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Abstract: TH-PO575

A Novel Magnetic Resonance Imaging Biomarker of Tibial Bone Quality in CKD

Session Information

Category: Bone and Mineral Metabolism

  • 402 Bone and Mineral Metabolism: Clinical


  • Salerno, Fabio R., Western University, London, Ontario, Canada
  • Akbari, Alireza, London Health Sciences Centre, London, Ontario, Canada
  • Hur, Lisa, Western University, London, Ontario, Canada
  • McIntyre, Christopher W., London Health Sciences Centre, London, Ontario, Canada

The assessment of uremic bone disease remains a challenge, with available blood-based markers correlating poorly with gold standard histological assessment of bone. Novel quantitative imaging biomarkers with potential for standardization are needed to avoid the need for bone biopsy studies. Our objective is to initially explore the clinical associations of a novel MRI-based biomarker of bone quality of the tibia in healthy controls, CKD stage 3-5 and HD patients.


10 healthy controls, 38 CKD stage 3 to 5 patients and 15 HD patients underwent MR with 1H+-weighted imaging of the right calf. Acquired images were analyzed as shown in Figure 1 and the tibial cortical-trabecular bone ratio (CTR) was calculated for each subject. CTR values were compared between groups with Student’s t-test for independent samples. Correlation analyses plotting CTR values in different groups against standard blood biomarkers were also run and standard curves interpolated as appropriate.


Refer to Figures 1 and 2.


Worsening renal function is associated with significant reduction in directly image CTR. This may represent a promising imaging biomarker of CKD-MBD and identifies erythropoiesis as being associated with bone quality in CKD patients.

Figure 1: Sample raw and segmented images of the right tibia in a healthy control (A, B), CKD (C, D) and HD patient (E, F).

Figure 2: A decrease in CTR was observed in CKD and HD patients when compared to Controls (A). A weak linear relationship was observed between CTR and Hemoglobin levels in Controls+CKD patients (B) and a polynomial-quadratic relationship was observed in HD patients (C).