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Zhou F, Sheng B, Lv F. Quantitative analysis of vertebral fat fraction and R2 * in osteoporosis using IDEAL-IQ sequence. BMC Musculoskelet Disord 2023; 24:721. [PMID: 37697287 PMCID: PMC10494397 DOI: 10.1186/s12891-023-06846-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 08/30/2023] [Indexed: 09/13/2023] Open
Abstract
OBJECTIVE To investigate the correlation between FF, R2* value of IDEAL-IQ sequence and bone mineral density, and to explore their application value in the osteoporosis. METHODS We recruited 105 women and 69 men aged over 30 years who voluntarily underwent DXA and MRI examination of lumbar spine at the same day. Participants were divided into normal, osteopenia and osteoporosis group based on T-score and BMD value of DXA examination. One-way ANOVA was adopted to compare the quantitative parameters among the three groups. Independent samples t-test was utilized to compare FF and R2* value between men and women.Pearson correlation analysis was used to research the correlation between FF, R2* value and BMD. RESULTS Age, height, weight, BMD and FF value were significantly different among three groups (p < 0.05). No significant difference was found in FF value between male and female group, while R2* value were significantly different. Vertebral FF was moderately negatively correlated with aBMD, especially in women (r = -0.638, p < 0.001). R2* was mildly to moderately positively correlated with aBMD in men (r = 0.350, p = 0.003), but not in women. Moreover, FF was positively correlated with age, R2* was negatively correlated with age in men, and BMD was negatively correlated with age. CONCLUSIONS The vertebral FF value of IDEAL-IQ sequence has the potential to be a new biological marker for the assessment of osteoporosis. Vertebral FF is moderately negatively correlated with aBMD, especially in women, allowing accuratly quantify the bone marrow fat. R2* value is mildly to moderately correlated with BMD in men and can be served as a complementary tool in the assessment of osteoporosis.
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Affiliation(s)
- Feng Zhou
- Department of Radiology, the First Affiliated Hospital of Chongqing Medical University, Yuzhong District, 1 Youyi Road, Chongqing, 400016 China
| | - Bo Sheng
- Department of Radiology, the First Affiliated Hospital of Chongqing Medical University, Yuzhong District, 1 Youyi Road, Chongqing, 400016 China
| | - Furong Lv
- Department of Radiology, the First Affiliated Hospital of Chongqing Medical University, Yuzhong District, 1 Youyi Road, Chongqing, 400016 China
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Chang FX, Fan DH, Huang G, He JH. Lumbar Spine Bone Mineral Density Measurement: Comparison of Dual-Energy X-Ray Absorptiometry and Fat Content Evaluation by Dixon Chemical Shift MRI. Int J Gen Med 2022; 15:6415-6424. [PMID: 35957757 PMCID: PMC9359785 DOI: 10.2147/ijgm.s370814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 07/22/2022] [Indexed: 11/23/2022] Open
Abstract
Background To assess whether the fat signal intensity and fat fraction (FF) of the lumbar vertebrae as measured on the Dixon chemical shift magnetic resonance imaging (MRI) technique can be correlated with the lumbar vertebra bone mineral density (BMD) measured using dual-energy X-ray absorptiometry (DXA). Methods Forty-five patients were retrospectively collected, and 180 lumbar vertebral bodies (L1-L4) were included. All patients underwent DXA and MRI examinations of the lumbar spine. Taking the T value of DXA as the gold standard and using the diagnostic criteria of the World Health Organization: T score ≥ −1.0SD as normal, −1.0 ~ −2.5SD as osteopenia, and ≤ −2.5SD as osteoporosis. Meanwhile, the signal intensity on T2WI was measured, and FF of L1-L4 vertebral bodies was calculated on MRI images. Bone marrow fat FF calculation formula: FF = [Mfat/(Mfat + Mwater)] × 100% (Mwater and Mfat refer to the total pixel signal intensity value of the region of interest in water image and lipid image, respectively). Finally, the association of signal intensity and FF with DXA was evaluated. Results Totally 180 vertebral bodies in 45 patients were enrolled. According to the T value, they were divided into the normal group (n = 70), osteopenia group (n = 40), and osteoporosis group (n = 70). The fat signal intensity of the normal group, osteopenia group, and osteoporosis group were 96.6 ± 21.8, 154.5 ± 48.7, 216.3 ± 92.6, and the FF were 30.1 ± 6.2%, 52.6 ± 7.6%, 77.5 ± 7.9%, respectively. Among the three groups, the lumbar T2 fat signal intensity and FF had statistical differences (P < 0.01). Besides, the lumbar fat signal intensity and FF were negatively related to DXA (r =−0.65 and −0.93, P < 0.01). Conclusion The fat content calculated using the Dixon chemical shift MRI had an inverse relation with BMD. Moreover, the Dixon chemical shift MRI might provide complementary information to osteoporosis-related research fields.
