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Comparative Study
. 2019;8(1):21-26.
doi: 10.14283/jfa.2018.16.

A Comparison between 6-point Dixon MRI and MR Spectroscopy to Quantify Muscle Fat in the Thigh of Subjects with Sarcopenia

A Grimm  1 , H Meyer, M D Nickel, M Nittka, E Raithel, O Chaudry, A Friedberger, M Uder, W Kemmler, K Engelke, H H Quick
Affiliations
Comparative Study

A Comparison between 6-point Dixon MRI and MR Spectroscopy to Quantify Muscle Fat in the Thigh of Subjects with Sarcopenia

A Grimm et al. J Frailty Aging. 2019.

Abstract

Background: Changes in muscle fat composition as for example observed in sarcopenia, affect physical performance and muscular function, like strength and power.

Objectives: The purpose of this study was to compare 6-point Dixon magnetic resonance imaging and multi-echo magnetic resonance spectroscopy sequences to quantify muscle fat. Setting, participants and measurements: Two groups were recruited (G1: 23 healthy young men (28 ± 4 years), G2: 56 men with sarcopenia (80 ± 5 years)). Proton density fat fraction was measured with a 6-point product and a 6-point prototype Dixon sequence in the left thigh muscle and with a high-speed multi-echo T2*-corrected H1 magnetic resonance spectroscopy sequence within the semitendinosus muscle of the left thigh. To evaluate the comparability among the different methods, Bland-Altman and linear regression analyses of the proton density fat fraction results were performed.

Results: Mean differences ± 1.96 * standard deviation between spectroscopy and 6pt Dixon sequences were 1.9 ± 3.3% and 1.5 ± 3.6% for the product and prototype sequences, respectively. High correlations were measured between the proton density fat fraction results of the 6-point Dixon sequences and spectroscopy (R = 0.95 for the product sequence and R = 0.97 for the prototype sequence).

Conclusions: Dixon imaging and spectroscopy sequences show comparable accuracy for fat measurements in the thigh. Spectroscopy is a local measurement, whereas Dixon sequences provide maps of the fat distribution. The high correlations of the 6-point Dixon sequences with spectroscopy support their clinical use. They provide higher spatial resolution than spectroscopy, but are not suitable for a more complicated spectral analysis to separate extra- and intramyocellular lipids.

Keywords: Magnetic resonance imaging; magnetic resonance spectroscopy; sarcopenia; thigh.

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Conflict of interest statement

Co-authors Heiko Meyer, PhD, Mathias Nittka, PhD, Marcel D. Nickel, PhD, and Esther Raithel, PhD, are employees of Siemens Healthcare GmbH, Erlangen, Germany. No other author has any conflict of interest to disclose.

Figures

Figure 1
Figure 1
Exemplary results of (a) a young G1 male (32 years) and (b) a G2 male with sarcopenia (82 years) of the T1w TSE sequence. The image field of view (FOV) was identically scaled for both subjects. While the femoral bone was comparable in size and diameter, the young individual showed a large muscle volume, almost no intramuscular fat, and very low subcutaneous fat. The sarcopenic patient in direct comparison showed reduced overall muscle volume, larger intra- and perimuscular fat portions, and a thick layer of subcutaneous fat
Figure 2
Figure 2
Resulting (a1 and b1) ‘fat' and (a2 and b2) ‘water' images of the 6pt Dixon product sequence of (a) the G1 and (b) the G2 subjects, shown in Fig 1. A local fat-water swap occurred in the whole muscle in the shown (a) G1 subject (muscle tissue results hyperintense in the (a1) ‘fat' image, while it results hypointense in the (a2) ‘water' image)
Figure 3
Figure 3
(a1 and a2) PDFF and (b1 and b2) PDWF maps of the 6pt Dixon prototype sequence of (a) the G1 and (b) the G2 subjects shown in Fig. 1. The squares in the PDFF maps mark the MRS volume of interest (VOI) evaluated. The VOI was aimed to place in regions without macroscopic fatty septa, if possible. PDFF in the semitendinosus muscle as determined by MRS were 2.35% (G1 subject) and 19.94% (G2 subject
Figure 4
Figure 4
Bland-Altman plots comparing PDFF of MRS with the 6pt Dixon (a) product and (b) prototype sequences for both subject groups pooled together. Mean = mean value, SD = standard deviation
See this image and copyright information in PMC

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