AUTHOR=Wan Taihu , Zhu Yuhang , Han Qinghe , Liu Lin 

TITLE=Changes in Vertebral Marrow Fat Fraction Using 3D Fat Analysis & Calculation Technique Imaging Sequence in Aromatase Inhibitor-Treated Breast Cancer Women

JOURNAL=Frontiers in Endocrinology

VOLUME=Volume 13 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2022.931231

DOI=10.3389/fendo.2022.931231

ISSN=1664-2392

ABSTRACT=Aromatase inhibitor (AI) is a cornerstone drug for postmenopausal women with estrogen receptor-positive early-stage breast cancer. Fat-bone interactions within the bone marrow milieu are growing areas of scientific interest. Although AIs treatment could lead to deterioration of skeleton, the association between AI medication and subsequent marrow adiposity remains elusive. A total of forty postmenopausal, early-staged, and hormone receptor-positive breast cancer patients who underwent treatment with adjuvant AIs and forty matched controls were included. Marrow proton density fat fraction (PDFF) at the L1−L4 vertebral bodies using 3D Fat Analysis & Calculation Technique imaging (FACT) sequence at 3.0T, bone mineral density (BMD) by dual energy x-ray absorptiometry, and serum bone turnover biomarkers were determined at baseline, and at 6, 12 months. We found that, in comparison to baseline, an increase of type I collagen cross-linked telopeptide was detected at 12 months (P <0.05). From baseline to 12 months, the PDFF measured using FACT was greatly increased. At 12 months, the median percent change of PDFF (4.9% vs 0.9%, P <0.05) were significantly different between the AIs treatments and controls. The same trend was observed for the marrow PDFF at 6 months relative to the respective values at baseline. Although BMD values were significantly reduced after 12 months in AIs-treated women, changes of BMD vs baseline condition were not significantly different between the AIs-treated and control groups [Δ BMD −1.6% to −1.8% vs −0.3% to −0.6%, respectively, P > 0.05]. In the AIs-treated group, Δ PDFF was associated with Δ BMD at the lumbar spine (r = −0.585, P < 0.001), but not in the controls. Taken together, over a 12-month period, spinal marrow fat content assessed with FACT sequence significantly increased in postmenopausal women with hormone-receptor-positive breast cancer receiving AIs treatment.