Validation of noninvasive quantification of bone marrow fat volume with microCT in aging rats
Research Highlights
► Marrow fat infiltration is one of the hallmarks of senile osteoporosis. ► Current methods of marrow fat quantification lack comparison with a gold standard. ► Image analysis of marrow fat has a good agreement with the gold standard. ► Image analysis is a promissory method to quantify fat infiltration in aging bone.
Introduction
Osteoporosis and its most devastating sequelae, fractures, is a rising global health, economic and social burden. Thus the early detection and treatment of individuals at risk of fractures is a priority before the fragility fracture cascade sets in. Bone Mineral Density (BMD) and Dual Energy X-ray Absorptiometry (DXA) have long been the recommended fracture surrogate and non-invasive tool respectively that estimate fracture risk. However, there is evidence that BMD alone, as defined by the World Health Organization (WHO), does not reliably predict fractures (Marshall et al., 1996), does not identify the majority who are at moderate risk (Pasco et al., 2006), and is limited for monitoring the effect of drug therapy (Delmas and Seeman, 2004). This has led to the development of clinical tools for predicting fracture risks such as the WHO Fracture Risk Assessment Tool (FRAX) (Kanis et al., 2005) and the Garvan fracture risk calculator (Nguyen et al., 2007). However, the validity of a purely clinical tool to predict fractures is still controversial (Leslie and Hans, 2009) and its accuracy may be limited by differences between cohorts (Sandhu et al., 2010).
In recent years it is increasingly recognized that trabecular microarchitecture confers bone its strength (Seeman and Delmas, 2006) and hence may explain the discrepancy between BMD and fracture risk (Delmas and Seeman, 2004). Several non-invasive methods [e.g. magnetic resonance imaging (MRI), and computed tomography (CT) scan] have been used to assess the microarchitecture of the different components of bone (Brandi, 2009). However despite their usefulness, there are other components of bone microarchitecture that have not been fully assessed. One of them is the presence of increasing levels of marrow fat (Burkhardt et al., 1987). In contrast to menopausal bone loss, age-related bone loss is not only associated with high levels of bone resorption, but also with increased adipogenesis (Rozman et al., 1989) and reduced osteoblastogenesis (Zhou et al., 2008), which affects bone mass. Biopsy studies have shown significant increase in marrow fat with age (Tanaka and Inoue, 1976), as well as an inverse relationship between fat volume (FV) and bone volume that was independent of sex and correlated with the changes seen in people with osteoporosis (Justesen et al., 2001).
Currently there are few non-invasive methods that have quantified marrow fat in humans. Among them, magnetic resonance imaging (MRI) has been the main modality showing increased marrow fat in older subjects (Schellinger et al., 2001) and in osteoporotic individuals (Yeung et al., 2005). However the correlations between MRI and BMD by DXA have been inconsistent and were limited to the vertebrae (Griffith et al., 2005, Schellinger et al., 2004, Shen et al., 2007). Furthermore, although studies using MRI suggest that the degree of marrow adiposity may be a better predictor of bone loss and thus could be used as a surrogate for fracture risk (Schellinger et al., 2004), the lack of histology correlation limits the validity of this conclusion. Due to these reasons and other technical limitations (e.g. metallic prosthesis), a reliable alternative method to quantify fat infiltration is still required. With the emerging use of high resolution imaging methods to assess bone microarchitecture, such as peripheral quantitative CT (pQCT) in humans and microCT (μCT) in bone samples, the development of new image analysis methods to quantify marrow fat could offer an alternative to MRI. In this study, we aimed to validate a new method of non-invasive quantification of bone marrow fat by correlating μCT image analyses with the gold standard (histology) in aging rats. We expect that this new method will facilitate marrow fat quantification in animal and human studies looking at the mechanisms of age-related bone loss and senile osteoporosis.
Section snippets
Animals
Twenty-two young mature (4-month-old, n = 12) and old (27-month-old, n = 10) male Louvain/c/rqrv (LOU) rats were studied. Male rats were selected due to their significantly higher levels of marrow fat infiltration as compared with old female LOU rats (Duque et al., 2009). Rats were obtained from the Aging LOU Rat Colony Infrastructure of the Quebec Network for Research on Aging (RQRV; www.rqrv.com). The rats were killed by rapid decapitation in block design fashion. Their bones were rapidly
Invasive and non-invasive identification of marrow fat in young and old LOU rats
Fig. 1 illustrates both bone micro architecture by histology analysis in young (A) and old (F) bone as compared with BV and FV labeling using SliceOMatic analysis of μCT sections obtained from the same femur in young (B, C–E) and old (G, H–J) male LOU rats. In agreement with fat identification using histological analysis (A and F), μCT labeling shows higher levels of FV in old rats (H–J) as compared to young rats (C–E).
