Can lumbar magnetic resonance imaging be used to predict osteoporosis in men?

Aim: This study aims to compare the findings of Dual Energy X-ray absorptiometry (DXA) and magnetic resonance imaging (MRI) in male patients and investigate MRI's effectiveness in diagnosing osteoporosis Material and Methods: This prospective, controlled study included 26 men diagnosed with osteoporosis by DXA and 26 men without osteoporosis, all of whom underwent lumbar MRI, with sagittal T1-weighted images (T1WI). A novel quantitative approach utilizing T1WI images for signal-to-noise ratio (SNR) measurements of lumbar vertebrae 1–4 (L1–L4) and M-scores derived from these SNR values has been calculated and the relationship with DXA T scores was investigated. Results: In men with osteoporosis, the average vertebra SNR values were found as follows: L1 vertebra 78.30 (18.16-185.98), L2 vertebra 77.47 (16.64-152.12), L3 vertebra 65.15 (16.34-151.72), L4 vertebra 63.53 (15.02-151.52), and the average of L1-L4 vertebrae was 72.54 (16.49-161.24). Compared to the control group, all values were statistically significant. The M value was measured as 1.66 (0.98-5.86) in men with osteoporosis, while it was 0.77 (0.88-1.06) in the control group (p = 0.018). In male patients with osteoporosis, the M score was found to be negatively correlated with the DXA values of the L1-L4 lumbar vertebrae (r = -0.408, p = 0.029). The optimal cutoff value for the M score was 0.38, which yielded a sensitivity of 69.2% and a specificity of 73.1%. Conclusion: The M score can be used as a screening method for osteoporosis in male patients for early diagnosis and treatment of high-risk patients before serious complications develop without additional radiation.