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Li B, Hua N, Li J, Andreu-Arasa VC, LeBedis C, Anderson SW. Quantification of spinal bone marrow fat fraction using three-material decomposition technique on dual-energy CT: A phantom study. Med Phys 2023. [PMID: 37129991 DOI: 10.1002/mp.16442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 04/13/2023] [Accepted: 04/13/2023] [Indexed: 05/03/2023] Open
Abstract
BACKGROUND Two-material decomposition is insufficient to quantify the fat fraction of spinal bone marrow, which is comprised of a mixture of bone minerals, water, and yellow marrow (fat). PURPOSE To develop an accurate three-material decomposition-based bone marrow fat fraction ( F F 3 M D $F{F_{3MD}}$ ) quantification technique for dual-energy CT. METHODS Bone marrow edema phantoms containing trabecular bone minerals, water, and fat were constructed using fat fractions and bone mineral density values matching those expected in healthy and edematous bone, and scanned on a commercial dual-energy CT. Fat quantified by F F 3 M D $F{F_{3MD}}$ were compared to MRI-based fat fraction ( F F M R I $F{F_{MRI}}$ ) and conventional two-material-decomposition-based fat fraction ( F F 2 M D $F{F_{2MD}}$ ) to evaluate its accuracy and dependency on various bone mineral densities. RESULTS F F 3 M D $F{F_{3MD}}$ demonstrated an excellent correlation with F F M R I $F{F_{MRI}}\;$ (r = 0.97, R2 = 0.96) in the phantom, significantly more accurate than FF2MD when confounding bone minerals are present (50 mg/cm3 : r = 1.02, R2 = 0.95 vs. r = 0.65, R2 = 0.79 (p < 0.01); 100 mg/cm3 : r = 0.81, R2 = 0.47 vs. r = 0.21, R2 = 0.21 (p < 0.05)). CONCLUSIONS F F 3 M D $F{F_{3MD}}$ accurately quantified bone marrow fat fraction, when compared with F F M R I $F{F_{MRI}}$ , in the specially constructed bone marrow phantom.
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Affiliation(s)
- Baojun Li
- Department of Radiology, Boston University School of Medicine, Boston, USA
| | - Ning Hua
- Department of Radiology, Boston University School of Medicine, Boston, USA
| | - Janelle Li
- Department of Radiology, Boston University School of Medicine, Boston, USA
| | | | - Christina LeBedis
- Department of Radiology, Boston University School of Medicine, Boston, USA
| | - Stephan W Anderson
- Department of Radiology, Boston University School of Medicine, Boston, USA
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Lins CF, Salmon CEG, de Souza LA, Moraes RDS, Silva-Pinto AC, Matos MA, Nogueira-Barbosa MH. Six-point DIXON and Magnetic Resonance Spectroscopy Techniques in Quantifying Bone Marrow Fat in Sickle Cell Disease. Acad Radiol 2022; 29:e73-e81. [PMID: 34257024 DOI: 10.1016/j.acra.2021.06.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 05/21/2021] [Accepted: 06/04/2021] [Indexed: 01/30/2023]
Abstract
RATIONALE AND OBJECTIVES To compare bone marrow fat quantification using magnetic resonance spectroscopy (MRS) and six-point DIXON (6PD) techniques in patients with sickle cell disease (SCD) and healthy subjects. MATERIALS AND METHODS Prospective study, with 43 SCD patients (24 homozygous [SS], 19 double heterozygous [SC), and 41 healthy subjects paired by age, weight and sex with SCD patients. All participants underwent magnetic resonance imaging with 6PD and single voxel MRS in the L3 vertebral body. Pearson's correlation, ROC curve, and bland-altman analysis were performed, p-values ≤0.05 were considered statistically significant for all tests. RESULTS Significant linear correlation was found between fat fraction (FF) by 6PD and Total Lipids (TL) (r = 0.932; p < 0.001) and Saturated Lipids (SL) (r = 0.934; p < 0.001), in all subjects. Strong correlations were also identified considering subjects of the SS/SC subgroups. Despite high correlations, no significant difference was observed only between FF and SL in the SS subgroup (Bland-Altman analysis), indicating excellent agreement between the fat estimations in this specific situation. Significant differences were observed in all variables (FF, TL, SL) comparing the SCD and healthy subjects. The ROC curve between SCD and healthy subjects showed the following areas under the curve: FF(0.924) > TL(0.883) > SL(0.892). CONCLUSIONS The comparison between fat quantification by the 6PD with MRS demonstrated an excellent correlation in SCD patients, especially in the SS subgroup, which usually has a higher degree of hemolysis. The diagnostic performance of 6PD and MRS is similar, with advantages of shorter imaging processing time and larger studied area with the 6PD.
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Affiliation(s)
- Carolina Freitas Lins
- Bahiana School of Medicine and Public Health Salvador, Bahia, Brasil; Clínica Delfin Medicina Diagnóstica, Salvador, Bahia, Brasil; Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Ribeirão Preto Medical School, USP Ribeirão Preto, Ribeirão Preto, São Paulo, Brasil; Ribeirão Preto Medical School Musculoskeletal Imaging Research Laboratory, São Paulo, Brasil.
