Zhang Shuo, Guo Qianrui, Yang Yang, Feng Hongbo, Zhao Yan, Guo Peng, Li Di, Du Xuemei, Song Qingwei
Department of Nuclear Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China.
Beijing United Imaging Research Institute of Intelligent Imaging, Beijing 100094, China.
Bioengineering (Basel). 2023 Jun 11;10(6):710. doi: 10.3390/bioengineering10060710.
The aim of this study is to search for the predictive value of 3D fat analysis and calculation technique (FACT) and intravoxel incoherent motion (IVIM) parameters in identifying osteoporosis in women.
We enrolled 48 female subjects who underwent 3.0 T MRI, including 3D FACT and IVIM sequences. Bone mineral density (BMD) values and Fracture Risk Assessment (FRAX) scores were obtained. Proton density fat fraction (PDFF) in the bone marrow and the real diffusion (D) value of intervertebral discs were measured on 3D FACT and IVIM images, respectively. Accuracy and bias were assessed by linear regression analysis and Bland-Altman plots. Intraclass correlation coefficients were used to assess the measurements' reproducibility. Spearman's rank correlation was applied to explore the correlation. MRI-based parameters were tested for significant differences among the three groups using ANOVA analyses. A receiver operating characteristic (ROC) analysis was performed.
The PDFF of the vertebral body showed a negative correlation with BMD (R = -0.393, = 0.005) and a positive correlation with the FRAX score (R = 0.706, < 0.001). The D value of intervertebral discs showed a positive correlation with BMD (R = 0.321, = 0.024) and a negative correlation with the FRAX score (R = -0.334, = 0.019). The area under the curve values from the ROC analysis showed that the 3D FACT and IVIM sequences could accurately differentiate between normal and osteoporosis (AUC = 0.88 using the PDFF; AUC = 0.77 using the D value). The PDFF value demonstrated a sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 78.6%, 89.5%, 84.6%, and 85.0%, respectively, in its ability to predict osteoporosis. The D value had a sensitivity, specificity, PPV, and NPV of 63.16%, 92.9%, 65.0%, and 77.8%, respectively, for predicting osteoporosis.
The 3D FACT- and IVIM-measured PDFF and D values are promising biomarkers in the assessment of bone quality and fracture risk.
本研究旨在探寻三维脂肪分析与计算技术（FACT）及体素内不相干运动（IVIM）参数在女性骨质疏松症识别中的预测价值。
我们纳入了48名接受3.0T磁共振成像（MRI）检查的女性受试者，检查包括三维FACT和IVIM序列。获取骨密度（BMD）值和骨折风险评估（FRAX）分数。分别在三维FACT和IVIM图像上测量骨髓中的质子密度脂肪分数（PDFF）以及椎间盘的真实扩散（D）值。通过线性回归分析和布兰德 - 奥特曼图评估准确性和偏差。使用组内相关系数评估测量的可重复性。应用斯皮尔曼等级相关分析相关性。使用方差分析（ANOVA）分析检验基于MRI的参数在三组之间的显著差异。进行受试者工作特征（ROC）分析。
椎体的PDFF与BMD呈负相关（R = -0.393，P = 0.005），与FRAX分数呈正相关（R = 0.706，P < 0.001）。椎间盘的D值与BMD呈正相关（R = 0.321，P = 0.024），与FRAX分数呈负相关（R = -0.334，P = 0.019）。ROC分析的曲线下面积值表明，三维FACT和IVIM序列能够准确区分正常与骨质疏松症（使用PDFF时AUC = 0.88；使用D值时AUC = 0.77）。PDFF值在预测骨质疏松症方面的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）分别为78.6%、89.5%、84.6%和85.0%。D值预测骨质疏松症的敏感性、特异性、PPV和NPV分别为63.16%、92.9%、65.0%和77.8%。
三维FACT和IVIM测量的PDFF和D值是评估骨质量和骨折风险的有前景的生物标志物。
