Identification of Abnormal BMD and Osteoporosis in Postmenopausal Women with T2*-corrected Q-Dixon and Reduced-FOV IVIM: Correlation with QCT

Objective: To investigate the predictive value of quantitative Dixon (Q-Dixon) and intravoxel incoherent motion (IVIM) parameters in identifying normal bone mineral density (BMD), osteopenia, and osteoporosis in postmenopausal women.

Methods: We enrolled 105 postmenopausal female subjects who underwent 3 T MRI, including T2*-corrected Q-Dixon and reduced-field-of-view (reduced-FOV) IVIM sequences. The measurement of Q-Dixon and IVIM parameters was performed on the L3 vertebral body. BMD values were obtained using quantitative computed tomography (QCT) examination, which served as the reference standard. The intraclass correlation coefficient (ICC) was used to assess the measurement reproducibility across observers. One-way ANOVA, Spearman analysis, and receiver operating characteristic curve analysis were performed.

Results: There were significant differences in FF, T2*, and D values between the three groups (p = 0.011, p = 0.021, p = 0.015). FF and T2* values were negatively correlated with BMD (r =  - 0.747, p < 0.001; r =  - 0.498, p = 0.007). D and f values were positively correlated with BMD (r = 0.659, p < 0.001; r = 0.472, p = 0.012). D values showed a significant negative correlation with FF values (r = 0.659, p < 0.001). f values showed a moderate negative correlation with FF values (r =  - 0.387, p = 0.026). The sensitivity (89.2%), specificity (92.7%), and accuracy (91.4%) of the Q-Dixon model in differentiating normal and abnormal BMD (osteopenia and osteoporosis) were superior to those of the IVIM model. Conversely, the IVIM model outperformed the Q-Dixon model in discriminating osteopenia and osteoporosis; the sensitivity, specificity, and accuracy were 85.4%, 81.5%, and 83.8%, respectively.

Conclusions: T2*-corrected Q-Dixon and reduced-FOV IVIM parameters have the potential to become new biomarkers in the assessment of abnormal BMD and osteoporosis in postmenopausal women.

Key Points: • T2*-corrected Q-Dixon and reduced-FOV IVIM parameters are correlated with BMD. • Fat quantification and bone trabecular microstructure information provided by T2*-corrected Q-Dixon outperforms reduced-FOV IVIM in identifying abnormal BMD. • Quantification of bone marrow water molecule diffusion movement and perfusion effects obtained from the reduced-FOV IVIM technique can differentiate osteopenia and osteoporosis more accurately than T2*-corrected Q-Dixon.