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Nyman JS, Ketsiri T, Louie EA, Harkins KD, Manhard MK, Gochberg DF, Lee DH, Desai MJ, Maslow J, Tanner SB, Does MD. Toward the use of MRI measurements of bound and pore water in fracture risk assessment. Bone 2023; 176:116863. [PMID: 37527697 PMCID: PMC10528882 DOI: 10.1016/j.bone.2023.116863] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/26/2023] [Accepted: 07/28/2023] [Indexed: 08/03/2023]
Abstract
The current clinical assessment of fracture risk lacks information about the inherent quality of a person's bone tissue. Working toward an imaging-based approach to quantify both a bone tissue quality marker (tissue hydration as water bound to the matrix) and a bone microstructure marker (porosity as water in pores), we hypothesized that the concentrations of bound water (Cbw) are lower and concentrations of pore water (Cpw) are higher in patients with osteoporosis (OP) than in age- and sex-matched adults without the disease. Using recent developments in ultrashort echo time (UTE) magnetic resonance imaging (MRI), maps of Cbw and Cpw were acquired from the uninjured distal third radius (Study 1) of 20 patients who experienced a fragility fracture of the distal radius (Fx) and 20 healthy controls (Non-Fx) and from the tibia mid-diaphysis (Study 2) of 30 women with clinical OP (low T-scores) and 15 women without OP (normal T-scores). In Study 1, Cbw was significantly lower (p = 0.0018) and Cpw was higher (p = 0.0022) in the Fx than in the Non-Fx group. In forward stepwise, logistic regression models using Bayesian Information Criterion for selecting the best set of predictors (from imaging parameters, age, BMI, and DXA scanner type), the area-under-the-receiver operator characteristics-curve (AUC with 95 % confidence intervals) was 0.73 (0.56, 0.86) for hip aBMD (best predictors without MRI) and 0.86 (0.70, 0.95) for the combination of Cbw and Cpw (best predictors overall). In Study 2, Cbw was significantly lower (p = 0.0005) in women with OP (23.8 ± 4.3 1H mol/L) than in women without OP (29.9 ± 6.4 1H mol/L); Cpw was significantly higher by estimate of 2.9 1H mol/L (p = 0.0298) with clinical OP, but only when accounting for the type of UTE-MRI scan with 3D providing higher values than 2D (p < 0.0001). Lastly, Cbw, but not Cpw, was sensitive to bone forming osteoporosis medications over 12-months. UTE-MRI-derived measurements of bound and pore water concentrations are potential, aBMD-independent predictors of fracture risk.
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Affiliation(s)
- Jeffry S Nyman
- Department of Orthopaedic Surgery, Vanderbilt University Medical Center, 1215 21st Ave. S., Suite 4200, Nashville, TN 37232, USA; Department of Biomedical Engineering, Vanderbilt University, 5824 Stevenson Center, Nashville, TN 37232, USA; Department of Veterans Affairs, Tennessee Valley Healthcare System, 1310 24th Ave. S., Nashville, TN 37212, USA; Vanderbilt Center for Bone Biology, Vanderbilt University Medical Center,1211 Medical Center Dr., Nashville, TN 37212, USA.