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Affiliation(s)
- Fei-Xia Chang
- Radiology Department, Dunhuang City Hospital, Dunhuang, 736200, People's Republic of China
| | - Dun-Hui Fan
- Department of General Surgery, Dunhuang City Hospital, Dunhuang, 736200, People's Republic of China
| | - Gang Huang
- Radiology Department, Gansu Provincial People's Hospital, Lanzhou, 730000, People's Republic of China
| | - Jian-Hong He
- Department of General Surgery, Dunhuang City Hospital, Dunhuang, 736200, People's Republic of China
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Zhao Y, Zhao T, Chen S, Zhang X, Serrano Sosa M, Liu J, Mo X, Chen X, Huang M, Li S, Zhang X, Huang C. Fully automated radiomic screening pipeline for osteoporosis and abnormal bone density with a deep learning-based segmentation using a short lumbar mDixon sequence. Quant Imaging Med Surg 2022; 12:1198-1213. [PMID: 35111616 DOI: 10.21037/qims-21-587] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 09/16/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND Although lumbar bone marrow fat fraction (BMFF) has been demonstrated to be predictive of osteoporosis, its utility is limited by the requirement of manual segmentation. Additionally, quantitative features beyond simple BMFF average remain to be explored. In this study, we developed a fully automated radiomic pipeline using deep learning-based segmentation to detect osteoporosis and abnormal bone density (ABD) using a <20 s modified Dixon (mDixon) sequence. METHODS In total, 222 subjects underwent quantitative computed tomography (QCT) and lower back magnetic resonance imaging (MRI). Bone mineral density (BMD) were extracted from L1-L3 using QCT as the reference standard; 206 subjects (48.8±14.9 years old, 140 females) were included in the final analysis, and were divided temporally into the training/validation set (142/64 subjects). A deep-learning network was developed to perform automated segmentation. Radiomic models were built using the same training set to predict ABD and osteoporosis using the mDixon maps. The performance was evaluated using the temporal validation set comprised of 64 subjects, along with the automated segmentation. Additional 25 subjects (56.1±8.8 years, 14 females) from another site and a different scanner vendor was included as independent validation to evaluate the performance of the pipeline. RESULTS The automated segmentation achieved an outstanding mean dice coefficient of 0.912±0.062 compared to manual in the temporal validation. Task-based evaluation was performed in the temporal validation set, for predicting ABD and osteoporosis, the area under the curve, sensitivity, specificity, and accuracy were 0.925/0.899, 0.923/0.667, 0.789/0.873, 0.844/0.844, respectively. These values were comparable to that of manual segmentation. External validation (cross-vendor) was also performed; the area under the curve, sensitivity, specificity, and accuracy were 0.688/0.913, 0.786/0.857, 0.545/0.944, 0.680/0.920 for ABD and osteoporosis prediction, respectively. CONCLUSIONS Our work is the first attempt using radiomics to predict osteoporosis with BMFF map, and the deep-learning based segmentation will further facilitate the clinical utility of the pipeline as a screening tool for early detection of ABD.
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Affiliation(s)
- Yinxia Zhao
- Department of Radiology, The Third Affiliated Hospital of Southern Medical University (Orthopaedic Hospital of Guangdong Province), Guangzhou, China
| | - Tianyun Zhao
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, USA
| | - Shenglan Chen
- Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, China
| | - Xintao Zhang
- Department of Radiology, The Third Affiliated Hospital of Southern Medical University (Orthopaedic Hospital of Guangdong Province), Guangzhou, China
| | - Mario Serrano Sosa
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, USA
| | - Jin Liu
- Department of Radiology, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Xianfu Mo
- Department of Radiology, The Third Affiliated Hospital of Southern Medical University (Orthopaedic Hospital of Guangdong Province), Guangzhou, China
| | - Xiaojun Chen
- Department of Radiology, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Mingqian Huang
- Department of Radiology, The Mount Sinai Hospital, New York, NY, USA
| | - Shaolin Li
- Department of Radiology, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Xiaodong Zhang
- Department of Radiology, The Third Affiliated Hospital of Southern Medical University (Orthopaedic Hospital of Guangdong Province), Guangzhou, China
| | - Chuan Huang
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, USA.,Department of Radiology, Stony Brook Medicine, Stony Brook, NY, USA
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The role of chemical shift magnetic resonance imaging in differentiating osteoporotic benign and malignant vertebral marrow lesions. Pol J Radiol 2021; 86:e468-e473. [PMID: 34567292 PMCID: PMC8449562 DOI: 10.5114/pjr.2021.108541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 08/04/2020] [Indexed: 11/17/2022] Open
Abstract
Purpose To evaluate the usefulness of chemical shift imaging (CSI) in differentiating benign osteoporotic and malignant vertebral marrow lesions. Material and methods Patients undergoing spinal magnetic resonance imaging (MRI) for back pain, which showed altered marrow signal intensity on conventional MRI sequences, were included in the study. Patients with acute traumatic vertebral fractures, infective spondylodiscitis, paravertebral collections, etc. were excluded. The patients underwent CSI. In-phase and opposed-phase images were taken to calculate the signal intensity ratio (SIR) of the abnormal vertebra. The SIR of the mean signal intensity measured on opposed-phase to mean signal intensity measured on in-phase images was measured and recorded. Results The studied population included 30 patients, in whom 58 vertebrae were accessed, which included 38 dorsal, 18 lumbar, 1 sacral, and 1 cervical. Out of 58 vertebrae, 46 (79%) were malignant and 12 (20%) were benign. The mean CSI/SIR of malignant lesions was 0.96 and the mean SIR of benign lesions was 0.76. Conclusions Conventional MRI sequences cannot always differentiate between benign and malignant lesions. So newer sequences like CSI have been developed. CSI SIR can be used as a new tool in differentiating benign osteoporotic and malignant vertebral marrow lesions.
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Wani IM, Arora S. Computer-aided diagnosis systems for osteoporosis detection: a comprehensive survey. Med Biol Eng Comput 2020; 58:1873-1917. [PMID: 32583141 DOI: 10.1007/s11517-020-02171-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 03/26/2020] [Indexed: 12/18/2022]
Abstract
Computer-aided diagnosis (CAD) has revolutionized the field of medical diagnosis. They assist in improving the treatment potentials and intensify the survival frequency by early diagnosing the diseases in an efficient, timely, and cost-effective way. The automatic segmentation has led the radiologist to successfully segment the region of interest to improve the diagnosis of diseases from medical images which is not so efficiently possible by manual segmentation. The aim of this paper is to survey the vision-based CAD systems especially focusing on the segmentation techniques for the pathological bone disease known as osteoporosis. Osteoporosis is the state of the bones where the mineral density of bones decreases and they become porous, making the bones easily susceptible to fractures by small injury or a fall. The article covers the image acquisition techniques for acquiring the medical images for osteoporosis diagnosis. The article also discusses the advanced machine learning paradigms employed in segmentation for osteoporosis disease. Other image processing steps in osteoporosis like feature extraction and classification are also briefly described. Finally, the paper gives the future directions to improve the osteoporosis diagnosis and presents the proposed architecture. Graphical abstract.
