Ultrashort echo time quantitative magnetization transfer (UTE-qMT) MRI distinguishes human diabetic bones from healthy ones

Motivation: There is no standardized method to probe bone quality, a key determinant of bone fracture risk of type 2 diabetes patients. Goal(s): We tested whether UTE quantitative MT (UTE-qMT) imaging and UTE-based water pool measurement can distinguish diabetic bones from healthy ones. Approach: Twenty-two ex vivo human diabetic bones and 13 healthy ones were scanned with UTE-MT, proton density UTE, and inversion recovery UTE sequences to measure qMT parameters and fractions of pore and bound water pools. Results: The proton exchange rates from UTE-qMT showed a significant decrease in diabetic bones. Impact: The proton exchange rate measured via UTE-qMT can distinguish diabetic bones from healthy ones. UTE-qMT may provide insight into molecular-scale bone quality that explains the increased fracture risk in type 2 diabetes patients despite the increased bone mineral density.