| | - Carlos Ernesto Garrido Salmon
- Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto da Universidade de São Paulo (FFCLRP-USP). São Paulo, Brasil
| | | | | | - Ana Cristina Silva-Pinto
- Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Ribeirão Preto Medical School, USP Ribeirão Preto, Ribeirão Preto, São Paulo, Brasil
| | | | - Marcello H Nogueira-Barbosa
- Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Ribeirão Preto Medical School, USP Ribeirão Preto, Ribeirão Preto, São Paulo, Brasil; Ribeirão Preto Medical School Musculoskeletal Imaging Research Laboratory, São Paulo, Brasil; Department of Orthopedic Surgery, University of Missouri Health Care, Columbia, Missouri
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Gassert FT, Kufner A, Gassert FG, Leonhardt Y, Kronthaler S, Schwaiger BJ, Boehm C, Makowski MR, Kirschke JS, Baum T, Karampinos DC, Gersing AS. MR-based proton density fat fraction (PDFF) of the vertebral bone marrow differentiates between patients with and without osteoporotic vertebral fractures. Osteoporos Int 2022; 33:487-496. [PMID: 34537863 PMCID: PMC8813693 DOI: 10.1007/s00198-021-06147-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 09/03/2021] [Indexed: 12/20/2022]
Abstract
UNLABELLED The bone marrow proton density fat fraction (PDFF) assessed with MRI enables the differentiation between osteoporotic/osteopenic patients with and without vertebral fractures. Therefore, PDFF may be a potentially useful biomarker for bone fragility assessment. INTRODUCTION To evaluate whether magnetic resonance imaging (MRI)-based proton density fat fraction (PDFF) of vertebral bone marrow can differentiate between osteoporotic/osteopenic patients with and without vertebral fractures. METHODS Of the 52 study patients, 32 presented with vertebral fractures of the lumbar spine (66.4 ± 14.4 years, 62.5% women; acute low-energy osteoporotic/osteopenic vertebral fractures, N = 25; acute high-energy traumatic vertebral fractures, N = 7). These patients were frequency matched for age and sex to patients without vertebral fractures (N = 20, 69.3 ± 10.1 years, 70.0% women). Trabecular bone mineral density (BMD) values were derived from quantitative computed tomography. Chemical shift encoding-based water-fat MRI of the lumbar spine was performed, and PDFF maps were calculated. Associations between fracture status and PDFF were assessed using multivariable linear regression models. RESULTS Over all patients, mean PDFF and trabecular BMD correlated significantly (r = - 0.51, P < 0.001). In the osteoporotic/osteopenic group, those patients with osteoporotic/osteopenic fractures had a significantly higher PDFF than those without osteoporotic fractures after adjusting for age, sex, weight, height, and trabecular BMD (adjusted mean difference [95% confidence interval], 20.8% [10.4%, 30.7%]; P < 0.001), although trabecular BMD values showed no significant difference between the subgroups (P = 0.63). For the differentiation of patients with and without vertebral fractures in the osteoporotic/osteopenic subgroup using mean PDFF, an area under the receiver operating characteristic (ROC) curve (AUC) of 0.88 (P = 0.006) was assessed. When evaluating all patients with vertebral fractures, those with high-energy traumatic fractures had a significantly lower PDFF than those with low-energy osteoporotic/osteopenic vertebral fractures (P < 0.001). CONCLUSION MR-based PDFF enables the differentiation between osteoporotic/osteopenic patients with and without vertebral fractures, suggesting the use of PDFF as a potential biomarker for bone fragility.
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Affiliation(s)
- F T Gassert
- Department of Radiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Ismaningerstr. 22, 81675, Munich, Germany.
| | - A Kufner
- Department of Radiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Ismaningerstr. 22, 81675, Munich, Germany
| | - F G Gassert
- Department of Radiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Ismaningerstr. 22, 81675, Munich, Germany
| | - Y Leonhardt
- Department of Radiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Ismaningerstr. 22, 81675, Munich, Germany
| | - S Kronthaler
- Department of Radiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Ismaningerstr. 22, 81675, Munich, Germany
| | - B J Schwaiger
- Department of Radiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Ismaningerstr. 22, 81675, Munich, Germany
- Department of Neuroradiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - C Boehm
- Department of Radiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Ismaningerstr. 22, 81675, Munich, Germany
| | - M R Makowski
- Department of Radiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Ismaningerstr. 22, 81675, Munich, Germany
| | - J S Kirschke
- Department of Neuroradiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - T Baum
- Department of Neuroradiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - D C Karampinos
- Department of Radiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Ismaningerstr. 22, 81675, Munich, Germany
| | - A S Gersing
- Department of Radiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Ismaningerstr. 22, 81675, Munich, Germany
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Quantification of bone marrow edema in rheumatoid arthritis by using high-speed T2-corrected multiecho acquisition of 1H magnetic resonance spectroscopy: a feasibility study. Clin Rheumatol 2021; 40:4639-4647. [PMID: 34155572 DOI: 10.1007/s10067-021-05764-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 04/06/2021] [Accepted: 05/03/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To determine whether high-speed T2-corrected multiecho (HISTO) sequences can quantify bone marrow edema (BME) in the capitate bone in rheumatoid arthritis (RA), and whether the HISTO fat fraction (FF) reflects therapeutic effectiveness. METHODS In this prospective study, 25 RA patients (19 women; average age, 45.08 ± 13.48 years) underwent 3.0-T MRI with HISTO at the baseline and after 4, 8, and 12 weeks of treatment. Rheumatoid factor (RF), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), platelet (PLT) count, and 28-joint Disease Activity Score using ESR (DAS28-ESR) were recorded on the day of each MRI examination by a rheumatologist blinded to the MRI findings. In addition, 21 healthy subjects (15 women; age, 49.17 ± 6.56 years) underwent only the HISTO sequence at a single time point. RESULTS HISTO FF values were significantly higher in the control group (74.5% ± 3.1%; range, 68.6-79.3%) than in the patient group (55.8% ± 17.7%; range, 15.6-79.0%) at the baseline (independent-samples t-test: t = 5.257, P = 0.000). The changes in HISTO FF and DAS28-ESR showed moderate negative correlations with each other at 4, 8, and 12 weeks, and all of them were statistically significant (P < 0.05). As the HISTO FF increased, the DAS28-ESR decreased. CONCLUSION The HISTO sequence can measure the bone marrow FF of the wrist joint bones in RA patients. The HISTO FF value increased as the DAS28-ESR decreased. The HISTO sequence may help quantify BME in RA and help monitor the effectiveness of RA treatment. Key Points •The HISTO sequence could measure the bone marrow FF of the wrist joint bones. •FF value increased as the DAS28-ESR decreased in RA patients. •The HISTO sequence can monitor the therapeutic effect of RA.
