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<p>This retrospective cross-sectional study investigated the diagnostic performance of four magnetic resonance imaging (MRI)-based vertebral bone quality (VBQ) scoring methods for identifying osteoporosis in postmenopausal women and explored the impact of MRI system variability, using quantitative computed tomography (QCT) as the reference standard. A total of 181 women who underwent lumbar spine QCT and MRI within a six-month interval were included. VBQ scores were calculated from routine sagittal T1-weighted images. Diagnostic performance was assessed using receiver operating characteristic curve analysis, correlations with QCT-derived bone mineral density (BMD) were evaluated using Spearman’s correlation, and agreement and inter-method variability were analyzed using appropriate comparative and agreement analyses. All four VBQ scoring methods demonstrated moderate diagnostic performance, with areas under the curve ranging from 0.739–0.783, and showed moderate negative correlations with BMD (<i>R</i> = − 0.488 to − 0.549). Significant differences were observed among VBQ scoring methods (<i>p</i> = 0.018) and across MRI systems from different vendors (<i>p</i> &lt; 0.001). An optimal cutoff value of VBQ &gt; 4.0 was identified using the Youden index. These findings suggest that MRI-derived VBQ scoring may serve as a useful, radiation-free, opportunistic adjunct for osteoporosis assessment in postmenopausal women undergoing lumbar MRI for other clinical indications. However, the observed inter-method and inter-scanner variability highlights the need for further standardization of VBQ scoring approaches and MRI acquisition protocols before broader clinical implementation.</p>

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MRI-Based Vertebral Bone Quality Scoring for Opportunistic Osteoporosis Screening in Postmenopausal Women: A QCT-Referenced Study

  • 期刊论文

  • 发表日期：

    2026年2月9日

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  • Jianrong He,
  • Zejun Liang,
  • Yiteng Zhang,
  • Yu Zhang,
  • Hanyu Li,
  • Hanyu Zheng,
  • Wenyue Xu,
  • Jian Zhang,
  • Zhenlin Li,
  • Jing Tang

摘要

This retrospective cross-sectional study investigated the diagnostic performance of four magnetic resonance imaging (MRI)-based vertebral bone quality (VBQ) scoring methods for identifying osteoporosis in postmenopausal women and explored the impact of MRI system variability, using quantitative computed tomography (QCT) as the reference standard. A total of 181 women who underwent lumbar spine QCT and MRI within a six-month interval were included. VBQ scores were calculated from routine sagittal T1-weighted images. Diagnostic performance was assessed using receiver operating characteristic curve analysis, correlations with QCT-derived bone mineral density (BMD) were evaluated using Spearman’s correlation, and agreement and inter-method variability were analyzed using appropriate comparative and agreement analyses. All four VBQ scoring methods demonstrated moderate diagnostic performance, with areas under the curve ranging from 0.739–0.783, and showed moderate negative correlations with BMD (R = − 0.488 to − 0.549). Significant differences were observed among VBQ scoring methods (p = 0.018) and across MRI systems from different vendors (p < 0.001). An optimal cutoff value of VBQ > 4.0 was identified using the Youden index. These findings suggest that MRI-derived VBQ scoring may serve as a useful, radiation-free, opportunistic adjunct for osteoporosis assessment in postmenopausal women undergoing lumbar MRI for other clinical indications. However, the observed inter-method and inter-scanner variability highlights the need for further standardization of VBQ scoring approaches and MRI acquisition protocols before broader clinical implementation.