Ultrashort echo time magnetization transfer (UTE-MT) MRI detects non-enzymatic crosslinking of collagen in ex vivo rat bones

Motivation: Type 2 diabetes (T2D) patients suffer from increased bone fracture risk despite preserved or even elevated bone mineral density (BMD). A better diagnostic tool that accurately reports the bone health of T2D patients is urgently needed. Goal(s): To develop an MRI method that can probe non-enzymatic crosslinking of bone collagen and compromise of bone mechanical properties. Approach: We used ultrashort echo time magnetization transfer (UTE-MT) MRI for measuring the degree of collagen crosslinking in ex vivo rat bones with ribosylation. Results: The UTE-MT showed sensitivity to bone collagen crosslinking via ribosylation and subsequent compromise of bone mechanical properties. Impact: The UTE-MT technique showed significant sensitivity to non-enzymatic crosslinking of bone collagen, a key mechanism that explains the increased fracture risk of T2D patients. The UTE-MT can be an accurate noninvasive diagnostic tool for probing bone health of T2D patients.