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Zeng Z, Ma X, Guo Y, Ye B, Xu M, Wang W. Quantifying Bone Marrow Fat Fraction and Iron by MRI for Distinguishing Aplastic Anemia from Myelodysplastic Syndromes. J Magn Reson Imaging 2021; 54:1754-1760. [PMID: 34117662 PMCID: PMC9292058 DOI: 10.1002/jmri.27769] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 05/19/2021] [Accepted: 05/21/2021] [Indexed: 01/19/2023] Open
Abstract
Background Bone marrow of patients with aplastic anemia (AA) is different from that of patients with myelodysplastic syndrome (MDS) and is difficult to identify by blood examination. IDEAL‐IQ (iterative decomposition of water and fat with echo asymmetry and least‐squares estimation) imaging might be able to quantify fat fraction (FF) and iron content in bone tissues. Purpose To determine if IDEAL‐IQ measurements of bone marrow FF and iron content can distinguish between patients with AA and MDS. Study Type Retrospective. Population Fifty‐seven patients with AA, 21 patients with MDS, and 24 healthy controls. Field Strength/Sequence 3.0 T, IDEAL‐IQ sequence. Assessment Three independent observers evaluated the IDEAL‐IQ images and measured FF and R2* in the left posterior superior iliac spine. Statistical Tests Kruskal–Wallis test, linear correlations, and Bland–Altman analysis were used. A P‐value of <0.05 was considered statistically significant. Results The FF in patients with AA (79.46% ± 15.00%) was significantly higher than that in patients with MDS (42.78% ± 30.09%) and control subjects (65.50% ± 14.73%). However, there was no significant difference in FF between control subjects and patients with MDS (P = 0.439). The R2* value of AA, MDS, and controls was 145.38 ± 53.33, (171.13 ± 100.89, and 135.99 ± 32.41/second, respectively, with no significant difference between the three groups (P = 0.553). Data Conclusion Quantitative IDEAL‐IQ magnetic resonance imaging may facilitate the diagnosis of AA and distinguish it from MDS. Level of Evidence 3 Technical Efficacy Stage 2
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Affiliation(s)
- Zhaolong Zeng
- Radiology Department, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.,Radiology Department, The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, China, Hangzhou, China
| | - Xiangzheng Ma
- Radiology Department, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.,Radiology Department, The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, China, Hangzhou, China
| | - Yifan Guo
- Radiology Department, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.,Radiology Department, The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, China, Hangzhou, China
| | - Baodong Ye
- Radiology Department, The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, China, Hangzhou, China.,Hematology Department, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Maosheng Xu
- Radiology Department, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.,Radiology Department, The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, China, Hangzhou, China
| | - Wei Wang
- Radiology Department, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.,Radiology Department, The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, China, Hangzhou, China
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T2-weighted Dixon MRI of the spine: A feasibility study of quantitative vertebral bone marrow analysis. Diagn Interv Imaging 2021; 102:431-438. [PMID: 33612414 DOI: 10.1016/j.diii.2021.01.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 01/17/2021] [Accepted: 01/30/2021] [Indexed: 12/30/2022]
Abstract
PURPOSE To compare the measurements of fat fraction (FF) and in-phase vs. opposed-phase ratio between two-dimensional T2-weighted (T2W) spin-echo (SE) Dixon and three-dimensional (3D) T1-weighted (T1W) volume interpolated breath-hold examination (VIBE) Dixon sequences in malignant vertebral lesions and normal vertebral bone marrow. MATERIALS AND METHODS Thirty patients with focal vertebral malignancies (20 men, mean age, 67.3±9.4 [SD] years; age range: 41-84 years) and 30 patients without malignant spinal disease (11 men, mean age, 70.1±12.9 [SD]; age range: 53-93 years) were retrospectively included. Each patient underwent spine MRI at 1.5 Tesla including T2W SE and T1W VIBE 2-point Dixon sequences. Two readers independently performed 3D-volume of interest (VOI) and region of interest (ROI)-based FF and IO-ratio measurements of malignant lesions and normal vertebrae. Student t-test, Pearson correlation (r) test and two-way mixed model intraclass correlation coefficients (ICC) were used to compare measurements. RESULTS T2W SE and T1W VIBE mean FF and IO-ratio were significantly smaller in malignancy compared to normal marrow, but there were significant differences of paired measurement mean values between T2W SE and T1W VIBE Dixon parameters in malignant lesions T2W SE VOI FF=9%, T2W SE ROI FF=7%, T2W SE IO-ratio=4% vs. T1W VIBE VOI FF=11%, T1W VIBE ROI FF=9%, T1W VIBE IO-ratio=-2%, and in normal vertebrae T2W SE VOI FF=74%, T2W SE ROI FF=77%, T2W SE IO-ratio=51% vs. T1W VIBE VOI FF=67%, T1W VIBE ROI FF=73%, T1W VIBE IO-ratio=58% (each P comparing the paired T2W TSE and T1W VIBE parameter, respectively<0.001). There was excellent positive correlation between T2W SE and T1W VIBE-FF (r≥0.99) and VOI and ROI FF measurements for each sequence (r≥0.99). Inter-reader agreement was excellent for all measurements (ICC≥0.94 for all). CONCLUSION Calculation of T2W SE Dixon derived FF is feasible and gave valid results that help discriminate between malignant vertebral lesions and normal vertebral bone marrow.
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Ognard J, Demany N, Mesrar J, Aho-Glélé LS, Saraux A, Ben Salem D. Mapping the medullar adiposity of lumbar spine in MRI: A feasibility study. Heliyon 2021; 7:e05992. [PMID: 33506138 PMCID: PMC7814159 DOI: 10.1016/j.heliyon.2021.e05992] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Revised: 11/01/2020] [Accepted: 01/12/2021] [Indexed: 11/21/2022] Open
Abstract
PURPOSE The bone medullar adiposity is a marker of bone quality to the point that there is a need to investigate the factors which influence or not the density and distribution of this fat in the spine, especially at the lumbar level. The purpose was to test the feasibility of a Dixon three-point technique and investigate the vertebral marrow fat distribution. MATERIAL AND METHODS A sagittal sequence Iterative Decomposition of Water and Fat with Echo Asymmetry and Least-squares Estimation (IDEAL) IQ was performed on the lumbar spine of 46 subjects who were not suffering from any bone disease (21 women and 25 men, aged 18-77 years). Medulla adiposity was determined directly from the measurement of the fat fraction in each vertebral body (T12 to S1) obtained on the fat cartography automatically generated by the IDEAL sequence. RESULTS Average vertebral fat fraction was 36.48% (SD 12.82), with a tendency to increase with age and to higher values among men. We observed a craniocaudal gradient of the fat fraction (β = 1.37; p < 0,001; SD 0.11) increasing with age in the lumbar spine from T12 to L5. Through multivariate analysis, this gradient was adjusted for sex, weight and height of the subjects. CONCLUSION This feasibility study shows the existence of a physiological craniocaudal gradient of vertebral medullar adiposity from T12 to L5. This gradient increases with age but it is independent of sex or BMI. The IDEAL sequence allows quick and reproducible measurement of the spine vertebral medullar adiposity.