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Affiliation(s)
- Insha Majeed Wani
- School of Computer Science and Engineering, SMVDU, Katra, J&K, India
| | - Sakshi Arora
- School of Computer Science and Engineering, SMVDU, Katra, J&K, India.
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Sieron D, Drakopoulos D, Loebelenz LI, Schroeder C, Ebner L, Obmann VC, Huber AT, Christe A. Correlation between fat signal ratio on T1-weighted MRI in the lower vertebral bodies and age, comparing 1.5-T and 3-T scanners. Acta Radiol Open 2020; 9:2058460120901517. [PMID: 32166041 PMCID: PMC7055425 DOI: 10.1177/2058460120901517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 12/30/2019] [Indexed: 11/28/2022] Open
Abstract
Background The hypothesis was that the fat-dependent T1 signal intensity in vertebral
bodies increases with age due to red-yellow marrow conversion. Purpose To analyze the increasing fatty conversion of red bone marrow with age. Material and Methods A continuous sample of 524 patients (age range 2–96 years) with normal lumbar
spine MRIs (T11–L5) was retrospectively selected in order to get a
representative sample from our 1.5-T and 3-T MRI units (Siemens, Erlangen,
Germany). Four radiologists read the images independently. Absolute T1
signal intensities were measured in the lower vertebral bodies and
standardized by dividing their value by the signal of the subcutaneous fat
on lumbar and sacral level. Results The standardized T1 signal correlated significantly with patients’ age at the
1.5-T unit, with the best correlation demonstrated by thoracic vertebra T11,
followed by lumbar vertebra L1, with correlation coefficients (R) of 0.64
(95% CI 0.53–0.72, P < 0.0001) and 0.49 (95% CI
0.38–0.59, P < 0.0001), respectively. For women and men,
the R values were similar in thoracic vertebra T11 at 0.62 (95% CI
0.49–0.72) and 0.64 (95% CI 0.44–0.77), respectively. The vertebral signal
correlated significantly better with age in the 1.5-T compared to the 3-T
unit on all vertebral levels: the best R value of the 3-T unit was only 0.20
(95% CI 0.09–0.30, P < 0.0001). Our study showed an
average increase of the relative T1 signal in T11 of 10% per decade. Conclusion T1 fat signal ratio increases with age in the vertebral bodies, which could
help estimating the age of a person. Best age correlation was found when
measuring T1 signal in T11, standardized by the sacral subcutaneous fat
signal and using a 1.5-T MRI.
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Affiliation(s)
- Dominik Sieron
- Department of Radiology, Division City and County Hospitals, INSELGROUP, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Dionysios Drakopoulos
- Department of Radiology, Division City and County Hospitals, INSELGROUP, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Laura I Loebelenz
- Department of Radiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Christophe Schroeder
- Department of Radiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Lukas Ebner
- Department of Radiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Verena C Obmann
- Department of Radiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Adrian T Huber
- Department of Radiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Andreas Christe
- Department of Radiology, Division City and County Hospitals, INSELGROUP, Bern University Hospital, University of Bern, Bern, Switzerland
- Department of Radiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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Mittal P, Gupta R, Mittal A, Joshi S. Chemical shift magnetic resonance imaging in differentiation of benign from malignant vertebral collapse in a rural tertiary care hospital in North India. J Neurosci Rural Pract 2019; 7:489-492. [PMID: 27695225 PMCID: PMC5006457 DOI: 10.4103/0976-3147.188623] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Introduction: Magnetic resonance imaging (MRI) is the modality of the first choice for evaluation of vertebral compression/collapse. Many MRI qualitative features help to differentiate benign from malignant collapse. We conducted this study to look for a quantitative difference in chemical shift values in benign and malignant collapse using dual-echo gradient echo in-phase/out-phase imaging. Materials and Methods: MRI examinations of a total of 38 patients were retrospectively included in the study who had vertebral compression/collapse with marrow edema in which final diagnosis was available at the time of imaging/follow-up. Signal intensity value in the region of abnormal marrow signal and adjacent normal vertebra was measured on in phase/out phase images. Signal intensity ratio (SIR) was measured by dividing signal intensity value on opposite phase images to that on in phase images. SIR was compared in normal vertebrae and benign and malignant vertebral collapse. Results: There were 21 males and 17 females with mean age of 52.4 years (range 28–76 years). Out of total 38 patients, 18 were of benign vertebral collapse and 20 of malignant vertebral collapse. SIR in normal vertebrae was 0.30 ± 0.14, 0.67 ± 0.18 in benign vertebral collapse, and 1.20 ± 0.27 in malignant vertebral collapse with significant difference in SIR of normal vertebrae versus benign collapse (P < 0.01) and in benign collapse versus malignant collapse (P < 0.01). Assuming a cutoff of <0.95 for benign collapse and ≥0.95 for malignant collapse, chemical shift imaging had a sensitivity of 90% and specificity of 94.4%. Conclusion: Chemical shift imaging is a rapid and useful sequence in differentiating benign from malignant vertebral collapse with good specificity and sensitivity.
