Use of proton density fat fraction MRI to predict the radiographic progression of osteoporotic vertebral compression fra
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MUSCULOSKELETAL
Use of proton density fat fraction MRI to predict the radiographic progression of osteoporotic vertebral compression fracture Jae Sung Yun 1,2 & Han-Dong Lee 3 & Kyu-Sung Kwack 1,2 & Sunghoon Park 1,2 Received: 17 March 2020 / Revised: 20 August 2020 / Accepted: 17 November 2020 # European Society of Radiology 2020
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. Keywords Compression . Magnetic resonance imaging . Spinal fractures
Abbreviations AUC Area under the curve BMD Bone mineral density BMI Body mass index * Sunghoon Park [email protected] 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
2
Musculoskeletal Imaging Laboratory, Ajou University Medical Center, Suwon, South Korea
3
Department of Orthopaedic Surgery, Ajou University School of Medicine, Suwon, South Korea
CSE-MRI DM FOV HTN ICC MRS OVCF PDFF ROC ROI TE TR VAS
Chemical shift-encoded magnetic resonance imaging Diabetes mellitus Field of view Hypertension Intraclass correlation coefficient Magnetic resonance spectroscopy Osteop
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