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Affiliation(s)
- Julien Ognard
- Service d'Imagerie Médicale, CHRU de Brest, Boulevard Tanguy-Prigent, 29609 Brest, France
- Laboratoire de Traitement de l'information Médicale—LaTIM (Inserm, U1101), 5, Avenue Foch, 29200 Brest cedex, France
| | - Nicolas Demany
- Service d'Imagerie Médicale, CHRU de Brest, Boulevard Tanguy-Prigent, 29609 Brest, France
| | - Jawad Mesrar
- Service d'Imagerie Médicale, CHRU de Brest, Boulevard Tanguy-Prigent, 29609 Brest, France
| | | | - Alain Saraux
- Service de Rhumatologie, CHRU de Brest, Boulevard Tanguy-Prigent, 29609 Brest, France
| | - Douraied Ben Salem
- Service d'Imagerie Médicale, CHRU de Brest, Boulevard Tanguy-Prigent, 29609 Brest, France
- Laboratoire de Traitement de l'information Médicale—LaTIM (Inserm, U1101), 5, Avenue Foch, 29200 Brest cedex, France
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Li D, Tao X, Zhang N, Huo A, Kang H, Xu C, Zhang Y, Peng Y. Do magnetic resonance imaging manifestations of skeletal system improve after treatment of Gaucher disease? Eur J Radiol 2020; 125:108851. [DOI: 10.1016/j.ejrad.2020.108851] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Revised: 12/21/2019] [Accepted: 01/23/2020] [Indexed: 02/05/2023]
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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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Swamy A, Burström G, Spliethoff JW, Babic D, Reich C, Groen J, Edström E, Elmi Terander A, Racadio JM, Dankelman J, Hendriks BHW. Diffuse reflectance spectroscopy, a potential optical sensing technology for the detection of cortical breaches during spinal screw placement. JOURNAL OF BIOMEDICAL OPTICS 2019; 24:1-11. [PMID: 30701722 PMCID: PMC6985697 DOI: 10.1117/1.jbo.24.1.017002] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 01/07/2019] [Indexed: 05/08/2023]
Abstract
Safe and accurate placement of screws remains a critical issue in open and minimally invasive spine surgery. We propose to use diffuse reflectance (DR) spectroscopy as a sensing technology at the tip of a surgical instrument to ensure a safe path of the instrument through the cancellous bone of the vertebrae. This approach could potentially reduce the rate of cortical bone breaches, thereby resulting in fewer neural and vascular injuries during spinal fusion surgery. In our study, DR spectra in the wavelength ranges of 400 to 1600 nm were acquired from cancellous and cortical bone from three human cadavers. First, it was investigated whether these spectra can be used to distinguish between the two bone types based on fat, water, and blood content along with photon scattering. Subsequently, the penetration of the bone by an optical probe was simulated using the Monte-Carlo (MC) method, to study if the changes in fat content along the probe path would still enable distinction between the bone types. Finally, the simulation findings were validated via an experimental insertion of an optical screw probe into the vertebra aided by x-ray image guidance. The DR spectra indicate that the amount of fat, blood, and photon scattering is significantly higher in cancellous bone than in cortical bone (p < 0.01), which allows distinction between the bone types. The MC simulations showed a change in fat content more than 1 mm before the optical probe came in contact with the cortical bone. The experimental insertion of the optical screw probe gave similar results. This study shows that spectral tissue sensing, based on DR spectroscopy at the instrument tip, is a promising technology to identify the transition zone from cancellous to cortical vertebral bone. The technology therefore has the potential to improve the safety and accuracy of spinal screw placement procedures.
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Affiliation(s)
- Akash Swamy
- Delft University of Technology, Department of Biomechanical Engineering, Delft, Netherlands
- Department of In-Body Systems, Philips Research, Royal Philips NV, Eindhoven, Netherlands
- Address all correspondence to Akash Swamy, E-mail:
| | - Gustav Burström
- Karolinska Institutet, Department of Clinical Neuroscience, Section for Neurosurgery, Stockholm, Sweden
- Karolinska University Hospital, Department of Neurosurgery, Stockholm, Sweden
| | - Jarich W. Spliethoff
- Department of In-Body Systems, Philips Research, Royal Philips NV, Eindhoven, Netherlands
| | - Drazenko Babic
- Department of In-Body Systems, Philips Research, Royal Philips NV, Eindhoven, Netherlands
| | - Christian Reich
- Department of In-Body Systems, Philips Research, Royal Philips NV, Eindhoven, Netherlands
| | - Joanneke Groen
- Department of In-Body Systems, Philips Research, Royal Philips NV, Eindhoven, Netherlands
| | - Erik Edström
- Karolinska Institutet, Department of Clinical Neuroscience, Section for Neurosurgery, Stockholm, Sweden
- Karolinska University Hospital, Department of Neurosurgery, Stockholm, Sweden
| | - Adrian Elmi Terander
- Karolinska Institutet, Department of Clinical Neuroscience, Section for Neurosurgery, Stockholm, Sweden
- Karolinska University Hospital, Department of Neurosurgery, Stockholm, Sweden
| | - John M. Racadio
- Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, United States
| | - Jenny Dankelman
- Delft University of Technology, Department of Biomechanical Engineering, Delft, Netherlands
| | - Benno H. W. Hendriks
- Delft University of Technology, Department of Biomechanical Engineering, Delft, Netherlands
- Department of In-Body Systems, Philips Research, Royal Philips NV, Eindhoven, Netherlands
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11
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Lee SH, Yoo HJ, Yu SM, Hong SH, Choi JY, Chae HD. Fat Quantification in the Vertebral Body: Comparison of Modified Dixon Technique with Single-Voxel Magnetic Resonance Spectroscopy. Korean J Radiol 2018; 20:126-133. [PMID: 30627028 PMCID: PMC6315074 DOI: 10.3348/kjr.2018.0174] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 08/03/2018] [Indexed: 11/15/2022] Open
Abstract
Objective To compare the lumbar vertebral bone marrow fat-signal fractions obtained from six-echo modified Dixon sequence (6-echo m-Dixon) with those from single-voxel magnetic resonance spectroscopy (MRS) in patients with low back pain. Materials and Methods Vertebral bone marrow fat-signal fractions were quantified by 6-echo m-Dixon (repetition time [TR] = 7.2 ms, echo time (TE) = 1.21 ms, echo spacing = 1.1 ms, total imaging time = 50 seconds) and single-voxel MRS measurements in 25 targets (23 normal bone marrows, two focal lesions) from 24 patients. The point-resolved spectroscopy sequence was used for localized single-voxel MRS (TR = 3000 ms, TE = 35 ms, total scan time = 1 minute 42 seconds). A 2 × 2 × 1.5 cm3 voxel was placed within the normal L2 or L3 vertebral body, or other lesions including a compression fracture or metastasis. The bone marrow fat spectrum was characterized on the basis of the magnitude of measurable fat peaks and a priori knowledge of the chemical structure of triglycerides. The imaging-based fat-signal fraction results were then compared to the MRS-based results. Results There was a strong correlation between m-Dixon and MRS-based fat-signal fractions (slope = 0.86, R2 = 0.88, p < 0.001). In Bland-Altman analysis, 92.0% (23/25) of the data points were within the limits of agreement. Bland-Altman plots revealed a slight but systematic error in the m-Dixon based fat-signal fraction, which showed a prevailing overestimation of small fat-signal fractions (< 20%) and underestimation of high fat-signal fractions (> 20%). Conclusion Given its excellent agreement with single-voxel-MRS, 6-echo m-Dixon can be used for visual and quantitative evaluation of vertebral bone marrow fat in daily practice.