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Affiliation(s)
- Puneet Mittal
- Department of Radiodiagnosis, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala, Haryana, India
| | - Ranjana Gupta
- Department of Radiodiagnosis, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala, Haryana, India
| | - Amit Mittal
- Department of Radiodiagnosis, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala, Haryana, India
| | - Sandeep Joshi
- Department of Medicine, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala, Haryana, India
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Swamy A, Burström G, Spliethoff JW, Babic D, Ruschke S, Racadio JM, Edström E, Terander AE, Dankelman J, Hendriks BHW. Validation of diffuse reflectance spectroscopy with magnetic resonance imaging for accurate vertebral bone fat fraction quantification. BIOMEDICAL OPTICS EXPRESS 2019; 10:4316-4328. [PMID: 31453013 PMCID: PMC6701522 DOI: 10.1364/boe.10.004316] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 06/09/2019] [Accepted: 06/11/2019] [Indexed: 05/12/2023]
Abstract
Safe and accurate placement of pedicle screws remains a critical step in open and minimally invasive spine surgery. The diffuse reflectance spectroscopy (DRS) technique may offer the possibility of intra-operative guidance for pedicle screw placement. Currently, Magnetic Resonance Imaging (MRI) is one of the most accurate techniques used to measure fat concentration in tissues. Therefore, the purpose of this study is to compare the accuracy of fat content measured invasively in vertebrae using DRS and validate it against the Proton density fat fraction (PDFF) derived via MRI. Chemical shift-encoding-based water-fat imaging of the spine was first performed on six cadavers. PDFF images were computed and manually segmented. 23 insertions using a custom-made screw probe with integrated optical fibers were then performed under cone beam computer tomography (CBCT). DR spectra were recorded at several positions along the trajectory as the optical screw probe was inserted turn by turn into the vertebral body. Fat fractions determined via DRS and MRI techniques were compared by spatially correlating the optical screw probe position within the vertebrae on CBCT images with respect to the PDFF images. The fat fraction determined by DRS was found to have a high correlation with those determined by MRI, with a Pearson coefficient of 0.950 (P< 0.001) as compared with PDFF measurements calculated from the MRI technique. Additionally, the two techniques were found to be comparable for fat fraction quantification within vertebral bodies (R2 = 0.905).
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Affiliation(s)
- Akash Swamy
- Department of Biomechanical Engineering, Delft University of Technology, Mekelweg 2, 2628 CD, Delft, the Netherlands
- Department of In-body Systems, Philips Research, Royal Philips NV, High Tech Campus 34, 5656 AE, Eindhoven, the Netherlands
| | - Gustav Burström
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden and Department of Neurosurgery, Karolinska University Hospital, 17176, Stockholm, Sweden
| | - Jarich W. Spliethoff
- Department of In-body Systems, Philips Research, Royal Philips NV, High Tech Campus 34, 5656 AE, Eindhoven, the Netherlands
| | - Drazenko Babic
- Department of In-body Systems, Philips Research, Royal Philips NV, High Tech Campus 34, 5656 AE, Eindhoven, the Netherlands
| | - Stefan Ruschke
- Department of Radiology, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Straße 22, 81675 München, Germany
| | - John M. Racadio
- Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, Ohio, USA
| | - Erik Edström
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden and Department of Neurosurgery, Karolinska University Hospital, 17176, Stockholm, Sweden
| | - Adrian Elmi Terander
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden and Department of Neurosurgery, Karolinska University Hospital, 17176, Stockholm, Sweden
| | - Jenny Dankelman
- Department of Biomechanical Engineering, Delft University of Technology, Mekelweg 2, 2628 CD, Delft, the Netherlands
| | - Benno H. W. Hendriks
- Department of Biomechanical Engineering, Delft University of Technology, Mekelweg 2, 2628 CD, Delft, the Netherlands
- Department of In-body Systems, Philips Research, Royal Philips NV, High Tech Campus 34, 5656 AE, Eindhoven, the Netherlands
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10
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Yang W, Xie Y, Song B, Xia C, Tang C, Li J. Effects of aging and menopause on pancreatic fat fraction in healthy women population: A strobe-compliant article. Medicine (Baltimore) 2019; 98:e14451. [PMID: 30762758 PMCID: PMC6408125 DOI: 10.1097/md.0000000000014451] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Pancreatic fat fraction has been shown to increase in many pathological situations. However, pancreatic fat fraction and its physiological changes in healthy women are still unclear. The aim of this study is to investigate the effect of aging and menopause on pancreatic fat fraction in healthy female population.This was a cross-sectional study. A phantom of fat-water mixtures was established. One hundred sixty-seven healthy women (20-70 years) were recruited. Fat fraction was quantified with double-echo chemical shift magnetic resonance imaging with T1 and T2* correction. The association between measured and actual fat fractions was determined with Pearson correlation. Linear regression analysis was used to establish the calibration curve. Fat fractions were analyzed via analysis of variance.A significant positive linear correlation was revealed between the measured and actual fat fractions on the phantom (r = 0.991, P < .001). There was no significant difference in fat fractions among caput, corpus, and cauda of the pancreas. Pancreatic fat fraction remained constant during the age of 20 to 40 years (4.41 ± 0.79%) but significantly increased during the ages of 41 to 50 and 51 to 70 years (7.49 ± 1.10% and 9.43 ± 1.51%, respectively, P < .001). Moreover, pancreatic fat fractions of the healthy women aged 41 to 70 years were still significantly higher than these in the groups aged 20 to 40 years when postmenopausal healthy women were removed (P < .001). For volunteers aged 46 to 49 years, pancreatic fat fraction of the postmenopausal women was significantly increased compared with that of their premenopausal counterparts (P < .001).We found that an even distribution of pancreatic fat in healthy women, aging and menopause as 2 independent risk factors for pancreatic steatosis, a fatty infiltration in the pancreas beginning in the fifth decade in women.