| | - Thammathida Ketsiri
- Department of Biomedical Engineering, Vanderbilt University, 5824 Stevenson Center, Nashville, TN 37232, USA; Institute of Imaging Science, Vanderbilt University Medical Center, 1161 21st Ave. S., Nashville, TN 37232, USA
| | - Elizabeth A Louie
- Institute of Imaging Science, Vanderbilt University Medical Center, 1161 21st Ave. S., Nashville, TN 37232, USA
| | - Kevin D Harkins
- Department of Biomedical Engineering, Vanderbilt University, 5824 Stevenson Center, Nashville, TN 37232, USA; Institute of Imaging Science, Vanderbilt University Medical Center, 1161 21st Ave. S., Nashville, TN 37232, USA; Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, 1161 21st Ave. S., Nashville, TN 37232, USA
| | - Mary Kate Manhard
- Imaging Research Center, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229, USA
| | - Daniel F Gochberg
- Institute of Imaging Science, Vanderbilt University Medical Center, 1161 21st Ave. S., Nashville, TN 37232, USA; Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, 1161 21st Ave. S., Nashville, TN 37232, USA
| | - Donald H Lee
- Department of Orthopaedic Surgery, Vanderbilt University Medical Center, 1215 21st Ave. S., Suite 4200, Nashville, TN 37232, USA
| | - Mihir J Desai
- Department of Orthopaedic Surgery, Vanderbilt University Medical Center, 1215 21st Ave. S., Suite 4200, Nashville, TN 37232, USA
| | - Jed Maslow
- Department of Orthopaedic Surgery, Vanderbilt University Medical Center, 1215 21st Ave. S., Suite 4200, Nashville, TN 37232, USA
| | - S Bobo Tanner
- Vanderbilt Center for Bone Biology, Vanderbilt University Medical Center,1211 Medical Center Dr., Nashville, TN 37212, USA; Department of Medicine, Division of Rheumatology, Vanderbilt University Medical Center, 1161 21st Ave. S., Nashville, TN 37232, USA
| | - Mark D Does
- Department of Biomedical Engineering, Vanderbilt University, 5824 Stevenson Center, Nashville, TN 37232, USA; Institute of Imaging Science, Vanderbilt University Medical Center, 1161 21st Ave. S., Nashville, TN 37232, USA; Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, 1161 21st Ave. S., Nashville, TN 37232, USA; Department of Electrical Engineering and Computer Science, Vanderbilt University, 400 24th Ave. S., Nashville, TN 37212, USA.
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Ketsiri T, Uppuganti S, Harkins KD, Gochberg DF, Nyman JS, Does MD. Finite element analysis of bone mechanical properties using MRI-derived bound and pore water concentration maps. Comput Methods Biomech Biomed Engin 2023; 26:905-916. [PMID: 35822868 PMCID: PMC9837311 DOI: 10.1080/10255842.2022.2098016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 06/10/2022] [Accepted: 06/30/2022] [Indexed: 01/17/2023]
Abstract
Ultrashort echo time (UTE) MRI techniques can be used to image the concentration of water in bones. Particularly, quantitative MRI imaging of collagen-bound water concentration (Cbw) and pore water concentration (Cpw) in cortical bone have been shown as potential biomarkers for bone fracture risk. To investigate the effect of Cbw and Cpw on the evaluation of bone mechanical properties, MRI-based finite element models of cadaver radii were generated with tissue material properties derived from 3 D maps of Cbw and Cpw measurements. Three-point bending tests were simulated by means of the finite element method to predict bending properties of the bone and the results were compared with those from direct mechanical testing. The study results demonstrate that these MRI-derived measures of Cbw and Cpw improve the prediction of bone mechanical properties in cadaver radii and have the potential to be useful in assessing patient-specific bone fragility risk.
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Affiliation(s)
- Thammathida Ketsiri
- Biomedical Engineering, Vanderbilt University, Nashville, TN, United States
- Vanderbilt University Institute of Imaging Science, Vanderbilt University, Nashville, TN, United States
| | - Sasidhar Uppuganti
- Department of Orthopaedic Surgery & Rehabilitation, Vanderbilt University, Nashville, TN, United States
- Tennessee Valley Healthcare System, Department of Veterans Affairs, Nashville, TN, United States
- Center for Bone Biology, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Kevin D. Harkins
- Biomedical Engineering, Vanderbilt University, Nashville, TN, United States
- Vanderbilt University Institute of Imaging Science, Vanderbilt University, Nashville, TN, United States
- Radiology & Radiological Sciences, Vanderbilt University, Nashville, TN, United States
| | - Daniel F. Gochberg
- Vanderbilt University Institute of Imaging Science, Vanderbilt University, Nashville, TN, United States
- Radiology & Radiological Sciences, Vanderbilt University, Nashville, TN, United States
- Department of Physics and Astronomy, Vanderbilt University, Nashville, TN, United States
| | - Jeffry S. Nyman
- Biomedical Engineering, Vanderbilt University, Nashville, TN, United States
- Vanderbilt University Institute of Imaging Science, Vanderbilt University, Nashville, TN, United States
- Department of Orthopaedic Surgery & Rehabilitation, Vanderbilt University, Nashville, TN, United States
- Tennessee Valley Healthcare System, Department of Veterans Affairs, Nashville, TN, United States
- Center for Bone Biology, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Mark D. Does
- Biomedical Engineering, Vanderbilt University, Nashville, TN, United States