Intra- and inter-rater reliability
For SliceOMatic/μCT the intra-rater reliability for duplicate measurements
Discussion
In this study we successfully correlated image and histology analysis of the marrow fat/bone relationship in the aging skeleton. We validated a non-invasive method of FV quantification with μCT images using well-established imaging software. Consistent with previous invasive studies (Justesen et al., 2001, Verma et al., 2002) and with our own previous report in this same model (Duque et al., 2009), our noninvasive quantification indicates that FV increases and BV decreases with age in this
Conclusion
In conclusion, non-invasive quantification of FV/BV ratio using image analysis software is a useful and reliable tool to quantify one of the hallmarks of age-related bone loss and senile osteoporosis. The fact that this method is comparable to histology for identifying age related changes in marrow adiposity assures the use of this noninvasive method for aging bone research in the near future.
Acknowledgements
This study was supported by a project grant from the Australian National Health and Medical Research Council (NHMRC, Grant # 632767) and by an operating grant from the Nepean Medical Research Foundation. A/Prof. Duque and Dr Li hold Fellowships from the University of Sydney Medical Research Foundation. Dr Demontiero holds a scholarship from The Rebecca Cooper Medical Research Foundation. The authors are deeply grateful to the members of the Quebec Network for Research in Aging for providing us
References (40)
- et al.
Changes in trabecular bone, hematopoiesis and bone marrow vessels in aplastic anemia, primary osteoporosis, and old age: a comparative histomorphometric study
Bone
(1987) - et al.
Changes in bone mineral density explain little of the reduction in vertebral or nonvertebral fracture risk with anti-resorptive therapy
Bone
(2004) - et al.
Accelerated bone loss in the LOU/c rat model of healthy ageing
Exp. Gerontol.
(2009) - et al.
Quantification of adiposity in small rodents using micro-CT
Methods
(2010) - et al.
In vivo quantification of subcutaneous and visceral adiposity by micro-computed tomography in a small animal model
Med. Eng. Phys.
(2009) - et al.
Morphometric analysis of noninvasively assessed bone biopsies: comparison of high-resolution computed tomography and histologic sections
Bone
(1996) - et al.
Age-related changes of human bone marrow: a histometric estimation of proliferative cells, apoptic cells, T cells, B cells, and macrophages
Mech. Ageing Dev.
(2000) - et al.
The LOU/c/jall rat as an animal model of healthy aging?
J. Gerontol. Biol. Sci. Med. Sci.
(2002) - et al.
Quantitative comparison and evaluation of software packages for assessment of abdominal adipose tissue distribution by magnetic resonance imaging
Int. J. Obes.
(2008) Microarchitecture, the key to bone quality
Rheumatology
(2009)
A longitudinal HR-pQCT study of alendronate treatment in post-menopausal women with low bone density: relations between density, cortical and trabecular micro-architecture, biomechanics, and bone turnover
J. Bone Miner. Res.
Validity of a new automated software program for visceral adipose tissue estimation
Int. J. Obes.
Vertebral bone mineral density, marrow perfusion, and fat content in healthy men and men with osteoporosis: dynamic contrast-enhanced MR imaging and MR spectroscopy
Radiology
Bone marrow plays a role in bone metabolism: histomorphometry of iliac bone in postmenopausal women
Calcif. Tissue Int.
Estimation of skeletal muscle mass by bioelectrical impedance analysis
J. Appl. Physiol.
Adipocyte tissue volume in bone marrow is increased with aging and in patients with osteoporosis
Biogerontology
Assessment of fracture risk
Osteoporos. Int.
Evaluation of a microcomputed tomography system to study trabecular bone structure
J. Orthop. Res.
Commentary on lumpers and splitters: the FRAX debate continues
J. Bone Miner. Res.
Bone density, geometry, microstructure and stiffness: relationships between peripheral and central skeletal sites assessed by DXA, HR-pQCT, and cQCT in premenopausal women
J. Bone Miner. Res.
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