UTE-MRI biomarkers distinguish femoral bone changes in aging and osteoporosis

Quantitative ultrashort echo time (UTE) MRI pore-to-matrix ratio (PMR) increased and matrix index (MI) decreased with aging and osteoporosis. Femoral head PMR differentiated Old Normal from Osteoporosis (5.35 vs 8.10, p<0.05); AUC 0.776 (95% CI 0.584-0.909).

• PMR and MI significantly correlated with DXA T-scores (PMR ρ = -0.406 to -0.211, MI ρ = 0.333-0.402; all p < 0.05).
• Interobserver reproducibility was substantial to almost perfect (ICC 0.73–0.99).
• MI showed AUC 0.738 (95% CI 0.548–0.886) for differentiating Old Normal from Osteoporosis.

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