Abstract
Bone consists of the mineralized component (i.e., cortex and trabeculae) and the non-mineralized component (i.e., bone marrow). Most of the routine clinical bone imaging uses X-ray-based techniques and focuses on the mineralized component. However, bone marrow adiposity has been also shown to have a strong linkage with bone health. Specifically, multiple previous studies have demonstrated a negative association between bone marrow fat fraction (BMFF) and bone mineral density. Magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS) are ideal imaging techniques for non-invasively investigating the properties of bone marrow fat. In the present work, we first review the most important MRI and MRS methods for assessing properties of bone marrow fat, including methodologies for measuring BMFF and bone marrow fatty acid composition parameters. Previous MRI and MRS studies measuring BMFF and fat unsaturation in the context of osteoporosis are then reviewed. Finally, previous studies investigating the relationship between bone marrow fat, other fat depots, and bone health in patients with obesity and type 2 diabetes are presented. In summary, MRI and MRS are powerful non-invasive techniques for measuring properties of bone marrow fat in osteoporosis, obesity, and type 2 diabetes and can assist in future studies investigating the pathophysiology of bone changes in the above clinical scenarios.
Highlights
Bone consists of the mineralized and the non-mineralized component
Quantitative measurements of the mineralized component have been traditionally performed by using dual-energy-X-ray-absorptiometry (DXA) or quantitative computed tomography (QCT) assessing bone mineral density (BMD) [1]
BMD is used in clinical routine to determine osteoporosis-associated fracture risk
Summary
Bone consists of the mineralized (i.e., cortex and trabeculae) and the non-mineralized component (i.e., bone marrow). The interaction of the mineralized and non-mineralized components plays an important role in bone loss pathophysiology. Quantitative measurements of the mineralized component have been traditionally performed by using dual-energy-X-ray-absorptiometry (DXA) or quantitative computed tomography (QCT) assessing bone mineral density (BMD) [1]. BMD is used in clinical routine to determine osteoporosis-associated fracture risk. Osteoporosis is defined as a skeletal disorder characterized by compromised bone strength predisposing an individual to an increased risk for fractures [2]. It is classified as a public health problem, since osteoporosis-related fractures are associated with a reduction in quality of life and an increased
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