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Marrow fat content and composition in beta-thalassemia: A study using(1)H-MRS

Background: beta-thalassemia is a genetic disease that causes abnormal production of red blood cells (ineffective erythropoiesis, IE). IE is a condition known to change bone marrow composition. Purpose: To evaluate the effect of IE on the marrow fat content and fat unsaturation levels in the proxima...

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Main Authors: Ismail, Umi Nabilah, Azlan, Che Ahmad, Khairullah, Shasha, Azman, Raja Rizal, Omar, Nur Farhayu, Md Shah, Mohammad Nazri, Yeong, Chai Hong, Jackson, Nicholas, Ng, Kwan Hoong
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Published: Wiley 2021
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R Medicine (General)
Online Access:http://eprints.um.edu.my/34194/
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spelling my.um.eprints.341942022-09-07T07:16:30Z http://eprints.um.edu.my/34194/ Marrow fat content and composition in beta-thalassemia: A study using(1)H-MRS Ismail, Umi Nabilah Azlan, Che Ahmad Khairullah, Shasha Azman, Raja Rizal Omar, Nur Farhayu Md Shah, Mohammad Nazri Yeong, Chai Hong Jackson, Nicholas Ng, Kwan Hoong R Medicine (General) Background: beta-thalassemia is a genetic disease that causes abnormal production of red blood cells (ineffective erythropoiesis, IE). IE is a condition known to change bone marrow composition. Purpose: To evaluate the effect of IE on the marrow fat content and fat unsaturation levels in the proximal femur using(1)H-MRS. Study Type: Prospective. Subjects: Twenty-three subjects were included in this study, seven control and 16 beta-thalassemia subjects. Field Strength/Sequence: 3.0T; stimulated echo acquisition Mode (STEAM); magnetic resonance spectroscopy (MRS) sequence. Assessment: Multiecho MRS scans were performed in four regions of the proximal left femur of each subject, that is, diaphysis, femoral neck, femoral head, and greater trochanter. The examined regions were grouped into red (diaphysis and femoral neck) and yellow marrow regions (femoral head and greater trochanter). Statistical Tests: The Jonckheere-Terpstra test was used to evaluate the impact of increasing disease severity on bone marrow fat fraction (BMFF), marrow conversion index, and fat unsaturation index (UI). Pairwise comparison analysis was performed when a significant trend (P < 0.05) was found. K-means clustering analysis was used to examine the clusters observed when BMFF in the red and yellow regions were studied (diaphysis against greater trochanter). Results: BMFF showed a significant decreasing trend with increasing disease severity in both red (T-JT= 109.00, z = -4.414,P < 0.05) and yellow marrow regions (T-JT= 108.00, z = -4.438,P < 0.05). The opposite trend was observed in UI in both bone marrow regions (red marrow: T-JT= 180.5, z = 3.515,P < 0.05; yellow marrow: T-JT= 155.0, z = 2.282,P= 0.05). Three distinct forms of marrow adipogenesis were found when plotting BMFF diaphysis against BMFF greater trochanter: 1) normal (centroid: 80.4%, 66.6%), 2) partial disruption (centroid: 51.1%, 16.6%), and 3) total disruption (centroid: 2.6%, 1.6%). Data Conclusion: beta-thalassemia is associated with decreased marrow fat, and increased marrow fat unsaturation level. Level of Evidence: 2 Technical Efficacy Stage:3 Wiley 2021-01 Article PeerReviewed Ismail, Umi Nabilah and Azlan, Che Ahmad and Khairullah, Shasha and Azman, Raja Rizal and Omar, Nur Farhayu and Md Shah, Mohammad Nazri and Yeong, Chai Hong and Jackson, Nicholas and Ng, Kwan Hoong (2021) Marrow fat content and composition in beta-thalassemia: A study using(1)H-MRS. Journal of Magnetic Resonance Imaging, 53 (1). pp. 190-198. ISSN 1053-1807, DOI https://doi.org/10.1002/jmri.27294 <https://doi.org/10.1002/jmri.27294>. 10.1002/jmri.27294
