbar vertebral osteoporosis by MRI fat quantification technique
Chumin Huang1, Wenzhao Yuan2, Chenhui Li2
1Department of Radiology, School of Medicine, the Sixth Affiliated Hospital of South China University of Technology (Nanhai District People's Hospital of Foshan), Foshan, Guangdong 528200, People's Republic of China; Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Guangxi Zhuang Autonomous Region, Nanning 530021, People's Republic of China.
Purpose:
To investigate the diagnostic value of the 3D multi-echo Dixon (ME-DIXON) and High-Speed T2-Corrected Multiecho Acquisition proton magnetic resonance spectroscopy (1H MRS, HISTO) sequences in MRI for lumbar spine osteoporosis.
Methods:
This study enrolled 138 eligible participants (aged 41-70 years), all of whom underwent both lumbar spine MRI and quantitative computed tomography (QCT). Demographic data, proton density fat fraction (PDFF) values from L1 to L4 vertebrae, and QCT-derived bone mineral density (BMD) were systematically collected. Participants were stratified into three groups based on BMD: osteoporosis, osteopenia, and normal. Differences in vertebral PDFF parameters among these three BMD cohorts were compared using one-way analysis of variance (ANOVA). Receiver operating characteristic (ROC) analysis and correlation analysis were performed to evaluate diagnostic performance and assess the correlation between PDFF and BMD, respectively.
Results:
The mean lumbar ME-DIXON-PDFF and HISTO-PDFF values showed negative correlations with BMD (r = -0.68, r = -0.56), age-adjusted(rp = -0.51, rp = -0.33) (all p < 0.05); Both ME-DIXON-PDFF (AUC = 0.833) and HISTO-PDFF (AUC = 0.819) demonstrated good diagnostic performance for osteoporosis. Performance improved after age adjustment (AUC = 0.868 for both models), with no significant difference between the two sequences (all p > 0.05).
Conclusion:
This study confirms a strong inverse correlation between MRI-derived PDFF and QCT-based BMD, and demonstrates diagnostic equivalence between the fully automated HISTO sequence and the established ME-DIXON sequence for osteoporosis identification. These findings support PDFF as a promising imaging biomarker for bone density assessment and validate the technical feasibility of automated spinal fat quantification.
