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Purpose <p>To investigate the diagnostic efficacy of vertebral fat fraction (FF) and R2* derived from the Fat Analysis and Calculation Technique (FACT) for Osteoporosis (OP) and explore their associations with clinical parameters.</p> Methods <p>A total of 123 patients with low back pain (59.1 ± 15.1 years, 41males) underwent lumbar FACT magnetic resonance imaging (MRI) and dual-energy X-ray absorptiometry (DXA) within 48&#xa0;h. FF, R2*, BMD, T-scores, and Z-scores were measured at L1–L4 vertebrae. Based on WHO criteria (T-score), subjects were categorized into normal (T ≥ − 1), osteopenia (− 2.5 &lt; T &lt; − 1), and OP (T ≤ − 2.5) groups. Statistical analyses included ANOVA, Pearson/Spearman correlations, and ROC curve analysis.</p> Results <p>The OP group exhibited significantly higher FF values compared to the normal group (overall: 59.8% vs. 47.7%, <i>P</i> &lt; 0.001), with a more pronounced increase in females (between-group FF difference: F = 23.5 vs. males F = 4.6). R2* decreased progressively with bone loss (overall: 134.2&#xa0;Hz vs. 162.0&#xa0;Hz in normal group, <i>P</i> = 0.001). FF showed a strong positive correlation with age (overall: <i>r</i> = 0.66, <i>P</i> &lt; 0.001) and negative correlations with BMD and T-scores (overall: <i>r</i> = − 0.42 and − 0.45, <i>P</i> &lt; 0.001). R2* was negatively correlated with age (overall: <i>r</i> = − 0.48, <i>P</i> &lt; 0.001), particularly in males (<i>r</i> = − 0.61 vs. females <i>r</i> = − 0.36). The multi-parameter model demonstrated superior diagnostic performance for osteopenia (AUC = 0.794, 95%CI: 0.699–0.866) and OP (AUC = 0.893, 95%CI: 0.814–0.947), outperforming single parameters.</p> Conclusion <p>FACT technology quantifies age and sex specific patterns of marrow FF and R2* during osteoporosis progression. The multi-parameter model significantly enhances diagnostic accuracy, providing a comprehensive imaging-metabolic biomarker for individualized OP assessment.</p>

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Role of vertebral fat fraction and R2* based on fat analysis and calculation technique in the quantitative assessment of osteoporosis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年7月30日

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  • Fang Wu,
  • Dongying Su,
  • Hui Hu,
  • Jinzhan Su,
  • Shufeng Fan,
  • Xia Song

摘要

Purpose

To investigate the diagnostic efficacy of vertebral fat fraction (FF) and R2* derived from the Fat Analysis and Calculation Technique (FACT) for Osteoporosis (OP) and explore their associations with clinical parameters.

Methods

A total of 123 patients with low back pain (59.1 ± 15.1 years, 41males) underwent lumbar FACT magnetic resonance imaging (MRI) and dual-energy X-ray absorptiometry (DXA) within 48 h. FF, R2*, BMD, T-scores, and Z-scores were measured at L1–L4 vertebrae. Based on WHO criteria (T-score), subjects were categorized into normal (T ≥ − 1), osteopenia (− 2.5 < T < − 1), and OP (T ≤ − 2.5) groups. Statistical analyses included ANOVA, Pearson/Spearman correlations, and ROC curve analysis.

Results

The OP group exhibited significantly higher FF values compared to the normal group (overall: 59.8% vs. 47.7%, P < 0.001), with a more pronounced increase in females (between-group FF difference: F = 23.5 vs. males F = 4.6). R2* decreased progressively with bone loss (overall: 134.2 Hz vs. 162.0 Hz in normal group, P = 0.001). FF showed a strong positive correlation with age (overall: r = 0.66, P < 0.001) and negative correlations with BMD and T-scores (overall: r = − 0.42 and − 0.45, P < 0.001). R2* was negatively correlated with age (overall: r = − 0.48, P < 0.001), particularly in males (r = − 0.61 vs. females r = − 0.36). The multi-parameter model demonstrated superior diagnostic performance for osteopenia (AUC = 0.794, 95%CI: 0.699–0.866) and OP (AUC = 0.893, 95%CI: 0.814–0.947), outperforming single parameters.

Conclusion

FACT technology quantifies age and sex specific patterns of marrow FF and R2* during osteoporosis progression. The multi-parameter model significantly enhances diagnostic accuracy, providing a comprehensive imaging-metabolic biomarker for individualized OP assessment.