Correction of QCT vBMD using MRI measurements of marrow adipose tissue

TY - JOUR

T1 - Correction of QCT vBMD using MRI measurements of marrow adipose tissue

AU - Cheng, Xiaoguang

AU - Blake, Glen M.

AU - Guo, Zhe

AU - Keenan Brown, J.

AU - Wang, Ling

AU - Li, Kai

AU - Xu, Li

PY - 2019/3/1

Y1 - 2019/3/1

N2 - Objective: Quantitative computed tomography (QCT) measurements of volumetric bone mineral density (vBMD) are subject to errors due to variations in the amount of bone marrow adipose tissue (BMAT). The purpose of our study was to describe and validate a novel method to correct lumbar spine trabecular vBMD measurements for BMAT using chemical shift-encoded magnetic resonance imaging (CSE-MRI). Methods: CSE-MRI measurements of proton density fat fraction (PDFF) were used to correct QCT spine vBMD measurements for BMAT based on the H2O and K2HPO4 basis set equivalent densities of bone, red and yellow bone marrow. BMAT corrected and uncorrected vBMD measurements of the L1 vertebra were compared with dual-energy QCT (DEQCT) measurements in 18 subjects (mean age: 68 y, range 60 to 93 y). A further 400 subjects (mean age: 53 y, range 21 to 82 y) had 120 kVp single-energy QCT and CES-MRI scans of L2–L4 and the data used to simplify the adipose tissue correction by deriving a linear equation between the CSE-MRI vBMD correction and fractional BMAT content. Results: Application of the CSE-MRI derived vBMD correction changed the bias (95% limits of agreement) compared with DEQCT from 26.7 (11.0 to 42.4) mg/cm3 to 2.2 (−9.5 to 13.9) mg/cm3 at 80 kVp, and from 22.4 (3.3 to 41.6) mg/cm3 to 2.9 (−12.6 to 18.4) mg/cm3 at 120 kVp. Data for the 400 subjects gave the following relationship valid at 120 kVp: vBMD correction (mg/cm3) = −12.96 + 75.76 × BMAT. Conclusion: CSE-MRI measurements of PDFF can be used to correct for BMAT content and improve the accuracy of lumbar spine QCT vBMD measurements calibrated using a K2HPO4 phantom.

AB - Objective: Quantitative computed tomography (QCT) measurements of volumetric bone mineral density (vBMD) are subject to errors due to variations in the amount of bone marrow adipose tissue (BMAT). The purpose of our study was to describe and validate a novel method to correct lumbar spine trabecular vBMD measurements for BMAT using chemical shift-encoded magnetic resonance imaging (CSE-MRI). Methods: CSE-MRI measurements of proton density fat fraction (PDFF) were used to correct QCT spine vBMD measurements for BMAT based on the H2O and K2HPO4 basis set equivalent densities of bone, red and yellow bone marrow. BMAT corrected and uncorrected vBMD measurements of the L1 vertebra were compared with dual-energy QCT (DEQCT) measurements in 18 subjects (mean age: 68 y, range 60 to 93 y). A further 400 subjects (mean age: 53 y, range 21 to 82 y) had 120 kVp single-energy QCT and CES-MRI scans of L2–L4 and the data used to simplify the adipose tissue correction by deriving a linear equation between the CSE-MRI vBMD correction and fractional BMAT content. Results: Application of the CSE-MRI derived vBMD correction changed the bias (95% limits of agreement) compared with DEQCT from 26.7 (11.0 to 42.4) mg/cm3 to 2.2 (−9.5 to 13.9) mg/cm3 at 80 kVp, and from 22.4 (3.3 to 41.6) mg/cm3 to 2.9 (−12.6 to 18.4) mg/cm3 at 120 kVp. Data for the 400 subjects gave the following relationship valid at 120 kVp: vBMD correction (mg/cm3) = −12.96 + 75.76 × BMAT. Conclusion: CSE-MRI measurements of PDFF can be used to correct for BMAT content and improve the accuracy of lumbar spine QCT vBMD measurements calibrated using a K2HPO4 phantom.

KW - Bone density accuracy errors

KW - Bone marrow adipose tissue

KW - Chemical shift encoded magnetic resonance imaging

KW - Proton density fat fraction

KW - Quantitative computed tomography

KW - Volumetric bone mineral density

UR - http://www.scopus.com/inward/record.url?scp=85059063925&partnerID=8YFLogxK

U2 - 10.1016/j.bone.2018.12.015

DO - 10.1016/j.bone.2018.12.015

M3 - Article

AN - SCOPUS:85059063925

SN - 8756-3282

VL - 120

SP - 504

EP - 511

JO - Bone

JF - Bone

ER -