Development of a novel method to measure bone marrow fat fraction in older women using high-resolution peripheral quantitative computed tomography

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Title: Development of a novel method to measure bone marrow fat fraction in older women using high-resolution peripheral quantitative computed tomography
Authors: Flehr, Alison, Källgård, Julius, Alvén, Jennifer, 1989, Lagerstrand, Kerstin M, Papalini, Evin, Wheeler, Michael, Vandenput, Liesbeth, Kahl, Fredrik, 1972, Axelsson, Kristian F., Sundh, Daniel, Mysore, Raghunath Shirish, Lorentzon, Mattias, 1970
Source: Osteoporosis International. 33(7):1545-1556
Subject Terms: Bone marrow adipose tissue (BMAT), High-resolution peripheral quantitative computed tomography (HR-pQCT, Bone mineral density (BMD), Magnetic resonance imaging (MRI)
Description: Bone marrow adipose tissue (BMAT) has been implicated in a number of conditions associated with bone deterioration and osteoporosis. Several studies have found an inverse relationship between BMAT and bone mineral density (BMD), and higher levels of BMAT in those with prevalent fracture. Magnetic resonance imaging (MRI) is the gold standard for measuring BMAT, but its use is limited by high costs and low availability. We hypothesized that BMAT could also be accurately quantified using high-resolution peripheral quantitative computed tomography (HR-pQCT). Methods: In the present study, a novel method to quantify the tibia bone marrow fat fraction, defined by MRI, using HR-pQCT was developed. In total, 38 postmenopausal women (mean [standard deviation] age 75.9 [3.1] years) were included and measured at the same site at the distal (n = 38) and ultradistal (n = 18) tibia using both MRI and HR-pQCT. To adjust for partial volume effects, the HR-pQCT images underwent 0 to 10 layers of voxel peeling to remove voxels adjacent to the bone. Linear regression equations were then tested for different degrees of voxel peeling, using the MRI-derived fat fractions as the dependent variable and the HR-pQCT-derived radiodensity as the independent variables. Results: The most optimal HR-pQCT derived model, which applied a minimum of 4 layers of peeled voxel and with more than 1% remaining marrow volume, was able to explain 76% of the variation in the ultradistal tibia bone marrow fat fraction, measured with MRI (p < 0.001). Conclusion: The novel HR-pQCT method, developed to estimate BMAT, was able to explain a substantial part of the variation in the bone marrow fat fraction and can be used in future studies investigating the role of BMAT in osteoporosis and fracture prediction.
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  Data: &lt;i&gt;Osteoporosis International&lt;/i&gt;. 33(7):1545-1556
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  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Bone+marrow+adipose+tissue+%28BMAT%29%22&quot;&gt;Bone marrow adipose tissue (BMAT)&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22High-resolution+peripheral+quantitative+computed+tomography+%28HR-pQCT%22&quot;&gt;High-resolution peripheral quantitative computed tomography (HR-pQCT&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Bone+mineral+density+%28BMD%29%22&quot;&gt;Bone mineral density (BMD)&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Magnetic+resonance+imaging+%28MRI%29%22&quot;&gt;Magnetic resonance imaging (MRI)&lt;/searchLink&gt;
– Name: Abstract
  Label: Description
  Group: Ab
  Data: Bone marrow adipose tissue (BMAT) has been implicated in a number of conditions associated with bone deterioration and osteoporosis. Several studies have found an inverse relationship between BMAT and bone mineral density (BMD), and higher levels of BMAT in those with prevalent fracture. Magnetic resonance imaging (MRI) is the gold standard for measuring BMAT, but its use is limited by high costs and low availability. We hypothesized that BMAT could also be accurately quantified using high-resolution peripheral quantitative computed tomography (HR-pQCT). Methods: In the present study, a novel method to quantify the tibia bone marrow fat fraction, defined by MRI, using HR-pQCT was developed. In total, 38 postmenopausal women (mean [standard deviation] age 75.9 [3.1] years) were included and measured at the same site at the distal (n = 38) and ultradistal (n = 18) tibia using both MRI and HR-pQCT. To adjust for partial volume effects, the HR-pQCT images underwent 0 to 10 layers of voxel peeling to remove voxels adjacent to the bone. Linear regression equations were then tested for different degrees of voxel peeling, using the MRI-derived fat fractions as the dependent variable and the HR-pQCT-derived radiodensity as the independent variables. Results: The most optimal HR-pQCT derived model, which applied a minimum of 4 layers of peeled voxel and with more than 1% remaining marrow volume, was able to explain 76% of the variation in the ultradistal tibia bone marrow fat fraction, measured with MRI (p &lt; 0.001). Conclusion: The novel HR-pQCT method, developed to estimate BMAT, was able to explain a substantial part of the variation in the bone marrow fat fraction and can be used in future studies investigating the role of BMAT in osteoporosis and fracture prediction.
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        Value: 10.1007/s00198-021-06224-7
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              Y: 2022
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