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Affiliation(s)
| | - Yi Xie
- Department of Gastroenterology
| | - Bin Song
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, P.R. China
| | - Chunchao Xia
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, P.R. China
| | | | - Jing Li
- Department of Gastroenterology
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The Application of Apparent Diffusion Coefficient and Chemical Shift Images in Differentiation of Benign and Malignant Vertebral Lesions. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2018. [DOI: 10.5812/ijcm.66003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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12
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Pokorney AL, Chia JM, Pfeifer CM, Miller JH, Hu HH. Improved fat-suppression homogeneity with mDIXON turbo spin echo (TSE) in pediatric spine imaging at 3.0 T. Acta Radiol 2017; 58:1386-1394. [PMID: 28165290 DOI: 10.1177/0284185117690424] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Background Robust fat suppression remains essential in clinical MRI to improve tissue signal contrast, minimize fat-related artifacts, and enhance image quality. Purpose To compare fat suppression between mDIXON turbo spin echo (TSE) and conventional frequency-selective and inversion-recovery methods in pediatric spine MRI. Material and Methods Images from T1-weighted (T1W) and T2-weighted (T2W) TSE sequences coupled with conventional methods and the mDIXON technique were compared in 36 patients (5.8 ± 5.4 years) at 3.0 T. Images from 42 pairs of T1W (n = 16) and T2W (n = 26) scans were acquired. Two radiologists reviewed the data and rated images using a three-point scale in two categories, including the uniformity of fat suppression and overall diagnostic image quality. The Wilcoxon rank-sum test was used to compare the scores. Results The Cohen's kappa coefficient for inter-rater agreement was 0.69 (95% confidence interval [CI], 0.56-0.83). Images from mDIXON TSE were considered superior in fat suppression ( P < 0.01) in 22 (rater 1) and 25 (rater 2) cases, respectively. In 13 (rater 1) and 11 (rater 2) cases, mDIXON TSE demonstrated improved diagnostic image quality ( P < 0.01). In three cases, fat suppression was superior using inversion-recovery and likewise in one case mDIXON had poorer image diagnostic quality. Lastly, mDIXON and conventional fat-suppression methods performed similarly in 17 (rater 1) and 14 (rater 2) cases, and yielded equal diagnostic image quality in 28 (rater 1) and 30 (rater 2) cases. Conclusion Robust fat suppression can be achieved with mDixon TSE pediatric spine imaging at 3.0 T and should be considered as a permanent replacement of traditional methods, in particular frequency-selective techniques.
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Affiliation(s)
- Amber L Pokorney
- Department of Medical Imaging and Radiology, Phoenix Children’s Hospital, Phoenix, AZ, USA
| | | | - Cory M Pfeifer
- Department of Medical Imaging and Radiology, Phoenix Children’s Hospital, Phoenix, AZ, USA
| | - Jeffrey H Miller
- Department of Medical Imaging and Radiology, Phoenix Children’s Hospital, Phoenix, AZ, USA
| | - Houchun H Hu
- Department of Medical Imaging and Radiology, Phoenix Children’s Hospital, Phoenix, AZ, USA
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Oei L, Koromani F, Rivadeneira F, Zillikens MC, Oei EHG. Quantitative imaging methods in osteoporosis. Quant Imaging Med Surg 2016; 6:680-698. [PMID: 28090446 DOI: 10.21037/qims.2016.12.13] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Osteoporosis is characterized by a decreased bone mass and quality resulting in an increased fracture risk. Quantitative imaging methods are critical in the diagnosis and follow-up of treatment effects in osteoporosis. Prior radiographic vertebral fractures and bone mineral density (BMD) as a quantitative parameter derived from dual-energy X-ray absorptiometry (DXA) are among the strongest known predictors of future osteoporotic fractures. Therefore, current clinical decision making relies heavily on accurate assessment of these imaging features. Further, novel quantitative techniques are being developed to appraise additional characteristics of osteoporosis including three-dimensional bone architecture with quantitative computed tomography (QCT). Dedicated high-resolution (HR) CT equipment is available to enhance image quality. At the other end of the spectrum, by utilizing post-processing techniques such as the trabecular bone score (TBS) information on three-dimensional architecture can be derived from DXA images. Further developments in magnetic resonance imaging (MRI) seem promising to not only capture bone micro-architecture but also characterize processes at the molecular level. This review provides an overview of various quantitative imaging techniques based on different radiological modalities utilized in clinical osteoporosis care and research.
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Affiliation(s)
- Ling Oei
- Department of Internal Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands; Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Fjorda Koromani
- Department of Internal Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands; Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Fernando Rivadeneira
- Department of Internal Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands; Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - M Carola Zillikens
- Department of Internal Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Edwin H G Oei
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
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Xiao Z, Li J, Li C, Zhang Y, She D, Cao D. Chemical shift MR imaging in the lumbar vertebra: the effect of field strength, scanner vendors and flip angles in repeatability of signal intensity index measurement. BMC Med Imaging 2016; 16:64. [PMID: 27884115 PMCID: PMC5123365 DOI: 10.1186/s12880-016-0167-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 11/14/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To evaluate the reproducibility of signal intensity index (SII) measurements with MRI systems from different vendors and with different field strengths, and to test the effectiveness of flip angle. METHODS Thirty-two healthy volunteers (mean age 35.3 ± 9.3 years) were enrolled in this ethics committee-approved study. Chemical shift MR imaging was performed on 1.5- and 3.0-T MR systems from three vendors. Two independent observers measured SII values in five lumbar segments. Inter- and intraobserver agreement was assessed using the interclass correlation coefficients (ICCs). Differences of mean SII values between different field strengths and MR vendors as well as flip angles were compared by using repeated-measures analysis of variance. Differences of mean SII values between different flip angles were also compared by using paired-sample t test. RESULTS Inter- and intra-observer correlation coefficients showed good agreement (all ICC > 0.75) when measuring SII values at different MR systems (ICCs ranging from 0.896 to 0.983) and flip angles (ICCs ranging from 0.824 to 0.983). There were no significant differences in mean SII values measured by different MR vendors with different field strengths (all p > 0.05 ranging from 0.337 to 0.824). The differences in the mean SII between the four different flip angles were statistically significant (all p < 0.05 ranging from < 0.001 to 0.004) except the group of flip angle 50° versus 70° (p = 0.116). CONCLUSION The SII measurement using chemical shift MR imaging may be comparable between different MR systems. Also high flip angles showed better stability to quantitate lumbar fat content.
