Quantitative Assessment of Lumbar Spine Bone Marrow in Patients with Different Severity of CKD by IDEAL-IQ Magnetic Resonance Sequence

Overview

Journal Front Endocrinol (Lausanne)

Specialty Endocrinology

Date 2022 Oct 7

PMID 36204094

Authors

Yan Xiong

Tongxiang He

Weiyin Vivian Liu

Yao Zhang

Shuang Hu

Donglin Wen

Yanan Wang

Peisen Zhang

Fan He

Xiaoming Li

Affiliations

Soon will be listed here.

Abstract

Background: Chronic kidney disease (CKD) has a significant negative impact on bone health. Bone marrow is an essential component of bone, mainly composed of trabecular bone and fat. The IDEAL-IQ sequence of MRI allows indirect quantification of trabecular bone mass by R2* and direct quantification of bone marrow fat content by FF map, respectively.

Objective: Our objective was to explore the association of CKD severity with bone marrow using IDEAL-IQ and whether mineral and bone metabolism markers alter this association.

Method: We recruited 68 CKD patients in this cross-sectional research (15 with CKD stages 3-4, 26 with stage 5, and 27 with stage 5d). All patients underwent lumbar spine IDEAL-IQ, BMD, and several bone metabolism markers (iPTH, 25-(OH)-VitD, calcium and phosphorus). Multiple linear regression analysis was used to examine the association of CKD severity with MRI measurements (R2* and FF).

Results: More severe CKD was associated with a higher R2* value [CKD 5d versus 3-4: 30.077 s (95% CI: 12.937, 47.217), for trend < 0.001], and this association was attenuated when iPTH was introduced [CKD 5d versus 3-4: 19.660 s (95% CI: 0.205, 39.114), for trend = 0.042]. Furthermore, iPTH had an association with R2* value [iPTH (pg/mL): 0.033 s (95% CI: 0.001, 0.064), = 0.041]. Besides, FF was mainly affected by age and BMI, but not CKD.

Conclusions: The bone marrow R2* value measured by IDEAL-IQ sequence is associated with CKD severity and iPTH. The R2* of IDEAL-IQ has the potential to reflect lumbar bone changes in patients with CKD.

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References

Silva B, Costa A, Cusano N, Kousteni S, Bilezikian J . Catabolic and anabolic actions of parathyroid hormone on the skeleton. J Endocrinol Invest. 2011; 34(10):801-10. PMC: 4315330. DOI: 10.3275/7925. View

Ge M, Zhang J, Wu B, Liu Z, Song H, Meng X . Effect of gadolinium on hepatic fat quantification using multi-echo reconstruction technique with T2* correction and estimation. Eur Radiol. 2015; 26(6):1913-20. DOI: 10.1007/s00330-015-3981-z. View

Veldhuis-Vlug A, Rosen C . Clinical implications of bone marrow adiposity. J Intern Med. 2017; 283(2):121-139. PMC: 5847297. DOI: 10.1111/joim.12718. View

Moorthi R, Fadel W, Eckert G, Ponsler-Sipes K, Moe S, Lin C . Bone marrow fat is increased in chronic kidney disease by magnetic resonance spectroscopy. Osteoporos Int. 2015; 26(6):1801-7. PMC: 4582653. DOI: 10.1007/s00198-015-3064-7. View

Leonard M . A structural approach to the assessment of fracture risk in children and adolescents with chronic kidney disease. Pediatr Nephrol. 2007; 22(11):1815-24. PMC: 6949198. DOI: 10.1007/s00467-007-0490-6. View

Griffith J, Yeung D, Antonio G, Wong S, Kwok T, Woo J . Vertebral marrow fat content and diffusion and perfusion indexes in women with varying bone density: MR evaluation. Radiology. 2006; 241(3):831-8. DOI: 10.1148/radiol.2413051858. View

Bredella M, Gerweck A, Barber L, Breggia A, Rosen C, Torriani M . Effects of growth hormone administration for 6 months on bone turnover and bone marrow fat in obese premenopausal women. Bone. 2014; 62:29-35. PMC: 4014200. DOI: 10.1016/j.bone.2014.01.022. View

