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Use of proton density fat fraction MRI to predict the radiographic progression of osteoporotic vertebral compression fracture

  • Musculoskeletal
  • Published:
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Abstract

Objective

This study evaluated the diagnostic performance of the proton density fat fraction (PDFF) in predicting the progression of osteoporotic vertebral compression fractures (OVCFs).

Methods

The cohort in this retrospective study consisted of 48 patients with OVCFs who underwent spine MRI that included PDFF between December 2016 and June 2018. The patients were divided into two groups (with versus without OVCF progression, based on the radiographic results obtained at the 6-month follow-up examination). Two musculoskeletal radiologists independently calculated the PDFF of the fracture and the PDFF ratio (fracture PDFF/normal vertebrae PDFF) using regions of interest. The mean values of these parameters were compared between the two groups, and the receiver operating characteristic curves were analysed.

Results

The mean age was significantly higher in the group with OVCF progression (71.6 ± 8.4 years) than in the group without (64.8 ± 10.5 years) (p = 0.018). According to reader 1, the PDFF ratio was significantly lower in the group with OVCF progression versus that without OVCF progression (0.38 ± 0.13 vs 0.51 ± 0.20; p = 0.009), whereas the difference in the PDFF itself was not statistically significant. The PDFF ratio [area under the curve (AUC) = 0.723; 95% confidence interval (CI), 0.575–0.842] had a larger AUC than did the PDFF (AUC = 0.667; 95% CI, 0.516–0.796). The optimal cut-off value of the PDFF ratio for predicting OVCF progression was 0.42; this threshold corresponded to sensitivity, specificity, and accuracy values of 84.0%, 60.9%, and 72.9%, respectively.

Conclusion

The age and PDFF ratio can be used to predict OVCF progression.

Key Points

• Chemical shift-encoded magnetic resonance imaging provides quantitative parameters for predicting OVCF progression.

• The PDFF ratio is significantly lower in patients with OVCF progression.

• The PDFF ratio is superior to the PDFF for predicting OVCF progression.

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Abbreviations

AUC:

Area under the curve

BMD:

Bone mineral density

BMI:

Body mass index

CSE-MRI:

Chemical shift-encoded magnetic resonance imaging

DM:

Diabetes mellitus

FOV:

Field of view

HTN:

Hypertension

ICC:

Intraclass correlation coefficient

MRS:

Magnetic resonance spectroscopy

OVCF:

Osteoporotic vertebral compression fracture

PDFF:

Proton density fat fraction

ROC:

Receiver operating characteristic

ROI:

Region of interest

TE:

Echo time

TR:

Repetition time

VAS:

Visual analogue scale

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Funding

The authors state that this work has not received any funding.

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Authors and Affiliations

  1. Division of Musculoskeletal Radiology, Department of Radiology, Ajou University School of Medicine, 164, World cup-ro, Yeongtong-gu, Suwon, Gyeonggi-do, 16499, South Korea

    Jae Sung Yun, Kyu-Sung Kwack & Sunghoon Park

  2. Musculoskeletal Imaging Laboratory, Ajou University Medical Center, Suwon, South Korea

    Jae Sung Yun, Kyu-Sung Kwack & Sunghoon Park

  3. Department of Orthopaedic Surgery, Ajou University School of Medicine, Suwon, South Korea

    Han-Dong Lee

Authors
  1. Jae Sung Yun
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  2. Han-Dong Lee
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  4. Sunghoon Park
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Correspondence to Sunghoon Park.

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The scientific guarantor of this publication is Sunghoon Park.

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The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

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No complex statistical methods were necessary for this paper.

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Written informed consent was waived by the Institutional Review Board.

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• retrospective

• diagnostic or prognostic study

• performed at one institution

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Yun, J.S., Lee, HD., Kwack, KS. et al. Use of proton density fat fraction MRI to predict the radiographic progression of osteoporotic vertebral compression fracture. Eur Radiol 31, 3582–3589 (2021). https://doi.org/10.1007/s00330-020-07529-7

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  • DOI: https://doi.org/10.1007/s00330-020-07529-7

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