Assessing Lumbar Spine Microstructure in Osteoporosis Using IVIM-DWI and IDEAL-IQ Sequences

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Background: Currently, dual-energy X-ray absorptiometry (DEXA) and quantitative CT (QCT) are commonly used in clinical practice to measure bone mineral density (BMD), offering diagnostic value but involving radiation and inability to visualize bone microstructure. This study aims to assess lumbar spine bone microstructure changes in normal, osteopenic, and osteoporotic groups using IVIM-DWI and IDEAL-IQ sequences to provide useful information for clinical practice. Methods: -test. Receiver operating characteristic (ROC) and Spearman's analyses evaluated diagnostic performance and correlations. Results: Significant differences existed in the ADCslow, f, FF and R2* between groups (P<0.05). BMD was weakly positively correlated with ADCslow, f, and R2* (r=0.494, 0.153, 0.182, 0.029, P<0.001) but a negative correlation with FF (r=-0.402, P<0.001). BMD and the ADCslow and R2* decreased but FF increased with age (P<0.05 for all), whereas no significant association existed between age and ADCfast or f value (P>0.05). FF had the highest areas under the curve (AUCs) (0.624, 0.831 and 0.747) and sensitivity (72.2%, 70.9% and 81.5%) in differentiating normal from osteopenia patients, normal from osteoporosis patients, and osteopenia from osteoporosis patients, respectively. ADCslow and f had the highest specificity (88%) in differentiating between normal and osteopenia patients, while ADCslow had the highest specificity (91.4%) in differentiating between normal and osteoporosis patients. Conclusion: Quantitative parameters extracted from IVIM-DWI and IDEAL-IQ have the potential to become good biomarkers for diagnosing OP.

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