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All MRI examinations were performed at 1.5\u00a0T. VBQ and FBQ were obtained using manually placed circular ROIs. FBQ was derived from coronal T1-weighted images using two approaches: femoroacetabular joint fluid (FBQfa) and cerebrospinal fluid (FBQcsf). Interobserver reproducibility was assessed using intraclass correlation coefficient (ICC). Correlations with DXA\n                      <jats:italic>T<\/jats:italic>\n                      -scores and diagnostic performance for osteoporosis were analyzed using Pearson coefficients and ROC curves.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 248 patients, VBQ demonstrated excellent reproducibility (ICC\u2009=\u20090.922) and a weak-to-moderate negative correlation with DXA\n                      <jats:italic>T<\/jats:italic>\n                      -scores (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009\u22120.307;\n                      <jats:italic>p\u2009<\/jats:italic>\n                      &lt;\u20090.001). VBQ values increased across DXA bone density categories, with an optimal cutoff of 3.61 for osteoporosis (AUC\u2009=\u20090.71). FBQcsf showed high reproducibility (ICC\u2009=\u20090.874) compared with FBQfa (ICC\u2009=\u20090.462) but no evidence of correlation with DXA (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.151). FBQcsf distinguished normal BMD from osteopenia (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002) and, after adjustment for age and sex, also differentiated patients with osteopenia from those with osteoporosis (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.011).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>VBQ can serve as an opportunistic exploratory screening marker of low BMD. FBQcsf may complement VBQ by identifying early marrow-related changes, although further validation is required.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00256-026-05330-z","type":"journal-article","created":{"date-parts":[[2026,8,8]],"date-time":"2026-08-08T00:02:36Z","timestamp":1786147356000},"page":"2953-2965","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Routine MRI for opportunistic osteoporosis screening: diagnostic accuracy of vertebral bone quality and a novel femoral bone quality score compared with DXA"],"prefix":"10.1007","volume":"55","author":[{"given":"Margrit Elis","family":"M\u00fcller","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo\u00e3o Paulo Colhado","family":"Ferreira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura Mulazzani Minuzzi","family":"Macedo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akemi","family":"Osawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonardo Kazunori","family":"Tsuji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daisy Terumi","family":"Kase","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas Kenzo","family":"Miyahara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9 Yui","family":"Aihara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0649-3662","authenticated-orcid":false,"given":"Adham","family":"do Amaral e Castro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,8]]},"reference":[{"issue":"10169","key":"5330_CR1","doi-asserted-by":"publisher","first-page":"364","DOI":"10.1016\/S0140-6736(18)32112-3","volume":"393","author":"JE Compston","year":"2019","unstructured":"Compston JE, McClung MR, Leslie WD. 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