{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T04:16:57Z","timestamp":1773893817426,"version":"3.50.1"},"reference-count":28,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T00:00:00Z","timestamp":1767312000000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Medical Physics"],"published-print":{"date-parts":[[2026,1]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n This study investigated the use of diffusion MRI models for diagnosing osteoporosis in women. Traditional methods, like DXA, struggle to assess bone quality. The research found that CTRW and FROC models effectively distinguished between healthy and osteoporotic bones, offering a promising approach for bone quality assessment and fracture risk prediction.<\/jats:p>\n <\/jats:sec>\n \n Purpose<\/jats:title>\n This study aims to evaluate the diagnostic efficacy of the conventional diffusion\u2010weighted imaging (DWI), continuous\u2010time random walk (CTRW), and fractional order calculus (FROC) models for osteoporosis in women.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n A total of 131 women with an average age of 60.6 \u00b1 8.5 years underwent magnetic resonance imaging (MRI) and dual\u2010energy X\u2010ray absorptiometry (DXA) of the lumbar spine. Diffusion metrics were derived from regions of interest (ROIs) on the b = 0 map, and applied to the quantitative map of conventional DWI (ADC), CTRW (\n \u03b1<\/jats:italic>\n CTRW<\/jats:sub>\n ,\n \u03b2<\/jats:italic>\n CTRW<\/jats:sub>\n , and\n D<\/jats:italic>\n CTRW<\/jats:sub>\n ), and FROC (\n \u00b5<\/jats:italic>\n FROC<\/jats:sub>\n ,\n \u03b2<\/jats:italic>\n FROC<\/jats:sub>\n , and\n D<\/jats:italic>\n FROC<\/jats:sub>\n ) models. These metrics were compared among three groups of normal, osteopenia, and osteoporosis subjects. Receiver operating characteristic (ROC) curves evaluated their diagnostic performance, and Spearman correlation assessed the relationship between diffusion parameters and clinical factors.\n P<\/jats:italic>\n < 0.05 was considered statistically significant.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n ADC,\n D<\/jats:italic>\n CTRW<\/jats:sub>\n ,\n D<\/jats:italic>\n FROC<\/jats:sub>\n , and\n \u00b5<\/jats:italic>\n FROC<\/jats:sub>\n values were significantly different in the osteoporosis and osteopenia groups compared to the normal group (\n p<\/jats:italic>\n = 0.001 \u223c 0.014). The\n D<\/jats:italic>\n CTRW<\/jats:sub>\n and\n D<\/jats:italic>\n FROC<\/jats:sub>\n metrics exhibited superior diagnostic performance, with the areas under the ROC curves (AUC) values of 0.699 and 0.697, respectively, surpassing the AUC of the conventional ADC of 0.687. Furthermore, a composite model combining\n \u03b1<\/jats:italic>\n CTRW<\/jats:sub>\n ,\n \u03b2<\/jats:italic>\n CTRW<\/jats:sub>\n , and\n D<\/jats:italic>\n CTRW<\/jats:sub>\n achieved an AUC of 0.722 for differentiating between the normal and osteoporosis groups, outperforming individual diffusion metrics and the combined FROC model. Moreover, Spearman correlations analysis showed that ADC,\n D<\/jats:italic>\n CTRW<\/jats:sub>\n ,\n D<\/jats:italic>\n FROC<\/jats:sub>\n and\n \u00b5<\/jats:italic>\n FROC<\/jats:sub>\n metrics exhibited significant correlation with FRAX (Fracture Risk Assessment Tool) scores.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n The CTRW diffusion metrics demonstrate significant potential as biomarkers for osteoporosis diagnosis in women, offering a valuable method for assessing bone quality and predicting fracture risk.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/mp.70112","type":"journal-article","created":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T13:25:42Z","timestamp":1767360342000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluating the feasibility of diffusion models for diagnosis of osteoporosis in women: A clinical diagnostic analysis of DWI, CTRW, and FROC diffusion models"],"prefix":"10.1002","volume":"53","author":[{"given":"Shuo","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Nuclear Medicine the First Affiliated Hospital of Dalian Medical University Dalian Liaoning China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yifan","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging Dalian Medical University Dalian Liaoning China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Information Center the First Affiliated Hospital of Dalian Medical University Dalian Liaoning China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaofan","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Scientific Research Beijing United Imaging Research Institute of Intelligent Imaging Beijing 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