Sensitivity and specificity assessment of DWI and ADC for the diagnosis of osteoporosis in postmenopausal patients

  • Mohammad Momeni
  • Mohammad AsadzadehEmail author
  • Karim Mowla
  • Mohammad Ghasem Hanafi
  • Mohammad Momen Gharibvand
  • Aliakbar Sahraeizadeh
Magnetic Resonance Imaging



In this study, we prospectively investigated the diagnostic capability of diffusion-weighted magnetic resonance imaging (DWI) in assessing vertebral marrow changes in postmenopausal women with osteoporosis.

Materials and methods

Sixty postmenopausal women (mean age 60.2 ± 6.11 years) underwent both dual-energy X-ray absorptiometry (DEXA) of the spine and MRI. Results were acquired from each patient’s L2 to L4, for a total of 180 lumbar vertebrae. Based on bone mineral density (BMD) measurements obtained from DEXA, the vertebrae were divided into three groups as follows: normal (n = 52), osteopenic (n = 92), and osteoporotic (n = 36). DWI of the vertebral body was performed to assess the apparent diffusion coefficient (ADC). The ADC outcomes were compared among the three groups and correlated with BMD.


ADC values (× 10−6 mm2/s) were significantly lower in the osteoporotic group (135.67 ± 44.10) in comparison to the normal group (561.85 ± 190.37) (P = 0.0001). The results showed a positive correlation between ADC and BMD values (r = 0.748, P = 0.0001). In receiver operating characteristic (ROC) analysis, the area under the curve for DWI was 0.912 (P = 0.001). A cut-off value of 400 mm2/s for the diagnosis of osteoporosis; had sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of 90.90%, 83.34%, 88.89%, 93.75%, and 76.93%, respectively.


ADC values correlated positively with BMD in women. DWI can allow quantitative evaluation of bone marrow changes and osteoporosis in postmenopausal women.


Osteoporosis Bone marrow Apparent diffusion coefficient (ADC) Bone mineral density (BMD) Diffusion weighted imaging (DWI) 


Authors’ contributions

Study conception and design: MA, MM, KM, MMG, MGH. Acquisition of data: MA MM, AS. Analysis and interpretation of data: MA, MMG, MM, AS. Drafting of manuscript: MA, KM, MGH, MMG, AS. Critical revision: MM, AS. Final approval and guarantor of the article: MA, MMG, MM, KM, MGH, AS.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of committee on Publication Ethics of Ahvaz Jundishapur University of Medical Sciences (IR.AJUMS.REC.1397.067) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Ethical standards

This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Italian Society of Medical Radiology 2019

Authors and Affiliations

  • Mohammad Momeni
    • 1
  • Mohammad Asadzadeh
    • 1
    Email author
  • Karim Mowla
    • 2
  • Mohammad Ghasem Hanafi
    • 1
  • Mohammad Momen Gharibvand
    • 1
  • Aliakbar Sahraeizadeh
    • 1
  1. 1.Department of Radiology, School of MedicineAhvaz Jundishapur University of Medical SciencesAhvazIran
  2. 2.Department of Rheumatology, School of MedicineAhvaz Jundishapur University of Medical SciencesAhvazIran

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