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Affiliation(s)
- Sang Hyup Lee
- Department of Radiology, Seoul National University Hospital, Seoul, Korea.,Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
| | - Hye Jin Yoo
- Department of Radiology, Seoul National University Hospital, Seoul, Korea.,Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
| | - Seung-Man Yu
- Department of Radiological Science, College of Health Science, Gimcheon University, Gimcheon, Korea
| | - Sung Hwan Hong
- Department of Radiology, Seoul National University Hospital, Seoul, Korea.,Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.,Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea
| | - Ja-Young Choi
- Department of Radiology, Seoul National University Hospital, Seoul, Korea.,Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
| | - Hee Dong Chae
- Department of Radiology, Seoul National University Hospital, Seoul, Korea.,Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
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12
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Diagnostic Performance of In-Phase and Opposed-Phase Chemical-Shift Imaging for Differentiating Benign and Malignant Vertebral Marrow Lesions: A Meta-Analysis. AJR Am J Roentgenol 2018; 211:W188-W197. [DOI: 10.2214/ajr.17.19306] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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13
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Arribart M, Ognard J, Guintard C, Domergue F, Hassani S, Ben Salem D, Jung JL. Magnetic Resonance Imaging Study of Adipose Tissues in the Head of a Common Dolphin (Delphinus delphis): Structure Identification and Influence of a Freezing-Thawing Cycle. Anat Histol Embryol 2016; 46:204-212. [PMID: 27990670 DOI: 10.1111/ahe.12258] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 11/11/2016] [Indexed: 11/28/2022]
Abstract
Magnetic resonance imaging (MRI) was used to scan the head of a common dolphin (Delphinus delphis) in order to visualize the different adipose tissues involved in echolocation functioning and to precisely delineate their anatomical topology. MRI scans were performed on the head taken from a freshly stranded carcass and repeated after a 2-week freezing time followed by thawing. The main fatty organs of the head, that is the melon, the mandibula bulba, the bursae cantantes, and their different connections with surrounding tissues were identified and labelled. The nasal sacs, other organs of echolocation, were also identified and labelled thanks to different MRI acquisitions. The shape, the location, the type of MRI signal of each organ and of their different connections were successfully analysed on all images, and then, the images of the head fresh or after thawing were compared. No impacts of the freezing/thawing cycle on the fatty tissues of the head were identified. Different parts were distinguished in the melon on the basis of the MRI signal emitted, corresponding most likely to the internal and external melon already identified by other analytical approaches, and linked to differences in lipid composition. MRI is shown here to be a useful tool to study the functional anatomy of the organs responsible for echolocation in odontocetes, with a particularly high level of precision.
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Affiliation(s)
- M Arribart
- Service d'anatomie comparée, Ecole Nationale Vétérinaire ONIRIS, 102 Route de Gachet, 44300, Nantes, France
| | - J Ognard
- Service d'Imagerie Forensique, LaTIM - INSERM UMR 1101, Université de Bretagne Occidentale, CHRU Brest, Boulevard Tanguy Prigent, 29609, Brest Cedex, France
| | - C Guintard
- Service d'anatomie comparée, Ecole Nationale Vétérinaire ONIRIS, 102 Route de Gachet, 44300, Nantes, France
| | - F Domergue
- Laboratoire de Biogenèse Membranaire, UMR 5200, Université de Bordeaux, 71 Avenue Edouard Bourlaux, 33883, Villenave d'Ornon Cédex, France
| | - S Hassani
- Laboratoire d'étude des mammifères marins - Océanopolis, Port de Plaisance du Moulin Blanc, 29200, Brest, France
| | - D Ben Salem
- Service d'Imagerie Forensique, LaTIM - INSERM UMR 1101, Université de Bretagne Occidentale, CHRU Brest, Boulevard Tanguy Prigent, 29609, Brest Cedex, France
| | - J-L Jung
- Laboratoire BioGeMME, Université de Bretagne Occidentale et Université Bretagne Loire - UFR Sciences et Techniques, 6 ave Le Gorgeu, 29200, Brest, France
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14
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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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15
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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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16
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Xu H, Zhang Y, Dong H, Pei F, Li G, Wu D. To assess the association between vertebral marrow fat content and colorectal adenoma in postmenopausal women using magnetic resonance spectroscopy. Acta Radiol 2016; 57:1033-9. [PMID: 26567964 DOI: 10.1177/0284185115616292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 10/18/2015] [Indexed: 12/26/2022]
Abstract
BACKGROUND Although lower bone mineral density (BMD) is considered to have an increased risk for colorectal adenoma, no association between marrow fat content and colorectal adenoma has been elucidated yet. PURPOSE To evaluate the relationship between marrow fat fraction (MFF) and the presence of colorectal adenoma in postmenopausal women using magnetic resonance spectroscopy (MRS). MATERIAL AND METHODS We performed a cross-sectional observational study on 152 postmenopausal patients with colorectal adenoma and 100 matched control subjects who underwent screening colonoscopy, biochemical measurements, dual-energy X-ray absorptiometry, and MRS. Logistic regression models were performed to assess the relationships among BMD, MFF, and colorectal adenoma. RESULTS With univariate analysis, marrow fat accumulation was higher and BMD values were lower in patients with colorectal adenoma compared with those in controls. After adjustment for potential confounders including demographics, health history, blood lipid levels, indexes of glucose metabolism, and validated measures of diet and physical activity, MFF was significantly positively associated with colorectal adenoma (odds ratio [OR], 1.64; 95% confidence interval [CI], 1.10-2.46; P = 0.008). Vertebral BMD, but not total hip and femoral neck BMD, was inversely related with colorectal adenoma (OR, 0.62; 95% CI, 0.14-0.89; P = 0.027). Additionally, MFF was associated with adenoma number, size, and high-risk adenoma (all P < 0.01). MFF was found to be an independent risk factor of a high-risk colorectal adenoma (OR, 2.08; 95% CI, 1.24-3.60; P = 0.019). CONCLUSION Marrow fat accumulation is highly associated with colorectal adenoma, particularly high-risk adenoma, in postmenopausal women.
