Association between 3 D CT-based volumetric fat infiltration of lumbar paraspinal muscles and bone mineral density: a clinical study.

C-VBQ and CT hounsfield units for DXA-defined low bone mass screening and their associations with bone turnover markers.

In patients undergoing cervical spine surgery, C-VBQ demonstrates consistent associations with C-HU and DXA T-scores, supporting its potential for opportunistic preoperative bone quality assessment and Integrating radiological indicators such as C-VBQ and C-HU with DXA and BTMs may enable a more comprehensive, but still cautiously interpreted, perioperative bone health evaluation.

Routine MRI for opportunistic osteoporosis screening: diagnostic accuracy of vertebral bone quality and a novel femoral bone quality score compared with DXA.

VBQ can serve as an opportunistic exploratory screening marker of low BMD and FBQcsf may complement VBQ by identifying early marrow-related changes, although further validation is required.

MRI-Based Vertebral Bone Quality Score and Paravertebral Muscle Parameters for Identifying Osteoporotic Vertebral Compression Fractures.

BACKGROUND Osteoporotic vertebral compression fractures (OVCFs) are prevalent but frequently remain unrecognized. While bone mineral density (BMD) is the primary assessment tool, MRI-based parameters associated with bone and muscle quality may offer additional value, yet sex-specific analyses are limited, despite sex differences in incidence and hormones. PURPOSE To explore the associations between MRI-based vertebral bone quality (VBQ) score, psoas muscle index (PMI), and paravertebral muscle fat infiltration (FI) fraction with OVCFs, and to assess the potential diagnostic performance of MRI parameters across sexes. STUDY TYPE Retrospective. POPULATION 260 subjects (≥ 50 years); 130 OVCF patients (73.0 years (67.0-80.0), 89 females) and 130 non-fracture (NF) patients (64.5 years (58.0-73.0), 76 females). FIELD STRENGTH AND SEQUENCES 3 T and 1.5 T. T1-weighted TSE and T2-weighted TSE (Siemens) and T1-weighted FSE and T2-weighted FSE (United Imaging). ASSESSMENT VBQ was calculated on sagittal T1-weighted MRI; PMI and FI were quantified on axial T2-weighted MRI at the L3 endplate by ImageJ. BMD was derived from CT using QCT PRO software. Two trained observers, blinded to clinical data, performed all MRI measurements. STATISTICAL TESTS Significance level was set at p < 0.05. t-test/Mann-Whitney U test, chi-squared test (χ2), Spearman's rank correlation coefficient, multivariate logistic regression, receiver operating characteristic (ROC) curve analysis with area under the curve (AUC). Bootstrap resampling (1000 iterations) for internal validation. RESULTS The OVCF group exhibited significantly elevated VBQ (3.71 ± 0.55 vs. 3.25 ± 0.58) and FI (24.11% (21.66-28.92) vs. 20.31% (18.90-22.14)), while PMI (3.42 ± 1.02 vs. 4.08 ± 1.14) and BMD (55.82 mg/cm3 (38.75-70.90) vs. 89.24 mg/cm3 (67.80-110.00)) were reduced. FI was independently associated with OVCFs exclusively in females (OR = 1.566). The combined MRI model (VBQ + FI + PMI) yielded a significantly higher AUC in females (AUC = 0.896) than in males (AUC = 0.720). DATA CONCLUSION VBQ, PMI, and FI reveal significant sex-specific correlations with OVCFs. The multi-parametric MRI model shows considerable potential as a diagnostic aid for OVCFs in individuals aged over 50, particularly in females. LEVEL OF EVIDENCE: 4 TECHNICAL EFFICACY STAGE 2 (Diagnostic Accuracy).

Beyond Bone Density Alone: Opportunistic Identification of Vertebral Compression Fractures in Breast Cancer Survivors Using Artificial Intelligence-Derived Vertebral Bone Density and Paraspinal Muscle–Fat Metrics

Background/Objectives: This study aimed to evaluate whether artificial intelligence-derived vertebral volumetric bone mineral density (AI-vBMD) and paraspinal intermuscular adipose tissue (IMAT) ratio from routine computed tomography (CT) could identify moderate-to-severe vertebral compression fractures (VCFs) in breast cancer survivors, and whether paraspinal IMAT ratio and routinely available clinical variables improved diagnostic performance. Methods: This retrospective study included 275 women with breast cancer who underwent routine non-contrast CT and lumbar quantitative computed tomography (QCT). Hounsfield unit-derived volumetric bone mineral density (HU-vBMD) was derived using a QCT-referenced HU-to-vBMD conversion equation, whereas AI-vBMD and paraspinal IMAT ratio were extracted using automated software. Moderate-to-severe VCF was defined as Genant grade ≥ 2. Agreement with QCT-vBMD was assessed using correlation, intraclass correlation coefficient (ICC), and Bland–Altman analysis. Model discrimination was evaluated using receiver operating characteristic analysis and DeLong tests. Results: Moderate-to-severe VCF was present in 75 patients (27.3%). HU-vBMD and AI-vBMD showed excellent agreement with QCT-vBMD (ICC, 0.978 and 0.987, respectively). AI-vBMD outperformed HU-vBMD for identifying VCFs (AUC, 0.738 vs. 0.714; p < 0.001). IMAT ratio showed comparable standalone discrimination to AI-vBMD (AUC, 0.760 vs. 0.738; p = 0.604). Adding IMAT ratio to AI-vBMD improved discrimination (AUC, 0.786 vs. 0.738; p = 0.038). The full model incorporating clinical covariates achieved the highest AUC (0.828; 95% CI, 0.778–0.878). Conclusions: AI-vBMD and paraspinal IMAT ratio automatically extracted from routine CT improved the diagnostic assessment of prevalent moderate-to-severe VCFs in breast cancer survivors. This study supports an automated CT-based approach that integrates vertebral bone density and paraspinal muscle–fat information for opportunistic identification of clinically relevant VCFs.

Assessment of vertebral bone quality in women with type 2 diabetes mellitus using digital tomosynthesis.

Combining universal access with high precision for revolutionary osteoporosis screening: CT-based 3D-HU volumetric bone density.

Three-dimensional HU represents a novel vBMD assessment methodology that achieves diagnostic parity with QCT using conventional CT scanners without extra radiation exposure or specialized equipment, and demonstrates that precise, universally accessible osteoporosis screening is now achievable.