Objective:　To　develop　a　novel　magnetic　resonance　imaging　(MRI)　phantom　for　producing　F-score　(for　fat)　and　W-score　(for　water)　and　to　evaluate　the　performance　of　these　scores　in　assessing　osteoporosis　and　related　vertebral　fractures.　Materials　and　methods:　First,　a　real-time　phantom　consisting　of　oil　and　water　tubes　was　manufactured.　Then,　30　female　volunteers　(age:　62.3　±　6.3 years)　underwent　lumbar　spine　examination　with　MRI　(using　a　novel　phantom)　and　dual-energy　X-ray　absorptiometry　(DXA),　following　ethical　approval.　MRI　phantom-based　F-score　and　W-score　were　defined　by　normalizing　the　vertebral　signal　intensities　(SIs)　by　the　oil　and　water　SIs　of　the　phantom　on　T1-　and　T2-weighted　images,　respectively.　The　diagnostic　performances　of　the　new　scores　for　assessing　osteoporosis　and　vertebral　fractures　were　examined　using　receiver　operating　characteristic　analysis　and　compared　with　DXA-measured　areal　bone　mineral　density　(DXA-aBMD).　Results:　The　F-score　and　W-score　were　greater　in　the　osteoporotic　patients　(3.93　and　2.29)　than　the　non-osteoporotic　subjects　(3.05　and　1.79)　and　achieved　AUC　values　of　0.85　and　0.74　(p　＜　0.05),　respectively,　when　detecting　osteoporosis.　Similarly,　F-score　and　W-score　had　greater　values　for　the　fracture　patients　(3.94　and　2.53)　than　the　non-fracture　subjects　(3.14　and　1.69)　and　produced　better　AUC　values　(0.90　for　W-score　and　0.79　for　F-score)　compared　to　DXA-aBMD　(AUC:　0.27,　p　＜　0.05).　In　addition, the　F-score　and　W-score　had　a　strong　correlation　(r　=　0.77;　p　＜　0.001).　Conclusion:　A　novel　real-time　lumber　spine　MRI　phantom　was　developed,　based　upon　which　newly　defined　F-score　and　W-score　were　able　to　detect　osteoporosis　and　demonstrated　an　improved　ability　over　DXA-aBMD　in　differentiating　patients　with　vertebral　fractures.　©　Italian　Society　of　Medical　Radiology　2024.