Elucidating the Correlation between Bone Mineral Density and Multifidus Muscle Characteristics: A Cross-Modal Study with Dual-Energy X-ray Absorptiometry and Spinal Computed Tomography Texture Analysis

Abstract

Background: Recent research underscores the clinical relevance of muscle conditions such as sarcopenia and their links to bone mineral density (BMD), yet notable gaps persist in the understanding of their interconnections. Our study addresses this by introducing a novel approach to decipher the correlation between BMD and the texture of the multifidus muscle, utilizing spinal computed tomography (CT) and dual-energy X-ray absorptiometry (DXA) to evaluate muscle texture, BMD, and bone mineral content (BMC) at the total lumbar vertebra and total hip. Methods: Our single-institution study examined 395 cases collected from 6 May 2012 to 30 November 2021. Each patient underwent a spinal CT scan and a DXA scan within a one-month interval. BMD and BMC at the total lumbar vertebra and total hip were measured. The texture features of the multifidus muscle from the axial cuts of T12 to S1 vertebrae were assessed via gray-level co-occurrence matrices. CT texture analysis values at angles of 45 + 45 and 90 degrees were calculated and correlated with BMD and BMC. A regression model was then constructed to predict BMD values, and the precision of these correlations was evaluated using mean square error (MSE) analysis. Results: Total lumbar BMC showed a correlation of 0.583–0.721 (MSE 1.568–1.842) and lumbar BMD of 0.632–0.756 (MSE 0.068–0.097). Total hip BMC had a correlation of 0.556–0.690 (MSE 0.448–0.495), while hip BMD ranged from 0.585 to 0.746 (MSE 0.072–0.092). Conclusions: The analysis of spinal CT texture alongside BMD and BMC measures provides a new approach to understanding the relationship between bone and muscle health. The strong correlations expected from our research affirm the importance of integrating bone and muscle measures in the prevention, diagnosis, and management of conditions such as sarcopenia and osteoporosis.

Keywords

• dual-energy X-ray absorptiometry (DXA)
• computed tomography Hounsfield unit (CT HU)
• bone mineral density (BMD)
• multifidus muscle
• morphometric texture analysis