Marrow adipose tissue imaging in humans.

Abstract Bone strength is affected not only by bone mineral density (BMD) and bone microarchitecture but also its microenvironment. Recent studies have focused on the role of marrow adipose tissue (MAT) in the pathogenesis of bone loss. Osteoblasts and adipocytes arise from a common mesenchymal stem cell within bone marrow and many osteoporotic states, including aging, medication use, immobility, over – and undernutrition are associated with increased marrow adiposity. Advancements in imaging technology allow the non-invasive quantification of MAT. This article will review magnetic resonance imaging (MRI)- and computed tomography (CT)-based imaging technologies to assess the amount and composition of MAT. The techniques that will be discussed are anatomic T1-weighted MRI, water-fat imaging, proton MR spectroscopy, single energy CT and dual energy CT. Clinical applications of MRI and CT techniques to determine the role of MAT in patients with obesity, anorexia nervosa, and type 2 diabetes will be reviewed. Highlights • Marrow adipose tissue can be assessed non-invasively using MRI- and CT-based imaging technologies. • Proton MR spectroscopy can determine the quantity and composition of marrow adipose tissue. • Water-fat imaging allows marrow adipose tissue assessment of different skeletal regions in a single examination. • Dual-energy CT can assess both bone mineral density and marrow adipose tissue in the same examination. [ABSTRACT FROM AUTHOR]