The aging spine: Data from the German National Cohort (NAKO)

Motivation: Opportunistic assessment of age-related changes of the spine in routine MRI can identify individuals with abnormal changes requiring further workup. Goal(s): To investigate age-related changes including bone marrow fat fraction (BMFF) and intervertebral disc (IVD) water content and to establish reference values in the general population. Approach: BMFFs and IVD water content were extracted from water-fat imaging (WFI) in whole-body MRI of participants aged 20-74 years of the German National Cohort (NAKO) using deep-learning based automatic segmentation. Results: BMFFs increased with age in both sexes. During menopause BMFF showed a steeper increase in women paralleled by a steeper decrease in IVD water content. Impact: We showed how WFI can depict physiologic changes in BMFF and IVD water content with age. Widespread use of clinical WFI combined with fully-automated image analysis could help detect individuals with increased fracture or cardiovascular risk due to high BMFF.