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Affiliation(s)
- Zebin Xiao
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, 20 Cha-Zhong Road, Fuzhou, Fujian, 350005, China
| | - Jian Li
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, 20 Cha-Zhong Road, Fuzhou, Fujian, 350005, China
| | - Chengqi Li
- Department of Radiology, Sanming Hospital of Integrated Traditional and Western, Sanming, Fujian, 365000, China
| | - Yuyang Zhang
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, 20 Cha-Zhong Road, Fuzhou, Fujian, 350005, China
| | - Dejun She
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, 20 Cha-Zhong Road, Fuzhou, Fujian, 350005, China
| | - Dairong Cao
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, 20 Cha-Zhong Road, Fuzhou, Fujian, 350005, China.
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Li G, Xu Z, Yuan W, Chang S, Chen Y, Calimente H, Hu J. Short- and midterm reproducibility of marrow fat measurements using mDixon imaging in healthy postmenopausal women. Skeletal Radiol 2016; 45:1385-90. [PMID: 27502625 DOI: 10.1007/s00256-016-2448-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 07/05/2016] [Accepted: 07/26/2016] [Indexed: 02/07/2023]
Abstract
OBJECTIVE We tested the short- and midterm reproducibility of vertebral marrow fat fraction (FF) measurements using mDixon imaging. MATERIALS AND METHODS Thirty postmenopausal women underwent mDixon scans to obtain L1-4 FF from three slices per vertebra by two independent observers (session 1). Measurements were repeated after 6 weeks (session 2) and 6 months (session 3). The mean FF for three regions of interest per vertebra was calculated. The coefficients of variation (CVs) were calculated for each participant and imaging session, and the intraclass correlation coefficients (ICCs) were calculated to assess interobserver and intersession agreements. RESULTS There were no significant differences in FF measurements among the three slices, imaging sessions or observers. The mean intrasubject CV for FF measurement reproducibility was 1.94 %. The interobserver agreement for the average FF value was excellent (ICC ≥0.945 for each session). The ICC for intersession agreement was excellent (ICC ≥0.955 between sessions). The mean intersession CV was lower within a short-term interval (2.97 %) than within sessions 1 and 3 (4.80 %) or sessions 3 and 2 (4.44 %). The overall mean CV for the reproducibility of FF measured with mDixon imaging over the short- and midterm was 4.09 % (95 % CI, 3.79-4.40 %). CONCLUSION mDixon is a reproducible method for FF quantification over short- and midterm intervals up to 6 months in healthy postmenopausal women. Our results also provide data by which a power analysis can be optimized when designing studies involving the use of FF derived from similar mDixon sequences.
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Affiliation(s)
- Guanwu Li
- Department of Radiology, Yueyang Hospital, Shanghai University of Traditional Chinese Medicine, 110 Ganhe Rd, Hongkou District, Shanghai, 200437, China.
| | - Zheng Xu
- Xinzhuang Community Health Center, Shanghai, 201199, China
| | - Wei Yuan
- Department of Spinal Disease Unit, Yueyang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, China
| | - Shixin Chang
- Department of Radiology, Yueyang Hospital, Shanghai University of Traditional Chinese Medicine, 110 Ganhe Rd, Hongkou District, Shanghai, 200437, China
| | - Yongsheng Chen
- Department of Radiology, Wayne State University, Detroit, 48202, MI, USA
| | - Horea Calimente
- Department of Radiology, Wayne State University, Detroit, 48202, MI, USA
| | - Jiani Hu
- Department of Radiology, Wayne State University, Detroit, 48202, MI, USA
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Li G, Xu Z, Gu H, Li X, Yuan W, Chang S, Fan J, Calimente H, Hu J. Comparison of chemical shift-encoded water-fat MRI and MR spectroscopy in quantification of marrow fat in postmenopausal females. J Magn Reson Imaging 2016; 45:66-73. [PMID: 27341545 DOI: 10.1002/jmri.25351] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2016] [Accepted: 06/06/2016] [Indexed: 12/22/2022] Open
Abstract
PURPOSE To validate a chemical shift-encoded (CSE) water-fat imaging for quantifying marrow fat fraction (FF), using proton magnetic resonance spectroscopy (MRS) as reference. MATERIALS AND METHODS Multiecho T2 -corrected MRS and CSE imaging with eight-echo gradient-echo acquisitions at 3T were performed to calculate marrow FF in 83 subjects, including 41 with normal bone mineral density (BMD), 26 with osteopenia, and 16 with osteoporosis (based on DXA). Eight participants were scanned three times with repositioning to assess the repeatability of CSE FF map measurements. Pearson correlation coefficient, Bland-Altman 95% limit of agreement, and Lin's concordance correlation coefficient were calculated. RESULTS The Pearson correlation coefficient was 0.979 and Lin's concordance correlation coefficient was 0.962 between CSE-based FF and MRS-based FF. All data points, calculated using the Bland-Altman method, were within the limits of agreement. The intra- and interrater agreement for average CSE-based FF was excellent (intrarater, intraclass correlation coefficient [ICC] = 0.993; interrater, ICC = 0.976-0.982 for different BMD groups). In the subgroups of varying BMD, inverse correlations were observed to be very similar between BMD (r = -0.560 to -0.710), T-score (r = -0.526 to -0.747), and CSE-based FF, and between BMD (r = -0.539 to -0.706), T-score (r = -0.501 to -0.742), and MRS-based FF even controlling for age, years since menopause, and body mass index. The repeatability for CSE FF map measurements expressed as absolute precision error was 1.45%. CONCLUSION CSE imaging is equally accurate in characterizing marrow fat content as MRS. Given its excellent correlation and concordance with MRS, the CSE sequence could be used as a potential replacement technique for marrow fat quantification. LEVEL OF EVIDENCE 1 J. Magn. Reson. Imaging 2017;45:66-73.
