Accurate assessment of precision errors: How to measure the reproducibility of bone densitometry techniques

Glüer, Claus C.; Blake, Glen; Lü, Ying; Blunt, Barbara A.; Jergas, M.; Genant, Harry K.

doi:10.1007/bf01774016

Cited by 1,143 publications

(694 citation statements)

References 12 publications

(10 reference statements)

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“…This study can be considered a first step toward establishing a possible role for TBS in the monitoring of osteoporosis therapy at the individual patient level, which would suppose known precision and LSC. (37) In the present study, the LSC was 3.1% for TBS, leading to 35% of treated patients being above LSC. Precision reported in this study is better than the generally reported precision for LS TBS reported in the literature, which ranges from 1.5% to 2.1%.…”

Section: Discussionmentioning

confidence: 42%

Effects of zoledronate versus placebo on spine bone mineral density and microarchitecture assessed by the trabecular bone score in postmenopausal women with osteoporosis: A three-year study

Popp

Guler

Lamy

et al. 2012

Journal of Bone and Mineral Research

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The trabecular bone score (TBS) is an index of bone microarchitectural texture calculated from anteroposterior dual-energy X-ray absorptiometry (DXA) scans of the lumbar spine (LS) that predicts fracture risk, independent of bone mineral density (BMD). The aim of this study was to compare the effects of yearly intravenous zoledronate (ZOL) versus placebo (PLB) on LS BMD and TBS in postmenopausal women with osteoporosis. Changes in TBS were assessed in the subset of 107 patients recruited at the Department of Osteoporosis of the University Hospital of Berne, Switzerland, who were included in the HORIZON trial. All subjects received adequate calcium and vitamin D3. In these patients randomly assigned to either ZOL (n ¼ 54) or PLB (n ¼ 53) for 3 years, BMD was measured by DXA and TBS assessed by TBS iNsight (v1.9) at baseline and 6, 12, 24, and 36 months after treatment initiation. Baseline characteristics (mean AE SD) were similar between groups in terms of age, 76.8 AE 5.0 years; body mass index (BMI), 24.5 AE 3.6 kg/m 2 ; TBS, 1.178 AE 0.1 but for LS T-score (ZOL-2.9 AE 1.5 versus PLB-2.1 AE 1.5). Changes in LS BMD were significantly greater with ZOL than with PLB at all time points (p < 0.0001 for all), reaching þ9.58% versus þ1.38% at month 36. Change in TBS was significantly greater with ZOL than with PLB as of month 24, reaching þ1.41 versus-0.49% at month 36; p ¼ 0.031, respectively. LS BMD and TBS were weakly correlated (r ¼ 0.20) and there were no correlations between changes in BMD and TBS from baseline at any visit. In postmenopausal women with osteoporosis, once-yearly intravenous ZOL therapy significantly increased LS BMD relative to PLB over 3 years and TBS as of 2 years. ß

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Section: Discussionmentioning

confidence: 42%

Effects of zoledronate versus placebo on spine bone mineral density and microarchitecture assessed by the trabecular bone score in postmenopausal women with osteoporosis: A three-year study

Popp

Guler

Lamy

et al. 2012

Journal of Bone and Mineral Research

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“…This registration procedure was previously used to demonstrate the high test-retest reliability and intrareader variability of our procedure (36). The reproducibility for knee cartilage volume measurements was further analyzed using the coefficient of 478 RAYNAULD ET AL variation of 4 intraobserver, interscan, and image acquisition in 1 session values for 8 healthy subjects (ages 25-35 years) and 8 subjects with knee OA (ages 55-65 years; Kellgren/Lawrence OA grade 2 or 3) using the root mean square (RMS) coefficient of variation percentage (CV%), as previously suggested (59). Difference-maps between baseline and acquisitions at 6, 12, 18, and 24 months were blinded for the time point that was being assessed.…”

Section: Methodsmentioning

confidence: 99%

Quantitative magnetic resonance imaging evaluation of knee osteoarthritis progression over two years and correlation with clinical symptoms and radiologic changes

Raynauld¹,

Martel‐Pelletier²,

Berthiaume³

et al. 2004

Arthritis & Rheumatism

238

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Objective. To evaluate the change in osteoarthritic (OA) knee cartilage volume over a two-year period with the use of magnetic resonance imaging (MRI) and to correlate the MRI changes with radiologic changes.Methods. Thirty-two patients with symptomatic knee OA underwent MRI of the knee at baseline and at 6, 12, 18, and 24 months. Loss of cartilage volumes were computed and contrasted with changes in clinical variables for OA and with standardized semiflexed knee radiographs at baseline at 1 and 2 years.Results. Progression of cartilage loss at all followup points was statistically significant (P < 0.0001), with a mean ؎ SD of 3.8 ؎ 5.1% for global cartilage loss and 4.3 ؎ 6.5% for medial compartment cartilage loss at 6 months, 3.6 ؎ 5.1% and 4.2 ؎ 7.5% at 12 months, and 6.1 ؎ 7.2% and 7.6 ؎ 8.6% at 24 months. Discriminant function analysis identified 2 groups of patients, those who progressed slowly (<2% of global cartilage loss; n ‫؍‬ 21) and those who progressed rapidly (>15% of global cartilage loss; n ‫؍‬ 11) over the 2 years of study. At baseline, there was a greater proportion of women (P ‫؍‬ 0.001), a lower range of motion (P ‫؍‬ 0.01), a greater circumference and higher level of pain (P ‫؍‬ 0.05) and stiffness in the study knee, and a higher body mass index in the fast progressor group compared with the slow progressor group. No statistical correlation between loss of cartilage volume and radiographic changes was seen.Conclusion. Quantitative MRI can measure the progression of knee OA precisely and can help to identify patients with rapidly progressing disease. These findings indicate that MRI could be helpful in assessing the effects of treatment with structure-modifying agents in OA.In people over the age of 60 years, osteoarthritis (OA) is a common cause of disability. Assessment of cartilage damage is important for monitoring disease progression and evaluating therapeutic response in OA. For many years, clinical studies of drug interventions in symptomatic knee OA have focused specifically on clinical parameters, such as pain and joint function, without assessing the effect of treatment on structural changes caused by the disease or the role of treatment in preventing cartilage degradation. Serial radiographs of affected joints appear to be a logical means of documenting the progression of OA over time (1), provided that a validated, reliable, and easily reproducible technique is used (2-5).

