Comparison Between Magnetic Resonance Imaging of Spine and Dual Energy X-Ray Absorptiometry Scan for Assessment Bone Mineral Density in Degenerative Spine Patients in Bhumibol Adulyadej Hospital: A Single-Center Study

Abstract

Purpose: To evaluate the diagnostic efficacy of the vertebral bone quality (VBQ) score in diagnosing osteoporosis.
Method: A retrospective analysis was conducted on patients who underwent both dual-energy X-ray absorptiometry (DXA) and magnetic resonance imaging of the lumbosacral spine. The VBQ score was compared with T-scores and Z-scores using the Pearson correlation coefficient to assess its diagnostic performance for osteoporosis.
Results: A total of 161 patients with degenerative spine disease were included. The mean age was 71.4 ± 10.1 years, comprising 122 females (75.8%) and 39 males (24.2%). The VBQ score showed a moderate negative correlation with spine and hip T-scores (r = –0.356 and –0.341, respectively). Receiver operating characteristic curve analysis for bone mineral density (BMD) and VBQ scores demonstrated an area under the curve of 0.652 (95% CI, 0.555–0.750) for osteopenia and 0.674 (95% CI, 0.558–0.790) for osteoporosis. For osteoporosis, the VBQ score had a positive predictive value of 32% (95% CI, 28.14%–36.23%), a negative predictive value of 92% (95% CI, 76.02%–98.01%), and an accuracy of 47.6% (95% CI, 37.78%–57.59%).
Conclusion: The VBQ score is a useful tool for primary screening of osteoporosis but cannot replace DXA scans. A VBQ score < 3.1 can be used to exclude osteoporosis, whereas a VBQ score ≥ 3.2 indicates the need for further evaluation with DXA, the current gold standard.