Biomechanical MRI detects reduced bone strength in subjects with vertebral fractures

Gao, Xing<sup>1</sup>; Din, Rahman Ud<sup>1</sup>; Cheng, Xiaoguang<sup>2</sup>; Yang, Haisheng<sup>1</sup>

Affiliations

¹Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing 100124, China

²Department of Radiology, Beijing Jishuitan Hospital, Beijing 100035, China

Abstract and keywords

Vertebral fracture is one of the most serious consequences of osteoporosis. Estimation of vertebral strength from magnetic resonance imaging (MRI) scans may provide a new approach for the prediction of vertebral fractures. To that end, we sought to establish a biomechanical MRI (BMRI) method to compute vertebral strength and test its ability to distinguish fracture from non-fracture subjects. This case-control study included 30 subjects without vertebral fractures and 15 subjects with vertebral fractures. All subjects underwent MRI with a mDIXON-Quant sequence and quantitative computed tomography (QCT), from which proton fat fraction-based bone marrow adipose tissue (BMAT) content and volumetric bone mineral density (vBMD) were measured, respectively. Nonlinear finite element analysis was applied to MRI and QCT scans of L2 vertebrae to compute vertebral strength (BMRI- and BCT-strength). The differences in BMAT content, vBMD, BMRI-strength and BCT-strength between the two groups were examined by t-tests. Receiver operating characteristic (ROC) analysis was performed to assess the ability of each measured parameter to distinguish fracture from non-fracture subjects. Results showed that the fracture group had 23 % lower BMRI-strength (P < .001) and 19 % higher BMAT content (P < .001) than the non-fracture group, whereas no significant difference in vBMD was detected between the two groups. A poor correlation was found between vBMD and BMRI-strength (R² = 0.33). Compared to vBMD and BMAT content, BMRI- and BCT-strength had the larger area under the curve (0.82 and 0.84, respectively) and provided better sensitivity and specificity in separating fracture from non-fracture subjects. In conclusion, BMRI is capable of detecting reduced bone strength in patients with vertebral fracture, and may serve as a new approach for risk assessment of vertebral fracture.

Keywords: Osteoporosis; Vertebral fracture; Bone strength; Magnetic resonance imaging; Finite element analysis

Links

DOI: 10.1016/j.bone.2023.116810

PubMed: 37207989

WoS: 001007126500001

History

Received: 2022-11-15

Revised: 2023-05-15

Accepted: 2023-05-16

Online: 2023-05-18

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