Associations between Bone Mineral Density and Longitudinal Changes of Vertebral Bone Marrow and Paraspinal Muscle Composition Assessed Using MR-Based Proton Density Fat Fraction and T2* Maps in Patients with and without Osteoporosis
Florian Tilman Gassert,
Leander Glanz,
Christof Boehm,
Jonathan Stelter,
Felix Gerhard Gassert,
Yannik Leonhardt,
Georg C. Feuerriegel,
Markus Graf,
Markus Wurm,
Thomas Baum,
Rickmer F. Braren,
Benedikt J. Schwaiger,
Marcus R. Makowski,
Dimitrios Karampinos,
Alexandra S. Gersing
Affiliations
Florian Tilman Gassert
Department of Radiology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, 81675 Munich, Germany
Leander Glanz
Department of Radiology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, 81675 Munich, Germany
Christof Boehm
Department of Radiology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, 81675 Munich, Germany
Jonathan Stelter
Department of Radiology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, 81675 Munich, Germany
Felix Gerhard Gassert
Department of Radiology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, 81675 Munich, Germany
Yannik Leonhardt
Department of Radiology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, 81675 Munich, Germany
Georg C. Feuerriegel
Department of Radiology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, 81675 Munich, Germany
Markus Graf
Department of Radiology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, 81675 Munich, Germany
Markus Wurm
Department of Trauma Surgery, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, 81675 Munich, Germany
Thomas Baum
Department of Neuroradiology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, 81675 Munich, Germany
Rickmer F. Braren
Department of Radiology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, 81675 Munich, Germany
Benedikt J. Schwaiger
Department of Neuroradiology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, 81675 Munich, Germany
Marcus R. Makowski
Department of Radiology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, 81675 Munich, Germany
Dimitrios Karampinos
Department of Radiology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, 81675 Munich, Germany
Alexandra S. Gersing
Department of Radiology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, 81675 Munich, Germany
Background: Proton-density fat fraction (PDFF) and T2* of the vertebrae, as well as the cross-sectional area (CSA) of the paraspinal musculature (PSM), have been suggested as biomarkers for bone fragility. The aim of this study was to longitudinally assess changes in PDFF, T2* and CSA of the PSM over 6 months in patients with and without osteoporosis. Methods: Opportunistic bone mineral density (BMD) measurements (BMD 3) were obtained from a CT acquired during the clinical routine work up in osteoporotic/osteopenic patients (n = 29, mean age 72.37 ± 10.12 years, 16 women). These patients were frequency-matched for age and sex to subjects with normal BMD values (n = 29). All study patients underwent 3T MR imaging at baseline and 6-month follow up, including spoiled gradient echo sequences for chemical shift encoding-based water-fat separation, from which T2* and PDFF values of the lumbar spine and the PSM were obtained. Moreover, the CSA of the PSM was assessed longitudinally. Changes in T2*, PDFF and CSA over 6 months were calculated for the vertebrae and PSM and associations with baseline BMD values were assessed. Results: The change in CSA of the PSM over 6 months was significantly lower in the osteoporotic/osteopenic group (−91.5 ± 311.7 mm2), compared to the non-osteoporotic group, in which the CSA increased (29.9 ± 164.0 mm2, p = 0.03). In a further analysis, patients with higher vertebral PDFF at baseline showed a significantly stronger increase in vertebral T2*, compared to those patients with lower vertebral PDFF at baseline (0.9 ± 1.6 ms vs. 0.0 ± 1.8 ms, p = 0.04). Moreover, patients with higher PSM PDFF at baseline showed a significantly stronger increase in vertebral T2*, compared to those patients with lower PSM PDFF at baseline (0.9 ± 2.0 ms vs. 0.0 ± 1.3 ms, p = 0.03). Conclusion: The PSM CSA decreased significantly longitudinally in patients with osteoporosis/osteopenia, compared to those without. Additionally, higher vertebral and PSM PDFF at baseline were associated with stronger changes in vertebral bone marrow T2*. Therefore, longitudinal PDFF and T2* mapping may be useful quantitative radiation-free tools for the assessment and prediction of muscle and bone health in patients with suspected osteoporosis/osteopenia.