Associations of incidental vertebral fractures and longitudinal changes of MR-based proton density fat fraction and T2*measurements of vertebral bone marrow

Leonhardt, Yannik; Ketschau, Jannik; Ruschke, Stefan; Gassert, Florian T.; Glanz, Leander; Feuerriegel, Georg C.; Gassert, Felix G.; Baum, Thomas; Kirschke, Jan S.; Braren, Rickmer F.; Schwaiger, Benedikt J.; Makowski, Marcus R.; Karampinos, Dimitrios C. und Gersing, Alexandra S. (2022): Associations of incidental vertebral fractures and longitudinal changes of MR-based proton density fat fraction and T2*measurements of vertebral bone marrow. In: Frontiers in Endocrinology, Bd. 13, 1046547

Abstract

BackgroundQuantitative magnetic resonance imaging (MRI) techniques such as chemical shift encoding-based water-fat separation techniques (CSE-MRI) are increasingly applied as noninvasive biomarkers to assess the biochemical composition of vertebrae. This study aims to investigate the longitudinal change of proton density fat fraction (PDFF) and T2* derived from CSE-MRI of the thoracolumbar vertebral bone marrow in patients that develop incidental vertebral compression fractures (VCFs), and whether PDFF and T2* enable the prediction of an incidental VCF. MethodsIn this study we included 48 patients with CT-derived bone mineral density (BMD) measurements at baseline. Patients that presented an incidental VCF at follow up (N=12, mean age 70.5 +/- 7.4 years, 5 female) were compared to controls without incidental VCF at follow up (N=36, mean age 71.1 +/- 8.6 years, 15 females). All patients underwent 3T MRI, containing a significant part of the thoracolumbar spine (Th11-L4), at baseline, 6-month and 12 month follow up, including a gradient echo sequence for chemical shift encoding-based water-fat separation, from which PDFF and T2* maps were obtained. Associations between changes in PDFF, T2* and BMD measurements over 12 months and the group (incidental VCF vs. no VCF) were assessed using multivariable regression models. Mixed-effect regression models were used to test if there is a difference in the rate of change in PDFF, T2* and BMD between patients with and without incidental VCF. ResultsPrior to the occurrence of an incidental VCF, PDFF in vertebrae increased in the VCF group (Delta(PDFF)=6.3 +/- 3.1%) and was significantly higher than the change of PDFF in the group without VCF (Delta(PDFF)=2.1 +/- 2.5%, P=0.03). There was no significant change in T2* (Delta(T2*)=1.7 +/- 1.1ms vs. Delta(T2*)=1.1 +/- 1.3ms, P=0.31) and BMD (Delta(BMD)=-1.2 +/- 11.3mg/cm(3) vs. Delta(BMD)=-11.4 +/- 24.1mg/cm(3), P= 0.37) between the two groups over 12 months. At baseline, no significant differences were detected in the average PDFF, T2* and BMD of all measured vertebrae (Th11-L4) between the VCF group and the group without VCF (P=0.66, P=0.35 and P= 0.21, respectively). When assessing the differences in rates of change, there was a significant change in slope for PDFF (2.32 per 6 months, 95% confidence interval (CI) 0.31-4.32;P=0.03) but not for T2* (0.02 per 6 months, CI -0.98-0.95;P=0.90) or BMD (-4.84 per 6 months, CI -23.4-13.7;P=0.60). ConclusionsIn our study population, the average change of PDFF over 12 months is significantly higher in patients that develop incidental fractures at 12-month follow up compared to patients without incidental VCF, while T2* and BMD show no significant changes prior to the occurrence of the incidental vertebral fractures. Therefore, a longitudinal increase in bone marrow PDFF may be predictive for vertebral compression fractures.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 1664-2392
• Sprache: Englisch