Proton density water fraction as a biomarker of bone marrow cellularity: Validation in ex vivo spine specimens

The purpose of this study was to evaluate a magnetic resonance imaging (MRI) technique for quantifying the proton density water fraction (PDWF) as a biomarker of bone marrow cellularity. Thirty-six human bone marrow specimens from 18 donors were excised and subjected to different measurements of tissue composition: PDWF quantification using a multiple gradient echo MRI technique, three biochemical assays (triglyceride, total lipid and water content) and a histological assessment of cellularity. Results showed a strong correlation between PDWF and bone marrow cellularity from histology (r = 0.72). A strong correlation was also found between PDWF and the biochemical assay of water content (r = 0.76). These results suggest the PDWF is a predictor of bone marrow cellularity in tissues and can provide a non-invasive assessment of bone marrow changes in clinical patients undergoing radiotherapy.