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Affiliation(s)
- Haidong Xu
- Department of Radiology, Ningbo Medical Treatment Center Lihuili Hospital, Zhejiang, PR China
| | - Yuqin Zhang
- Department of Radiology, Ningbo Medical Treatment Center Lihuili Hospital, Zhejiang, PR China
| | - Haibo Dong
- Department of Radiology, Ningbo Medical Treatment Center Lihuili Hospital, Zhejiang, PR China
| | - Feng Pei
- Department of Anus-intestines, Ningbo Medical Treatment Center Lihuili Hospital, Zhejiang, PR China
| | - Guanwu Li
- Department of Radiology, Yueyang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, PR China
| | - Dongmei Wu
- Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai, PR China
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17
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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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18
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Karampinos DC, Ruschke S, Dieckmeyer M, Eggers H, Kooijman H, Rummeny EJ, Bauer JS, Baum T. Modeling of T2* decay in vertebral bone marrow fat quantification. NMR IN BIOMEDICINE 2015; 28:1535-1542. [PMID: 26423583 DOI: 10.1002/nbm.3420] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Revised: 07/29/2015] [Accepted: 08/31/2015] [Indexed: 06/05/2023]
Abstract
Bone marrow fat fraction mapping using chemical shift encoding-based water-fat separation is becoming a useful tool in investigating the association between bone marrow adiposity and bone health and in assessing cancer treatment-induced bone marrow damage. Vertebral bone marrow is characterized by short T2* relaxation times, which are in general different for the water and fat components and can confound fat quantification. The purpose of the present study is to compare different approaches to T2* correction in chemical shift encoding-based water-fat imaging of vertebral bone marrow using single-voxel MRS as reference. Eight-echo gradient-echo imaging and single-voxel MRS measurements were made on the spine (L3-L5) of 25 healthy volunteers. Different approaches were evaluated for correction of T2* effects: (a) single-T2* correction, (b) dual-T2* correction, (c) T2' correction using the a priori-known T2 from the MRS at each vertebral body and (d) T2' correction using the a priori-known T2 equal to previously measured average values. Dual-T2* correction resulted in noisier imaging fat fraction maps than single-T2* correction or T2' correction using a priori-known T2. Linear regression analysis between imaging and MRS fat fraction showed a slope significantly different from 1 when using single-T2* correction (R(2) = 0.96) or dual-T2* correction (R(2) = 0.87). T2' correction using the a priori-known T2 resulted in a slope not significantly different from 1, an intercept significantly different from 0 (between 2.4% and 3%) and R(2) = 0.96. Therefore, a T2' correction using a priori-known T2 can remove the fat fraction bias induced by the difference in T2* between water and fat components without degrading noise performance in fat fraction mapping of vertebral bone marrow.
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Affiliation(s)
- Dimitrios C Karampinos
- Department of Diagnostic and Interventional Radiology, Technische Universität München, Munich, Germany
| | - Stefan Ruschke
- Department of Diagnostic and Interventional Radiology, Technische Universität München, Munich, Germany
| | - Michael Dieckmeyer
- Department of Diagnostic and Interventional Radiology, Technische Universität München, Munich, Germany
| | | | | | - Ernst J Rummeny
- Department of Diagnostic and Interventional Radiology, Technische Universität München, Munich, Germany
| | - Jan S Bauer
- Section of Neuroradiology, Technische Universität München, Munich, Germany
| | - Thomas Baum
- Department of Diagnostic and Interventional Radiology, Technische Universität München, Munich, Germany
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19
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Abduljabbar FH, Al-jurayyan A, Alqahtani S, Sardar ZM, Saluja RS, Ouellet J, Weber M, Steffen T, Beckman L, Jarzem P. Does Balloon Kyphoplasty Deliver More Cement Safely into Osteoporotic Vertebrae with Compression Fractures Compared with Vertebroplasty? A Study in Vertebral Analogues. Global Spine J 2015; 5. [PMID: 26225279 PMCID: PMC4516756 DOI: 10.1055/s-0035-1546818] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Study Design A biomechanical and radiographic study using vertebral analogues. Objectives Kyphoplasty and vertebroplasty are widely used techniques to alleviate pain in fractures secondary to osteoporosis. However, cement leakage toward vital structures like the spinal cord can be a major source of morbidity and even mortality. We define safe cement injection as the volume of the cement injected into a vertebra before the cement leakage occurs. Our objective is to compare the amount of cement that can be safely injected into an osteoporotic vertebra with simulated compression fracture using either vertebroplasty or balloon kyphoplasty techniques. Methods Forty artificial vertebral analogues made of polyurethane with osteoporotic cancellous matrix representing the L3 vertebrae were used for this study and were divided into four groups of 10 vertebrae each. The four groups tested were: low-viscosity cement injected using vertebroplasty, high-viscosity cement injected using vertebroplasty, low-viscosity cement injected using balloon kyphoplasty, and high-viscosity cement injected using balloon kyphoplasty. The procedures were performed under fluoroscopic guidance. The injection was stopped when the cement started protruding from the created vascular channel in the osteoporotic vertebral fracture model. The main outcome measured was the volume of the cement injected safely into a vertebra before leakage through the posterior vascular channel. Results The highest volume of the cement injected was in the vertebroplasty group using high-viscosity cement, which was almost twice the injected volume in the other three groups. One-way analysis of variance comparing the four groups showed a statistically significant difference (p < 0.005). Conclusions High-viscosity cement injected using vertebroplasty delivers more cement volume before cement leakage and fills the vertebral body more uniformly when compared with balloon kyphoplasty in osteoporotic vertebrae with compression fractures.
