Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Fat Quantification in the Vertebral Body: Comparison of Modified Dixon Technique with Single-Voxel Magnetic Resonance Spectroscopy

  • Sang Hyup Lee (Department of Radiology, Seoul National University Hospital) ;
  • Hye Jin Yoo (Department of Radiology, Seoul National University Hospital) ;
  • Seung-Man Yu (Department of Radiological Science, College of Health Science, Gimcheon University) ;
  • Sung Hwan Hong (Department of Radiology, Seoul National University Hospital) ;
  • Ja-Young Choi (Department of Radiology, Seoul National University Hospital) ;
  • Hee Dong Chae (Department of Radiology, Seoul National University Hospital)
  • Received : 2018.03.20
  • Accepted : 2018.08.03
  • Published : 2019.01.01
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Abstract

Objective: To compare the lumbar vertebral bone marrow fat-signal fractions obtained from six-echo modified Dixon sequence (6-echo m-Dixon) with those from single-voxel magnetic resonance spectroscopy (MRS) in patients with low back pain. Materials and Methods: Vertebral bone marrow fat-signal fractions were quantified by 6-echo m-Dixon (repetition time [TR] = 7.2 ms, echo time (TE) = 1.21 ms, echo spacing = 1.1 ms, total imaging time = 50 seconds) and single-voxel MRS measurements in 25 targets (23 normal bone marrows, two focal lesions) from 24 patients. The point-resolved spectroscopy sequence was used for localized single-voxel MRS (TR = 3000 ms, TE = 35 ms, total scan time = 1 minute 42 seconds). A 2 × 2 × 1.5 cm3 voxel was placed within the normal L2 or L3 vertebral body, or other lesions including a compression fracture or metastasis. The bone marrow fat spectrum was characterized on the basis of the magnitude of measurable fat peaks and a priori knowledge of the chemical structure of triglycerides. The imaging-based fat-signal fraction results were then compared to the MRS-based results. Results: There was a strong correlation between m-Dixon and MRS-based fat-signal fractions (slope = 0.86, R2 = 0.88, p < 0.001). In Bland-Altman analysis, 92.0% (23/25) of the data points were within the limits of agreement. Bland-Altman plots revealed a slight but systematic error in the m-Dixon based fat-signal fraction, which showed a prevailing overestimation of small fat-signal fractions (< 20%) and underestimation of high fat-signal fractions (> 20%). Conclusion: Given its excellent agreement with single-voxel-MRS, 6-echo m-Dixon can be used for visual and quantitative evaluation of vertebral bone marrow fat in daily practice.

Keywords

Acknowledgement

This study was supported by the Bio & Medical Technology Development Program of the National Research Foundation (NRF) funded by the Ministry of Science & ICT (2017M3A9D8064198).