institution Universiti Malaya
building UM Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Malaya
content_source UM Research Repository
url_provider http://eprints.um.edu.my/
topic R Medicine (General)
spellingShingle R Medicine (General)
Ismail, Umi Nabilah
Azlan, Che Ahmad
Khairullah, Shasha
Azman, Raja Rizal
Omar, Nur Farhayu
Md Shah, Mohammad Nazri
Yeong, Chai Hong
Jackson, Nicholas
Ng, Kwan Hoong
Marrow fat content and composition in beta-thalassemia: A study using(1)H-MRS
description Background: beta-thalassemia is a genetic disease that causes abnormal production of red blood cells (ineffective erythropoiesis, IE). IE is a condition known to change bone marrow composition. Purpose: To evaluate the effect of IE on the marrow fat content and fat unsaturation levels in the proximal femur using(1)H-MRS. Study Type: Prospective. Subjects: Twenty-three subjects were included in this study, seven control and 16 beta-thalassemia subjects. Field Strength/Sequence: 3.0T; stimulated echo acquisition Mode (STEAM); magnetic resonance spectroscopy (MRS) sequence. Assessment: Multiecho MRS scans were performed in four regions of the proximal left femur of each subject, that is, diaphysis, femoral neck, femoral head, and greater trochanter. The examined regions were grouped into red (diaphysis and femoral neck) and yellow marrow regions (femoral head and greater trochanter). Statistical Tests: The Jonckheere-Terpstra test was used to evaluate the impact of increasing disease severity on bone marrow fat fraction (BMFF), marrow conversion index, and fat unsaturation index (UI). Pairwise comparison analysis was performed when a significant trend (P < 0.05) was found. K-means clustering analysis was used to examine the clusters observed when BMFF in the red and yellow regions were studied (diaphysis against greater trochanter). Results: BMFF showed a significant decreasing trend with increasing disease severity in both red (T-JT= 109.00, z = -4.414,P < 0.05) and yellow marrow regions (T-JT= 108.00, z = -4.438,P < 0.05). The opposite trend was observed in UI in both bone marrow regions (red marrow: T-JT= 180.5, z = 3.515,P < 0.05; yellow marrow: T-JT= 155.0, z = 2.282,P= 0.05). Three distinct forms of marrow adipogenesis were found when plotting BMFF diaphysis against BMFF greater trochanter: 1) normal (centroid: 80.4%, 66.6%), 2) partial disruption (centroid: 51.1%, 16.6%), and 3) total disruption (centroid: 2.6%, 1.6%). Data Conclusion: beta-thalassemia is associated with decreased marrow fat, and increased marrow fat unsaturation level. Level of Evidence: 2 Technical Efficacy Stage:3
format Article
author Ismail, Umi Nabilah
Azlan, Che Ahmad
Khairullah, Shasha
Azman, Raja Rizal
Omar, Nur Farhayu
Md Shah, Mohammad Nazri
Yeong, Chai Hong
Jackson, Nicholas
Ng, Kwan Hoong
author_facet Ismail, Umi Nabilah
Azlan, Che Ahmad
Khairullah, Shasha
Azman, Raja Rizal
Omar, Nur Farhayu
Md Shah, Mohammad Nazri
Yeong, Chai Hong
Jackson, Nicholas
Ng, Kwan Hoong
author_sort Ismail, Umi Nabilah
title Marrow fat content and composition in beta-thalassemia: A study using(1)H-MRS
title_short Marrow fat content and composition in beta-thalassemia: A study using(1)H-MRS
title_full Marrow fat content and composition in beta-thalassemia: A study using(1)H-MRS
title_fullStr Marrow fat content and composition in beta-thalassemia: A study using(1)H-MRS
title_full_unstemmed Marrow fat content and composition in beta-thalassemia: A study using(1)H-MRS
title_sort marrow fat content and composition in beta-thalassemia: a study using(1)h-mrs
publisher Wiley
publishDate 2021
url http://eprints.um.edu.my/34194/
_version_ 1744649163220451328
score 13.211869

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