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Affiliation(s)
- Guanwu Li
- Department of Radiology, Yueyang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.,Department of Radiology, Wayne State University, Detroit, Michigan, USA
| | - Zheng Xu
- Xin-Zhuang Community Health Center, Shanghai, China
| | - Hao Gu
- Xin-Zhuang Community Health Center, Shanghai, China
| | - Xuefeng Li
- Department of Radiology, Yueyang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wei Yuan
- Department of Spinal Disease Unit, Yueyang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Shixin Chang
- Department of Radiology, Yueyang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jingzheng Fan
- East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Horea Calimente
- Department of Radiology, Wayne State University, Detroit, Michigan, USA
| | - Jiani Hu
- Department of Radiology, Wayne State University, Detroit, Michigan, USA
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Discrimination between benign and malignant in vertebral marrow lesions with diffusion weighted MRI and chemical shift. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2016. [DOI: 10.1016/j.ejrnm.2016.02.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
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Zhang L, Li S, Hao S, Yuan Z. Quantification of fat deposition in bone marrow in the lumbar vertebra by proton MRS and in-phase and out-of-phase MRI for the diagnosis of osteoporosis. JOURNAL OF X-RAY SCIENCE AND TECHNOLOGY 2016; 24:257-266. [PMID: 27002905 DOI: 10.3233/xst-160549] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The goal for this study was to investigate if proton MRS (1H-MRS) and out-of-phase and in-phase MRI can quantify the fat deposition in bone marrow within the lumbar vertebra that can be used to distinguish well between osteoporosis patients and healthy control subjects. Sixty-eight subjects participated in this study. The diagnostic results from dual-energy x-ray absorptiometry served as the gold standard, which was able to separate the subjects into osteoporosis (38 subjects) and non-osteoporosis group (30 subjects). Then the 68 subjects were further scanned by 1H-MRS and in-phase and out-of-phase MRI and the findings from the imaging methods were also compared and analyzed. It was found that the measured signal intensity ratio (SIR), lipid-water ratio (LWR) and fat fraction (FF) in L2 vertebra from the two imaging methods were able to identify the fat deposition in bone marrow, which could be used to diagnose osteoporosis. Diagnostic accuracy for osteoporosis based on identified SIR, LRW and FF was analyzed by using ROC curves. Our findings suggested that statistically significant differences were identified between osteoporosis patients and healthy subjects. The sensitivity and specificity equal to 78.9% and 75.9% for SIR, 79.2% and 66.7% for LRW, 71.4% and 72.4% for FF, can be achieved when fat deposition-related parameters in bone marrow from the lumbar vertebra are used as classifiers. Our results showed that fat deposition-related parameters including fat content in bone marrow and water content in the lumbar vertebra are clearly different between the osteoporosis and non-osteoporosis group, suggesting that both 1H-MRS and in-phase and out-of-phase MRI can be used for diagnosing osteoporosis and monitoring its progression.
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Affiliation(s)
- Lingyan Zhang
- Department of Medical Imaging, The Third Affiliated Hospital of Southern Medical University (Academy of Orthopedics. Guangdong Province) Guangzhou, China
| | - Shaolin Li
- Department of Medical Imaging, The Third Affiliated Hospital of Southern Medical University (Academy of Orthopedics. Guangdong Province) Guangzhou, China
| | - Shuai Hao
- Department of Medical Imaging, The Third Affiliated Hospital of Southern Medical University (Academy of Orthopedics. Guangdong Province) Guangzhou, China
| | - Zhen Yuan
- Bioimaging Core, Faculty of Health Sciences, University of Macau, Taipa, Macau SAR, China
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Osteoporotic or malignant vertebral fracture? This is the question. What can we do about it? THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2015. [DOI: 10.1016/j.ejrnm.2014.11.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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Quantitative chemical-shift MR imaging cutoff value: Benign versus malignant vertebral compression – Initial experience. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2014. [DOI: 10.1016/j.ejrnm.2014.05.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Zidan DZ, Elghazaly HA. Can unenhanced multiparametric MRI substitute gadolinium-enhanced MRI in the characterization of vertebral marrow infiltrative lesions? THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2014. [DOI: 10.1016/j.ejrnm.2014.02.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
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Fat Fraction Estimation of the Vertebrae in Females Using the T2*-IDEAL Technique in Detection of Reduced Bone Mineralization Level. J Comput Assist Tomogr 2014; 38:320-4. [DOI: 10.1097/rct.0b013e3182aa4d9d] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kühn JP, Hernando D, Meffert PJ, Reeder S, Hosten N, Laqua R, Steveling A, Ender S, Schröder H, Pillich DT. Proton-density fat fraction and simultaneous R2* estimation as an MRI tool for assessment of osteoporosis. Eur Radiol 2013; 23:3432-9. [PMID: 23812246 DOI: 10.1007/s00330-013-2950-7] [Citation(s) in RCA: 98] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Revised: 05/20/2013] [Accepted: 06/03/2013] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To investigate multi-echo chemical shift-encoded MRI-based mapping of proton density fat fraction (PDFF) and fat-corrected R2* in bone marrow as biomarkers for osteoporosis assessment. METHODS Fifty-one patients (28 female; mean age 69.7 ± 9.0 years) underwent dual energy X-ray absorptiometry (DXA). On the basis of the t score, 173 valid vertebrae bodies were divided into three groups (healthy, osteopenic and osteoporotic). Three echo chemical shift-encoded MRI sequences were acquired at 3 T. PDFF and R2* with correction for multiple-peak fat (R2*MP) were measured for each vertebral body. Kruskal-Wallis test and post hoc analysis were performed to evaluate differences between groups. Further, the area under the curve (AUC) for each technique was calculated using logistic regression analysis. RESULTS On the basis of DXA, 92 samples were normal (53 %), 47 osteopenic (27 %) and 34 osteoporotic (20 %). PDFF was increased in osteoporosis compared with healthy (P = 0.007). R2*MP showed significant differences between normal and osteopenia (P = 0.004), and between normal and osteoporosis (P < 0.001). AUC to differentiate between normal and osteoporosis was 0.698 for R2*MP, 0.656 for PDFF and 0.74 for both combined. CONCLUSION PDFF and R2*MP are moderate biomarkers for osteoporosis. PDFF and R2*MP combination might improve the prediction in differentiating healthy subjects from those with osteoporosis.