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Affiliation(s)
- Fahad H. Abduljabbar
- McGill Scoliosis and Spine Centre, McGill University Health Centre, Montreal, Canada,Department of Orthopedic Surgery, King Abdulaziz University, Jeddah, Saudi Arabia,Address for correspondence Fahad H. Abduljabbar, MBBS Montreal General HospitalOrthopaedic Resident1650 Cedar AvenueT8-200Montreal, QC H3G 1A4Canada
| | - Abdulaziz Al-jurayyan
- McGill Scoliosis and Spine Centre, McGill University Health Centre, Montreal, Canada,Department of Orthopedic Surgery, King Saud University, Riyadh, Saudi Arabia
| | - Saad Alqahtani
- McGill Scoliosis and Spine Centre, McGill University Health Centre, Montreal, Canada,Department of Orthopedic Surgery, University of Dammam, Dammam, Saudi Arabia
| | - Zeeshan M. Sardar
- McGill Scoliosis and Spine Centre, McGill University Health Centre, Montreal, Canada
| | - Rajeet Singh Saluja
- McGill Scoliosis and Spine Centre, McGill University Health Centre, Montreal, Canada
| | - Jean Ouellet
- McGill Scoliosis and Spine Centre, McGill University Health Centre, Montreal, Canada
| | - Michael Weber
- McGill Scoliosis and Spine Centre, McGill University Health Centre, Montreal, Canada
| | - Thomas Steffen
- Orthopedic Research Laboratory, McGill University Health Centre, Montreal, Canada
| | - Lorne Beckman
- Orthopedic Research Laboratory, McGill University Health Centre, Montreal, Canada
| | - Peter Jarzem
- McGill Scoliosis and Spine Centre, McGill University Health Centre, Montreal, Canada
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20
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Moorthi RN, Fadel W, Eckert GJ, Ponsler-Sipes K, Moe SM, Lin C. Bone marrow fat is increased in chronic kidney disease by magnetic resonance spectroscopy. Osteoporos Int 2015; 26:1801-7. [PMID: 25701052 PMCID: PMC4582653 DOI: 10.1007/s00198-015-3064-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2015] [Accepted: 02/02/2015] [Indexed: 11/30/2022]
Abstract
UNLABELLED In aging, the bone marrow fills with fat and this may lead to higher fracture risk. We show that a bone marrow fat measurement by magnetic resonance spectroscopy (MRS), a newer technique not previously studied in chronic kidney disease (CKD), is useful and reproducible. CKD patients have significantly higher bone marrow fat than healthy adults. INTRODUCTION Renal osteodystrophy leads to increased morbidity and mortality in patients with CKD. Traditional bone biopsy histomorphometry is used to study abnormalities in CKD, but the bone marrow, the source of osteoblasts, has not been well characterized in patients with CKD. METHODS To determine the repeatability of bone marrow fat fraction assessment by MRS and water-fat imaging (WFI) at four sites in patients with CKD, testing was performed to determine the coefficients of reproducibility and intraclass coefficients (ICCs). We further determined if this noninvasive technique could be used to determine if there are differences in the percent bone marrow fat in patients with CKD compared to matched controls using paired t tests. RESULTS The mean age of subjects with CKD was 59.8 ± 7.2 years, and the mean eGFR was 24 ± 8 ml/min. MRS showed good reproducibility at all sites in subjects with CKD and controls, with a coefficient of reproducibilities ranging from 2.4 to 13 %. MRS and WFI assessment of bone marrow fat showed moderate to strong agreement (ICC 0.6-0.7) at the lumbar spine, with poorer agreement at the iliac crest and no agreement at the tibia. The mean percent bone marrow fat at L2-L4 was 13.8 % (95 % CI 8.3-19.7) higher in CKD versus controls (p < 0.05). CONCLUSIONS MRS is a useful and reproducible technique to study bone marrow fat in CKD. Patients with CKD have significantly higher bone marrow fat than healthy adults; the relationship with bone changes requires further analyses.
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Affiliation(s)
- R N Moorthi
- Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN, 46202, USA.
| | - W Fadel
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
- Richard M. Fairbanks School of Public Health, Indianapolis, IN, 46202, USA
| | - G J Eckert
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
- Richard M. Fairbanks School of Public Health, Indianapolis, IN, 46202, USA
| | - K Ponsler-Sipes
- Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - S M Moe
- Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
- Roudebush Veterans Administration Medical Center, Indianapolis, IN, 46202, USA
| | - C Lin
- Department of Radiology, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
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21
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Abstract
Liver fat, iron, and combined overload are common manifestations of diffuse liver disease and may cause lipotoxicity and iron toxicity via oxidative hepatocellular injury, leading to progressive fibrosis, cirrhosis, and eventually, liver failure. Intracellular fat and iron cause characteristic changes in the tissue magnetic properties in predictable dose-dependent manners. Using dedicated magnetic resonance pulse sequences and postprocessing algorithms, fat and iron can be objectively quantified on a continuous scale. In this article, we will describe the basic physical principles of magnetic resonance fat and iron quantification and review the imaging techniques of the "past, present, and future." Standardized radiological metrics of fat and iron are introduced for numerical reporting of overload severity, which can be used toward objective diagnosis, grading, and longitudinal disease monitoring. These noninvasive imaging techniques serve an alternative or complimentary role to invasive liver biopsy. Commercial solutions are increasingly available, and liver fat and iron quantitative imaging is now within reach for routine clinical use and may soon become standard of care.
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Affiliation(s)
- Takeshi Yokoo
- From the *Department of Radiology, †Advanced Imaging Research Center, and ‡Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX
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22
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Ojanen X, Borra RJH, Havu M, Cheng SM, Parkkola R, Nuutila P, Alen M, Cheng S. Comparison of vertebral bone marrow fat assessed by 1H MRS and inphase and out-of-phase MRI among family members. Osteoporos Int 2014; 25:653-62. [PMID: 23943163 DOI: 10.1007/s00198-013-2472-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Accepted: 07/24/2013] [Indexed: 12/11/2022]
Abstract
UNLABELLED Inphase and out-of-phase magnetic resonance imaging is a robust and fast method which can provide similar vertebral bone marrow fat estimation as (1)H proton magnetic resonance spectroscopy, indicating that this technique is a potentially useful tool in both research and clinical practice. INTRODUCTION The importance of evaluating bone marrow fat lies in the fact that osteoporosis and obesity, two disorders of body composition, are growing in prevalence. Bone fat mass can be reliably assessed using proton magnetic resonance spectroscopy ((1)H MRS), but this method is technically demanding and needs advanced post-processing unlike inphase and out-of-phase magnetic resonance imaging (MRI), which is a robust and fast method. METHODS We compared vertebral bone marrow fat (BMF) content assessed by inphase and out-of-phase MRI and (1)H MRS using a 1.5-T MRI scanner in mothers (n = 34, aged 49.4 years), fathers (n = 31, aged 53.1 years) and their daughters (n = 40, aged 20.3 years) who participated in the CALEX family study. Signal intensity on the inphase and out-of-phase MRI was analyzed from the same location and size of the single-voxel (1)H MRS measurement. RESULTS Positive correlations were found between (1)H MRS and inphase and out-of-phase MRI in the axial plane (r = 0.746, p < 0.001) and sagittal plane (r = 0.804, p < 0.001). The mean differences between (1)H MRS and inphase and out-of-phase MRI in the axial and sagittal planes were relatively small, at 4.13 and 2.67 %, and the agreement between techniques was 89.4 and 93.2 %, respectively. Girls had a significantly lower vertebral BMF than mothers and fathers with both methods (for all, p < 0.001). CONCLUSIONS We conclude that inphase and out-of-phase MRI can provide similar vertebral BMF estimation as (1)H MRS, indicating that this technique is a potentially useful tool in both research and clinical practice.
