The diagnostic cutoff value of vertebral bone quality score for osteoporosis is significantly influenced by the magnetic field in patients undergoing lumbar surgery
Year: 2025
Type: article
Study design: Observational Study
Abstract: Background: The diagnostic efficacy of the magnetic resonance imaging (MRI)-based vertebral bone quality (VBQ) score for osteoporosis in patients undergoing lumbar surgery has been documented; however, whether the VBQ is influenced by different magnetic field strengths (1.5 T and 3.0 T) remains controversial. This study aimed to investigate the influence of magnetic fields on the diagnostic efficacy of the VBQ score via self-paired patients who underwent both 1.5 T and 3.0 T MRI scanning. Methods: This retrospective study included consecutive patients aged >50 years who underwent ≥2 MRI examinations within a 6-month period at our department for degenerative lumbar surgery from June 2022 to June 2024. Patients were included only if they had both dual-energy X-ray absorptiometry (DXA) and quantitative computed tomography (QCT) results obtained within the same period. There were three MRI scanners in our institution: the GE 1.5 T (General Electric), the GE 3.0 T (General Electric), and the PH 3.0 T (Philips Healthcare, Amsterdam, the Netherlands). The self-paired VBQ scores were compared between the different magnetic fields and scan manufacturers using paired t-tests. The Steiger’s Z test, correlation analysis, logistic regression analysis, and receiver operating characteristic (ROC) curve analysis were performed to explore the influence of the magnetic fields on the diagnostic value of the VBQ score. Results: A total of 104 patients were included who underwent ≥2 MRI scans with available DXA and QCT results. The mean age was 65.3±8.8 years with 56.7% female participants. In self-paired analysis, a significantly higher VBQ score was found in 1.5 T compared with 3.0 T (3.2±0.59 vs. 2.71±0.66, P<0.001), whereas no difference was observed between different MRI scanners of 3.0 T. Correlation analysis and logistic regression analysis of the self-paired patients revealed that the VBQ 1.5 T was more accurately associated with osteoporosis than the VBQ 3.0 T, with the strongest relationship in VBQ 1.5 T with QCT (r=−0.529). ROC analysis revealed that the diagnostic efficacy for osteoporosis was comparable between the VBQ 1.5 T and the VBQ 3.0 T [QCT-defined osteoporosis: VBQ 1.5 T area under the curve (AUC) =0.709 vs. VBQ 3.0 T AUC =0.697; DeLong test P=0.904]. Conclusions: The VBQ 1.5 T has a significantly higher cutoff value for osteoporosis than the VBQ 3.0 T in patients undergoing lumbar surgery. It is essential to mention the magnetic resonance (MR) field when applying the VBQ score in the screening of osteoporosis.
Language: English
Subfield: Orthopedics and Sports Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4414483630