References

  1. Hu HH, Kim HW, Nayak KS, Goran MI. Comparison of fat-water MRI and single-voxel MRS in the assessment of hepatic and pancreatic fat fractions in humans. Obesity (Silver Spring) 2010;18:841-847 
  2. Livingstone RS, Begovatz P, Kahl S, Nowotny B, Strassburger K, Giani G, et al. Initial clinical application of modified Dixon with flexible echo times: hepatic and pancreatic fat assessments in comparison with (1)H MRS. MAGMA 2014;27:397-405 
  3. Kim YP, Kannengiesser S, Paek MY, Kim S, Chung TS, Yoo YH, et al. Differentiation between focal malignant marrow-replacing lesions and benign red marrow deposition of the spine with T2*-corrected fat-signal fraction map using a three-echo volume interpolated breath-hold gradient echo Dixon sequence. Korean J Radiol 2014;15:781-791 
  4. Yoo HJ, Hong SH, Kim DH, Choi JY, Chae HD, Jeong BM, et al. Measurement of fat content in vertebral marrow using a modified dixon sequence to differentiate benign from malignant processes. J Magn Reson Imaging 2017;45:1534-1544 
  5. Griffith JF, Yeung DK, Antonio GE, Lee FK, Hong AW, Wong SY, et al. Vertebral bone mineral density, marrow perfusion, and fat content in healthy men and men with osteoporosis: dynamic contrast-enhanced MR imaging and MR spectroscopy. Radiology 2005;236:945-951 
  6. Griffith JF, Yeung DK, Antonio GE, Wong SY, Kwok TC, Woo J, et al. Vertebral marrow fat content and diffusion and perfusion indexes in women with varying bone density: MR evaluation. Radiology 2006;241:831-838 
  7. Li X, Kuo D, Schafer AL, Porzig A, Link TM, Black D, et al. Quantification of vertebral bone marrow fat content using 3 Tesla MR spectroscopy: reproducibility, vertebral variation, and applications in osteoporosis. J Magn Reson Imaging 2011;33:974-979 
  8. Karampinos DC, Melkus G, Baum T, Bauer JS, Rummeny EJ, Krug R. Bone marrow fat quantification in the presence of trabecular bone: initial comparison between water-fat imaging and single-voxel MRS. Magn Reson Med 2014;71:1158-1165 
  9. Longo R, Pollesello P, Ricci C, Masutti F, Kvam BJ, Bercich L, et al. Proton MR spectroscopy in quantitative in vivo determination of fat content in human liver steatosis. J Magn Reson Imaging 1995;5:281-285 
  10. Kim H, Taksali SE, Dufour S, Befroy D, Goodman TR, Petersen KF, et al. Comparative MR study of hepatic fat quantification using single-voxel proton spectroscopy, two-point dixon and three-point IDEAL. Magn Reson Med 2008;59:521-527 
  11. Thomsen C, Becker U, Winkler K, Christoffersen P, Jensen M, Henriksen O. Quantification of liver fat using magnetic resonance spectroscopy. Magn Reson Imaging 1994;12:487-495 
  12. Mehta SR, Thomas EL, Bell JD, Johnston DG, Taylor-Robinson SD. Non-invasive means of measuring hepatic fat content. World J Gastroenterol 2008;14:3476-3483 
  13. Fischer MA, Nanz D, Shimakawa A, Schirmer T, Guggenberger R, Chhabra A, et al. Quantification of muscle fat in patients with low back pain: comparison of multi-echo MR imaging with single-voxel MR spectroscopy. Radiology 2013;266:555-563 
  14. Yoo YH, Kim HS, Lee YH, Yoon CS, Paek MY, Yoo H, et al. Comparison of multi-echo Dixon methods with volume interpolated breath-hold gradient echo magnetic resonance imaging in fat-signal fraction quantification of paravertebral muscle. Korean J Radiol 2015;16:1086-1095 
  15. Berglund J, Ahlstrom H, Johansson L, Kullberg J. Two-point Dixon method with flexible echo times. Magn Reson Med 2011;65:994-1004 
  16. Eggers H, Brendel B, Duijndam A, Herigault G. Dual-echo Dixon imaging with flexible choice of echo times. Magn Reson Med 2011;65:96-107 
  17. Kukuk GM, Hittatiya K, Sprinkart AM, Eggers H, Gieseke J, Block W, et al. Comparison between modified Dixon MRI techniques, MR spectroscopic relaxometry, and different histologic quantification methods in the assessment of hepatic steatosis. Eur Radiol 2015;25:2869-2879 
  18. Shen W, Gong X, Weiss J, Jin Y. Comparison among T1-weighted magnetic resonance imaging, modified Dixon method, and magnetic resonance spectroscopy in measuring bone marrow fat. J Obes 2013;2013:298675 
  19. Hines CD, Yu H, Shimakawa A, McKenzie CA, Brittain JH, Reeder SB. T1 independent, T2* corrected MRI with accurate spectral modeling for quantification of fat: validation in a fat-water-SPIO phantom. J Magn Reson Imaging 2009;30:1215-1222 
  20. Karampinos DC, Ruschke S, Dieckmeyer M, Eggers H, Kooijman H, Rummeny EJ, et al. Modeling of T2* decay in vertebral bone marrow fat quantification. NMR Biomed 2015;28:1535-1542 
  21. Regis-Arnaud A, Guiu B, Walker PM, Krause D, Ricolfi F, Ben Salem D. Bone marrow fat quantification of osteoporotic vertebral compression fractures: comparison of multi-voxel proton MR spectroscopy and chemical-shift gradient-echo MR imaging. Acta Radiol 2011;52:1032-1036 
  22. Shen W, Scherzer R, Gantz M, Chen J, Punyanitya M, Lewis CE, et al. Relationship between MRI-measured bone marrow adipose tissue and hip and spine bone mineral density in African-American and Caucasian participants: the CARDIA study. J Clin Endocrinol Metab 2012;97:1337-1346 
  23. Yu H, Shimakawa A, McKenzie CA, Brodsky E, Brittain JH, Reeder SB. Multiecho water-fat separation and simultaneous R2* estimation with multifrequency fat spectrum modeling. Magn Reson Med 2008;60:1122-1134 
  24. Karampinos DC, Ruschke S, Dieckmeyer M, Diefenbach M, Franz D, Gersing AS, et al. Quantitative MRI and spectroscopy of bone marrow. J Magn Reson Imaging 2018;47:332-353 
  25. Dieckmeyer M, Ruschke S, Cordes C, Yap SP, Kooijman H, Hauner H, et al. The need for T2 correction on MRS-based vertebral bone marrow fat quantification: implications for bone marrow fat fraction age dependence. NMR Biomed 2015;28:432-439 
  26. Liu CY, McKenzie CA, Yu H, Brittain JH, Reeder SB. Fat quantification with IDEAL gradient echo imaging: correction of bias from T(1) and noise. Magn Reson Med 2007;58:354-364 
  27. Grimm A, Meyer H, Nickel MD, Nittka M, Raithel E, Chaudry O, et al. Evaluation of 2-point, 3-point, and 6-point Dixon magnetic resonance imaging with flexible echo timing for muscle fat quantification. Eur J Radiol 2018;103:57-64 
  28. Reeder SB, Robson PM, Yu H, Shimakawa A, Hines CD, McKenzie CA, et al. Quantification of hepatic steatosis with MRI: the effects of accurate fat spectral modeling. J Magn Reson Imaging 2009;29:1332-1339 
  29. Hamilton G, Middleton MS, Bydder M, Yokoo T, Schwimmer JB, Kono Y, et al. Effect of PRESS and STEAM sequences on magnetic resonance spectroscopic liver fat quantification. J Magn Reson Imaging 2009;30:145-152