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“…Thus, the femoral bone structure variations close to the joint line, as quantified by the slope direction, appeared to be indicative of the disease extent in advanced OA patients. Reproducibility of the technique, including scan and quantification processes, was assessed using the coefficient of variation (26). The reproducibility of the image acquisition and segmentation with quantification of bone structure parameters in the femur (region R2) was 5.4, 2.9, 2.7, and 5.2% for BV/TV, Tb.N, Tb.Th, and Tb.Sp, respectively, and 4.0, 3.3, 1.4, and 4.6% in the tibia (region R1).…”

Section: As Shown Inmentioning

confidence: 99%

Magnetic resonance imaging of normal and osteoarthritic trabecular bone structure in the human knee

Beuf¹,

Ghosh²,

Newitt³

et al. 2002

Arthritis & Rheumatism

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Objective. To use high-resolution magnetic resonance imaging (MRI) to evaluate the trabecular bone structure in the distal femur and the proximal tibia and its to correlate the findings with different stages of osteoarthritis (OA) of the human knee.Methods. Axial images of the distal femur and proximal tibia were obtained at 1.5 T in patients without and with mild OA and with severe OA. The spatial resolution was 195 ؋ 195 m 2 with a 1-mm slice thickness. Apparent measures of trabecular bone volume fraction (BV/TV), trabecular number (Tb.N), trabecular separation (Tb.Sp), and trabecular thickness (Tb.Th) were calculated.Results. Significant differences existed in the trabecular bone structure of the femur and tibia. Differences in trabecular bone structure between the tibia and the femur decreased with the degree of OA. The apparent BV/TV, Tb.N, and Tb.Sp in the femoral condyles could be used to differentiate healthy patients or patients with mild OA from patients with severe OA (P < 0.05). Among individuals, the structural variation of the lateral and medial femoral condyle was indicative of the extent of the disease.Conclusion. High-resolution MRI of the knee joint can provide a noninvasive assessment of trabecular bone structure. Trabecular bone structure, determined by high-resolution MRI, shows significant variation in patients with varying degrees of OA. The impact of OA on trabecular bone is different in the tibia than in the femur, and this difference depends on the extent of the disease.Osteoarthritis (OA) is a multifactorial disease characterized by the progressive loss of articular hyaline cartilage and the development of altered joint congruency, subchondral sclerosis, intraosseous cysts, and osteophytes. It affects about 14% of the adult population (1) and is the second most common cause of permanent disability among subjects over the age of 50 years (2). In addition to changes in articular cartilage that occur in OA, it has been suggested that early changes are seen in the adjoining subchondral and trabecular bone (3).In a guinea pig model, Layton et al (4) observed with microscopic computed tomography (CT) that an initial loss of trabecular bone volume fraction and thinning of trabeculae was followed, in the advanced stages of OA, by an increase of trabecular bone volume fraction via eventual thickening of trabeculae. In a canine OA model induced by anterior cruciate ligament (ACL) transection, Dedrick et al (5) demonstrated an increase in subchondral bone thickness, accompanied by a decrease in trabecular thickness. Using magnification radiographs of humans, Lynch et al (6) showed an increase in the horizontal trabecular thickness of the tibia in early OA, followed by an increase in vertical connectivity of trabeculae in advanced disease. More recently, Buckland-Wright and colleagues (7) showed that the structural changes in the trabecular bone microarchitecture in patients with ACL ruptures are detectable by fractal analysis of radiographs, well before joint space narrowing and other radiologic ...

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Accurate assessment of precision errors: How to measure the reproducibility of bone densitometry techniques

Cited by 1,143 publications

References 12 publications

Effects of zoledronate versus placebo on spine bone mineral density and microarchitecture assessed by the trabecular bone score in postmenopausal women with osteoporosis: A three-year study

Effects of zoledronate versus placebo on spine bone mineral density and microarchitecture assessed by the trabecular bone score in postmenopausal women with osteoporosis: A three-year study

Quantitative magnetic resonance imaging evaluation of knee osteoarthritis progression over two years and correlation with clinical symptoms and radiologic changes

Magnetic resonance imaging of normal and osteoarthritic trabecular bone structure in the human knee

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