- Vanderbilt University Institute of Imaging Science, Vanderbilt University, Nashville, TN, United States
- Radiology & Radiological Sciences, Vanderbilt University, Nashville, TN, United States
- Electrical Engineering, Vanderbilt University, Nashville, TN, United States
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Scholten H, Lohr D, Wech T, Köstler H. Fast measurement of the gradient system transfer function at 7 T. Magn Reson Med 2023; 89:1644-1659. [PMID: 36468622 DOI: 10.1002/mrm.29523] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 10/21/2022] [Accepted: 10/23/2022] [Indexed: 12/12/2022]
Abstract
PURPOSE In this work, a new method to determine the gradient system transfer function (GSTF) with high frequency resolution and high SNR is presented, using fast and simple phantom measurements. The GSTF is an effective instrument for hardware characterization and calibration, which can be used to correct for gradient distortions, or enhance gradient fidelity. METHODS The thin-slice approach for phantom-based measurements of the GSTF is expanded by adding excitations that are shifted after the application of the probing gradient, to capture long-lasting field fluctuations with high SNR. A physics-informed regularization procedure is implemented to derive high-quality transfer functions from a small number of measurements. The resulting GSTFs are evaluated by means of gradient time-course estimation and pre-emphasis of a trapezoidal test gradient on a 7T scanner. RESULTS The GSTFs determined with the proposed method capture sharp mechanical resonances with a high level of detail. The measured trapezoidal gradient progressions are authentically reproduced by the GSTF estimations on all three axes. The GSTF-based pre-emphasis considerably improves the gradient fidelity in the plateau phase of the test gradient and almost completely eliminates lingering field oscillations. CONCLUSION The presented approach allows fast and simple characterization of gradient field fluctuations caused by long-living eddy current and vibration effects, which become more pronounced at ultrahigh field strengths.
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Affiliation(s)
- Hannah Scholten
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Würzburg, Germany
| | - David Lohr
- Chair of Molecular and Cellular Imaging, Comprehensive Heart Failure Center (CHFC), University Hospital Würzburg, Würzburg, Germany
| | - Tobias Wech
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Würzburg, Germany
| | - Herbert Köstler
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Würzburg, Germany
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Harkins KD, Ketsiri T, Nyman JS, Does MD. Fast bound and pore water mapping of cortical bone with arbitrary slice oriented two-dimensional ultra-short echo time. Magn Reson Med 2023; 89:767-773. [PMID: 36226656 PMCID: PMC9897494 DOI: 10.1002/mrm.29484] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 09/07/2022] [Accepted: 09/20/2022] [Indexed: 02/05/2023]
Abstract
PURPOSE Extend fast, two-dimensional (2D) methods of bound and pore water mapping in bone to arbitrary slice orientation. METHODS To correct for slice profile artifacts caused by gradient errors of half pulse 2D ultra-short echo time (UTE), we developed a library of predistorted gradient waveforms that can be used to interpolate optimized gradient waveforms for 2D UTE slice selection. We also developed a method to estimate and correct for a bulk phase difference between the two half pulse excitations used for 2D UTE signal excitation. Bound water images were acquired in three healthy subjects with adiabatic inversion recovery prepared 2D UTE, while pore water images were acquired after short-T2 signals were suppressed with double adiabatic inversion recovery preparation. The repeatability of bound and pore water imaging with 2D UTE was tested by repeating acquisitions after repositioning. RESULTS The library-based interpolation of optimized slice select gradient waveforms combined with the method to estimate bulk phase between two excitations provided compact slice profiles for half pulse excited 2D UTE. Quantitative bound and pore water values were highly repeatable-the pooled SD of bound water across all three subjects was 0.38 mol1 $$ {}^1 $$ H/L, while pooled SD of pore water was 0.30 mol1 $$ {}^1 $$ H/L. CONCLUSION Fast, quantitative, 2D UTE-based bound and pore water images can be acquired at arbitrary oblique orientations after correcting for errors in the slice select gradient waveform and bulk phase shift between the two half acquisitions.
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Affiliation(s)
- Kevin D Harkins
- Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Institute of Image Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA
| | - Thammathida Ketsiri
- Institute of Image Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA
| | - Jeffry S Nyman
- Institute of Image Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA
- Department of Veterans Affairs, Tennessee Valley Healthcare System, Nashville, Tennessee, USA
- Orthopaedic Surgery and Rehabilitation, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Center for Bone Biology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Mark D Does
- Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Institute of Image Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA
- Electrical Engineering, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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