Woods G, Ewing S, Sigurdsson S, Kado D, Ix J, Hue T . Chronic Kidney Disease Is Associated With Greater Bone Marrow Adiposity. J Bone Miner Res. 2018; 33(12):2158-2164. PMC: 6702945. DOI: 10.1002/jbmr.3562. View

Carmona R, Pritz J, Bydder M, Gulaya S, Zhu H, Williamson C . Fat composition changes in bone marrow during chemotherapy and radiation therapy. Int J Radiat Oncol Biol Phys. 2014; 90(1):155-63. PMC: 4159416. DOI: 10.1016/j.ijrobp.2014.05.041. View

10.

Nickolas T, Leonard M, Shane E . Chronic kidney disease and bone fracture: a growing concern. Kidney Int. 2008; 74(6):721-31. PMC: 4139042. DOI: 10.1038/ki.2008.264. View

11.

Griffith J, Yeung D, Antonio G, Lee F, Hong A, Wong S . Vertebral bone mineral density, marrow perfusion, and fat content in healthy men and men with osteoporosis: dynamic contrast-enhanced MR imaging and MR spectroscopy. Radiology. 2005; 236(3):945-51. DOI: 10.1148/radiol.2363041425. View

12.

Langub M, Monier-Faugere M, Qi Q, Geng Z, Koszewski N, Malluche H . Parathyroid hormone/parathyroid hormone-related peptide type 1 receptor in human bone. J Bone Miner Res. 2001; 16(3):448-56. DOI: 10.1359/jbmr.2001.16.3.448. View

13.

Majumdar S, Thomasson D, Shimakawa A, Genant H . Quantitation of the susceptibility difference between trabecular bone and bone marrow: experimental studies. Magn Reson Med. 1991; 22(1):111-27. DOI: 10.1002/mrm.1910220112. View

14.

Bredella M, Torriani M, Hosseini Ghomi R, Thomas B, Brick D, Gerweck A . Vertebral bone marrow fat is positively associated with visceral fat and inversely associated with IGF-1 in obese women. Obesity (Silver Spring). 2010; 19(1):49-53. PMC: 3593350. DOI: 10.1038/oby.2010.106. View

15.

Chen R, Bai Y, Liu T, Zhang G, Han Y, Chen L . Evaluation of Glypican-3 Expression in Hepatocellular Carcinoma by Using IDEAL IQ Magnetic Resonance Imaging. Acad Radiol. 2020; 28(8):e227-e234. DOI: 10.1016/j.acra.2020.05.015. View

16.

Majumdar S, Genant H . In vivo relationship between marrow T2* and trabecular bone density determined with a chemical shift-selective asymmetric spin-echo sequence. J Magn Reson Imaging. 1992; 2(2):209-19. DOI: 10.1002/jmri.1880020215. View

17.

Amling M, Grote H, Vogel M, Hahn M, Delling G . Three-dimensional analysis of the spine in autopsy cases with renal osteodystrophy. Kidney Int. 1994; 46(3):733-43. DOI: 10.1038/ki.1994.328. View

18.

. KDIGO 2017 Clinical Practice Guideline Update for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD). Kidney Int Suppl (2011). 2019; 7(1):1-59. PMC: 6340919. DOI: 10.1016/j.kisu.2017.04.001. View

19.

Bredella M, Gill C, Gerweck A, Landa M, Kumar V, Daley S . Ectopic and serum lipid levels are positively associated with bone marrow fat in obesity. Radiology. 2013; 269(2):534-41. PMC: 3807082. DOI: 10.1148/radiol.13130375. View

20.

Bredella M, Lin E, Gerweck A, Landa M, Thomas B, Torriani M . Determinants of bone microarchitecture and mechanical properties in obese men. J Clin Endocrinol Metab. 2012; 97(11):4115-22. PMC: 3485587. DOI: 10.1210/jc.2012-2246. View