Improved 3-T MRI Proximal Femur Microarchitecture Parameters Correlate with Higher DEXA Bone Mineral Density T-Scores

Motivation: Current osteoporosis diagnostics, primarily reliant on DEXA-assessed BMD, have limited sensitivity. This study addresses the need for markers that assess bone quality beyond BMD for improved fracture risk assessment. Goal(s): To determine the relationship between MRI-derived femoral microarchitecture metrics and DEXA BMD T-scores in post-menopausal women. Approach: This prospective, observational study correlated DEXA T-scores with 3-T MRI-derived femoral microarchitecture parameters to identify strength of association. Results: Significant correlations were found between DEXA-derived BMD T-scores and MRI-derived femur microarchitecture parameters. Impact: This study suggests that MRI metrics of bone microarchitecture could complement DEXA in osteoporosis assessment, together offering a more comprehensive tool to improve fracture risk prediction and enhance patient-specific treatment strategies for osteoporosis.