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Affiliation(s)
- X Ojanen
- Department of Health Sciences, University of Jyväskylä, Jyväskylä, 40014, Finland,
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23
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Scheller EL, Troiano N, Vanhoutan JN, Bouxsein MA, Fretz JA, Xi Y, Nelson T, Katz G, Berry R, Church CD, Doucette CR, Rodeheffer MS, Macdougald OA, Rosen CJ, Horowitz MC. Use of osmium tetroxide staining with microcomputerized tomography to visualize and quantify bone marrow adipose tissue in vivo. Methods Enzymol 2014; 537:123-39. [PMID: 24480344 DOI: 10.1016/b978-0-12-411619-1.00007-0] [Citation(s) in RCA: 129] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Adipocytes reside in discrete, well-defined depots throughout the body. In addition to mature adipocytes, white adipose tissue depots are composed of many cell types, including macrophages, endothelial cells, fibroblasts, and stromal cells, which together are referred to as the stromal vascular fraction (SVF). The SVF also contains adipocyte progenitors that give rise to mature adipocytes in those depots. Marrow adipose tissue (MAT) or marrow fat has long been known to be present in bone marrow (BM) but its origin, development, and function remain largely unknown. Clinically, increased MAT is associated with age, metabolic diseases, drug treatment, and marrow recovery in children receiving radiation and chemotherapy. In contrast to the other depots, MAT is unevenly distributed in the BM of long bones. Conventional quantitation relies on sectioning of the bone to overcome issues with distribution but is time-consuming, resource intensive, inconsistent between laboratories and may be unreliable as it may miss changes in MAT volume. Thus, the inability to quantitate MAT in a rapid, systematic, and reproducible manner has hampered a full understanding of its development and function. In this chapter, we describe a new technique that couples histochemical staining of lipid using osmium tetroxide with microcomputerized tomography to visualize and quantitate MAT within the medullary canal in three dimensions. Imaging of osmium staining provides a high-resolution map of existing and developing MAT in the BM. Because this method is simple, reproducible, and quantitative, we expect it will become a useful tool for the precise characterization of MAT.
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Affiliation(s)
- Erica L Scheller
- Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Nancy Troiano
- Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Joshua N Vanhoutan
- Department of Internal Medicine, Endocrinology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Mary A Bouxsein
- Center for Advanced Orthopedic Studies, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - Jackie A Fretz
- Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Yougen Xi
- Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Tracy Nelson
- Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Griffin Katz
- Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Ryan Berry
- Section of Comparative Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Christopher D Church
- Section of Comparative Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Casey R Doucette
- Maine Medical Center Research Institute, Scarborough, Maine, USA
| | - Matthew S Rodeheffer
- Section of Comparative Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Ormond A Macdougald
- Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Clifford J Rosen
- Maine Medical Center Research Institute, Scarborough, Maine, USA
| | - Mark C Horowitz
- Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, Connecticut, USA.
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24
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Martin J, Nicholson G, Cowin G, Ilente C, Wong W, Kennedy D. Rapid determination of vertebral fat fraction over a large range of vertebral bodies. J Med Imaging Radiat Oncol 2013; 58:155-63. [DOI: 10.1111/1754-9485.12143] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Accepted: 11/11/2013] [Indexed: 10/25/2022]
Affiliation(s)
- Jarad Martin
- Calvary Mater Newcastle; Newcastle New South Wales Australia
- School of Medicine; University of Queensland; Toowoomba Queensland Australia
- Centre for Advanced Imaging; University of Queensland; Brisbane Queensland Australia
| | - Geoffrey Nicholson
- School of Medicine; University of Queensland; Toowoomba Queensland Australia
| | - Gary Cowin
- Centre for Advanced Imaging; University of Queensland; Brisbane Queensland Australia
| | - Clare Ilente
- Toowoomba Cancer Research Centre; Toowoomba Queensland Australia
| | - Winnie Wong
- Toowoomba Cancer Research Centre; Toowoomba Queensland Australia
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25
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Gender and age groups interactions in the quantification of bone marrow fat content in lumbar spine using 3T MR spectroscopy: a multivariate analysis of covariance (Mancova). Eur J Radiol 2013; 82:e697-702. [PMID: 23938236 DOI: 10.1016/j.ejrad.2013.07.012] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2012] [Revised: 07/05/2013] [Accepted: 07/19/2013] [Indexed: 02/08/2023]
Abstract
INTRODUCTION There is an age-related conversion of red to yellow bone marrow in the axial skeleton, with a gender-related difference less well established. Our purpose was to clarify the variability of bone marrow fat fraction (FF) in the lumbar spine due to the interaction of gender and age groups. METHODS 44 healthy volunteers (20 males, 30-65 years old and 24 females, 30-69 years old) underwent 3T magnetic resonance spectroscopy (MRS) and conventional MRI examination of the lumbar spine; single-voxel spectrum was acquired for each vertebral body (VB). After controlling body mass index (BMI), a two-way between-groups multivariate analysis of covariance (MANCOVA) assessed the gender and age group differences in FF quantification for each lumbar VB. RESULTS There was a significant interaction between gender and age group, p=.017, with a large effect size (partial η(2)=.330). However the interaction explained only 33% of the observed variance. Main effects were not statistically significant. BMI was non-significantly related to FF quantification. CONCLUSIONS Young males showed a high FF content, which declined in the 4th decade, then increased the next 3 decades to reach a FF content just below the initial FF means. Females' FF were low in the 3rd decade, depicted an accelerated increase in the 4th decade, then a gradual increase the next 3 decades to reach a FF content similar to males' values. Our findings suggest that quantification of bone marrow FF using MRS might be used as a surrogate biomarker of bone marrow activity in clinical settings.
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