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Affiliation(s)
- Jens-Peter Kühn
- Department of Diagnostic Radiology and Neuroradiology, Medical University Greifswald, Sauerbruch-Strasse 1, 17489, Greifswald, Germany,
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Yanik B, Keyik B, Conkbayir I. Fatty degeneration of multifidus muscle in patients with chronic low back pain and in asymptomatic volunteers: quantification with chemical shift magnetic resonance imaging. Skeletal Radiol 2013; 42:771-8. [PMID: 23263412 DOI: 10.1007/s00256-012-1545-8] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2012] [Revised: 10/02/2012] [Accepted: 11/04/2012] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To evaluate and compare the fatty degeneration of multifidus muscles by chemical shift magnetic resonance imaging (MRI) in patients with chronic low back pain and in asymptomatic volunteers. MATERIALS AND METHODS Sixty-five patients with lumbar disc pathology were selected prospectively for this study. The control group consisted of 25 asymptomatic volunteers. The patients were grouped according to the fatty degeneration of multifidus muscles by a semiquantitative method (grade 0-4) on axial T2 weighted imaging. Chemical shift MRI was performed in the axial plane using a double-echo fast low-angle shot (FLASH) sequence. Fatty degeneration was calculated through signal intensity suppression rate (SISR) and signal intensity index (SII). RESULTS The semiquantitative grading of fatty degeneration of the multifidus muscle was 0 in 25 of 65 patients (patient group 0), 1 in 20 patients (patient group 1), 2 in 20 patients (patient group 2). Neither grade 3 nor grade 4 were detected in patient groups. For the control group, patient group 0, patient group 1, and patient group 2, median SISR values were 5.00, -9.00, -17.50, and -22.50 %, respectively. SII median values were -4.20 % for the control group, 7.00 % for patient group 0, 12.50 % for patient group 1, and 19.50 % for patient group 2. SISR values in the multifidus muscle calculated for the patient groups were significantly lower than those calculated for the control group. SII values in patients groups were significantly higher than in the control group. CONCLUSIONS Chemical shift MRI may be a useful method to quantitatively evaluate the fatty degeneration in multifidus muscle in patients with low back pain.
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Affiliation(s)
- Bahar Yanik
- Department of Radiology, Balikesir University, School of Medicine, Balikesir, Turkey.
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Assessment of lumbar vertebrae morphology by magnetic resonance imaging in osteoporosis. Skeletal Radiol 2012; 41:1583-90. [PMID: 22592591 DOI: 10.1007/s00256-012-1435-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2011] [Revised: 04/20/2012] [Accepted: 04/24/2012] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate the lumbar spinal morphology in patients with and without osteoporosis by comparing the endplate changes, intervertebral disc changes, and vertebral heights. DESIGN This is a retrospective study. Medical records of the 3,530 patients admitted to the Physical Medicine and Rehabilitation outpatient clinics with low back pain between August 2010 and August 2011 were retrospectively reviewed. A total of 64 patients of whom 57 were females (89.1 %) and seven were males (10.9 %) were included in the study. Participants were divided into an osteoporosis group, an osteopenia group, and a nonosteoporotic control group, according to bone mineral densities. RESULTS In this study, mid heights of L3, L4, and L5 vertebrae were found to be higher in the normal group than in both the osteopenic and osteoporotic groups. Mid part heights of L1-2, L2-3, and L5-S1 intervertebral discs were significantly lower in the normal group when compared to the osteopenic and osteoporotic groups. End-plate marrow abnormality was detected in L1 lower end plate in 75 % of normal subjects, 40.6 % of osteopenics, and 25 % of osteoporotics. Statistically significant difference in the presence of Schmorl nodes in L5 vertebra lower end plates was present between groups; 58.3 % of normals, 34.4 % of osteopenics and 15 % of osteoporotics had Schmorl nodes in L5 vertebra lower end plates. There was a significant difference regarding disc degeneration and intradiscal gas presence in L5-S1 intervertebral discs between groups; 66.7 % of normals, 28.1 % of osteopenics, and 25 % of osteoporotics had severe disc degeneration and intradiscal gas was present in L5-S1 intervertebral discs. CONCLUSIONS Significant changes in morphology of the lumbar spine and intervertebral discs were found. It was revealed that the effects of osteoporosis are not limited to the bone but also present in the intervertebral discs. Mid heights of intervertebral discs were higher in the osteoporotic and osteopenic groups when compared to normal subjects along with the lowered mid heights of lumbar vertebrae. It was also observed that stronger vertebral bones were associated with more disc and vertebral degeneration.
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MRI of spinal bone marrow: part I, techniques and normal age-related appearances. AJR Am J Roentgenol 2012; 197:1298-308. [PMID: 22109283 DOI: 10.2214/ajr.11.7005] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE This article reviews MRI protocols, including routine and nonroutine pulse sequences as well as the normal MRI appearance of spinal marrow and expected age-related changes. CONCLUSION Routine MRI of the spine provides useful evaluation of the spinal bone marrow, but nonroutine MRI pulse sequences are increasingly being used to evaluate bone marrow pathology. An understanding of MRI pulse sequences and the normal and age-related appearances of bone marrow is important for the practicing radiologist.
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