Cortical Bone Mechanical Assessment via Free Water Relaxometry at 3 T

Background Investigation of cortical bone using magnetic resonance imaging is a developing field, which uses short/ultrashort echo time (TE) pulse sequences to quantify bone water content and to obtain indirect information about bone microstructure. Purpose To improve the accuracy of the previously proposed technique of free water T-1 quantification and to seek the relationship between cortical bone free water T-1 and its mechanical competence. Study Type Prospective. Subjects Twenty samples of bovine tibia bone. Field Strength/Sequences 3.0 T; ultra-fast two-dimensional gradient echo, Radio frequency-spoiled three-dimensional gradient echo. Assessment Cortical bone free water T-1 was quantified via three different methods: inversion recovery (IR), variable flip angle (VFA), and variable repetition time (VTR). Signal-to-noise ratio was measured by dividing the signal of each segmented sample to background noise. Segmentation was done manually. The effect of noise on T-1 quantification was evaluated. Then, the samples were subjected to mechanical compression test to measure the toughness, yield stress, ultimate stress, and Young modulus. Statistical Tests All the statistical analysis (Shapiro-Wilk, way analysis of variance, paired t test, Pearson correlation, and Bland-Altman plot) were done using SPSS. Results Significant difference was found between T-1 quantification groups (P < 0.05). Average T-1 of each quantification method differed significantly after adding noise (P < 0.05). VFA-T-1 values significantly correlated with toughness (r = -0.68, P < 0.05), ultimate stress (r = -0.71, P < 0.05), and yield stress (r = -0.62, P < 0.05). No significant correlation was found between VTR-T-1 values and toughness (P = 0.07), ultimate stress (P = 0.47), yield stress (P = 0.30), and Young modulus (P = 0.39). Data Conclusion Pore water T-1 value is associated with bone mechanical competence, and VFA method employing short-TE pulse sequence seems a superior technique to VTR method for this quantification. Level of Evidence 2 Technical Efficacy 1

Automated summary

The study aims to quantify cortical bone water content using MRI and explore its relationship with mechanical competence. Results show significant correlations between VFA method and bone toughness, ultimate stress, and yield stress, indicating its superiority for this quantification.