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• Clinical Article •
R2* and PDFF quantification: evaluation of lumbar spine bone marrow iron deposition, fat content and diagnostic value of osteoporosis in middle-aged and elderly women
GAO Lei  MIAO Miao  ZHANG Wei  LIU Ying  ZHANG Lei  YANG Boyang  ZHAO Jian 

Cite this article as: GAO L, MIAO M, ZHANG W, et al. R2* and PDFF quantification: evaluation of lumbar spine bone marrow iron deposition, fat content and diagnostic value of osteoporosis in middle-aged and elderly women[J]. Chin J Magn Reson Imaging, 2025, 16(3): 90-95. DOI:10.12015/issn.1674-8034.2025.03.014.


[Abstract] Objective R2* value and proton density fat fraction (PDFF) of lumbar spine in middle-aged and elderly women were measured by mDixon-Quant technique to evaluate iron deposition and fat content in bone marrow, explore the correlations between R2*, PDFF and bone mineral density (BMD) and evaluate the diagnostic value for osteoporosis (OP).Materials and Methods A total of 105 middle-aged and elderly women underwent lumbar spine MRI using the mDixon-Quant sequence. R2* values and PDFF of L1 to L5 vertebrae were measured, and BMD of L1 to L5 vertebrae were obtained after post-processing of lumbar spine quantitative computed tomography (QCT) scans. General clinical data were recorded. The trend of changes in values of R2*, PDFF, and BMD of L1 to L5 vertebrae were evaluated. Partial correlation analysis was performed to assess associations among R2*, PDFF, and BMD. The diagnostic efficacy of R2* and PDFF on OP was evaluated using receiver operating characteristic (ROC) curve analysis and DeLong's test was used to compare the diagnostic efficacy.Results R2* value and BMD gradually decreased from lumbar 1 to lumbar 5 vertebrae (Ptrend < 0.05), and the PDFF gradually increased (Ptrend < 0.05). After age adjustment, lumbar R2* demonstrated a negative correlation with PDFF (r = -0.227, P = 0.020), and a positive correlation with lumbar BMD (r = 0.332, P < 0.001). The area under curve (AUC) of R2* and PDFF diagnosis for OP were 0.792 and 0.702, respectively, difference showed no statistical significance (P = 0.07). The AUC of R2* combined with PDFF in diagnosis of OP was 0.804, 95% confidence interval (95% CI) was (0.702 to 0.865), sensitivity was 81.8% and specificity was 73.5%, and the diagnostic efficacy was better than that of PDFF (P = 0.01). R2* was associated with BMD and PDFF.Conclusions There were physiological gradient changes in R2*, PDFF and BMD of lumbar spine in middle-aged and elderly women. The efficacy of R2* in diagnosis of OP was comparable to that of PDFF, R2* combined with PDFF achieved the highest diagnostic efficacy on OP.
[Keywords] lumbar spine；osteoporosis；magnetic resonance imaging；mDixon-Quant；bone marrow fat；iron deposition

GAO Lei   MIAO Miao   ZHANG Wei   LIU Ying   ZHANG Lei   YANG Boyang   ZHAO Jian*  

Department of Medical Imaging, Hebei Medical University Third Hospital, Shijiazhuang 050051, China

Corresponding author: ZHAO J, E-mail: 37400408@hebmu.edu.cn

Conflicts of interest   None.

Received  2024-12-28
Accepted  2025-03-07
DOI: 10.12015/issn.1674-8034.2025.03.014
Cite this article as: GAO L, MIAO M, ZHANG W, et al. R2* and PDFF quantification: evaluation of lumbar spine bone marrow iron deposition, fat content and diagnostic value of osteoporosis in middle-aged and elderly women[J]. Chin J Magn Reson Imaging, 2025, 16(3): 90-95. DOI:10.12015/issn.1674-8034.2025.03.014.

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