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A new diagnostic score to detect osteoporosis in patients undergoing lumbar spine MRI

  • Musculoskeletal
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Abstract

Objectives

Signal intensity of lumbar-spine at magnetic resonance imaging (MRI) correlates to bone mineral density (BMD). Our aim was to define a quantitative MRI-based score to detect osteoporosis on lumbar-spine MRI.

Methods

After Ethics Committee approval, we selected female patients who underwent both lumbar-spine MRI and dual-energy X-ray absorptiometry (DXA) and a reference group of 131 healthy females (20–29 years) who underwent lumbar-spine MRI. We measured the intra-vertebral signal-to-noise ratio in L1-L4. We introduced an MRI-based score (M-score), on the model of T-score. M-score diagnostic performance in diagnosing osteoporosis was estimated against DXA using receiver operator characteristic (ROC) analysis.

Results

We included 226 patients (median age 65 years), 70 (31 %) being osteoporotic at DXA. MRI signal-to-noise ratio correlated to BMD (r = −0.677, P < 0.001). M-score negatively correlated to T-score (r = −0.682, P < 0.001). Setting a 90 %-specificity, an M-score threshold of 5.5 was found, distinguishing osteoporosis from non-osteoporosis (sensitivity 54 %; ROC AUC 0.844). Thirty-one (14 %) patients had a fragility fracture, with osteoporosis detected in 15 (48 %) according to M-score and eight (26 %) according to T-score (P = 0.016).

Conclusions

M-score obtained on lumbar spine MRI is a quantitative method correlating with osteoporosis. Its diagnostic value remains to be demonstrated on a large prospective cohort of patients.

Key Points

• M-score is a quantitative score potentially screening osteoporosis on lumbar-spine MRI;

• This method showed good intra- and inter-reader reproducibility;

• M-score may be used for identifying patients who should undergo DXA.

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Acknowledgments

The scientific guarantor of this publication is Michele Bandirali. 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. The authors state that this work has not received any funding. One of the authors, Giovanni Di Leo, has significant statistical expertise. Institutional Review Board approval was obtained. Written informed consent was waived by the Institutional Review Board. Methodology: retrospective, case–control study, performed at one institution.

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Authors and Affiliations

  1. Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Milano, via Festa del Perdono 7, 20122, Milano, Italy

    Michele Bandirali & Carmelo Messina

  2. Radiology Unit, IRCCS Policlinico San Donato, via Morandi 30, 20097, San Donato Milanese, Italy

    Giovanni Di Leo, Giacomo Davide Edoardo Papini, Luca Maria Sconfienza & Francesco Sardanelli

  3. Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, via Morandi 30, 20097, San Donato Milanese, Italy

    Luca Maria Sconfienza & Francesco Sardanelli

  4. Mineralometria Ossea Computerizzata e Ambulatorio Malattie Metabolismo Minerale e Osseo, Servizio di Medicina Nucleare, IRCCS Fondazione Ca’ Granda Ospedale Maggiore Policlinico, via Francesco Sforza 9, 20122, Milano, Italy

    Fabio Massimo Ulivieri

Authors
  1. Michele Bandirali
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  2. Giovanni Di Leo
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  3. Giacomo Davide Edoardo Papini
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  4. Carmelo Messina
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  5. Luca Maria Sconfienza
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  6. Fabio Massimo Ulivieri
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  7. Francesco Sardanelli
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Correspondence to Carmelo Messina.

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Bandirali, M., Di Leo, G., Papini, G.D.E. et al. A new diagnostic score to detect osteoporosis in patients undergoing lumbar spine MRI. Eur Radiol 25, 2951–2959 (2015). https://doi.org/10.1007/s00330-015-3699-y

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  • DOI: https://doi.org/10.1007/s00330-015-3699-y

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