Bone strain index reproducibility and soft tissue thickness influence: a dual x-ray photon absorptiometry phantom study

Messina, Carmelo; Piodi, L.; Rinaudo, Luca; Emili, Ilaria; Porro, Francesca; Buonomenna, Ciriaco; Sconfienza, Luca Maria; Vergani, L.; Ulivieri, Fabio Massimo

doi:10.1186/s41747-019-0110-9

Cited by 17 publications

(8 citation statements)

References 22 publications

(21 reference statements)

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“…Usually, BMD reproducibility is known to be very good and typically represents the standard of reference for other DXA-based measurements. This has been recently confirmed by Messina et al BMD reproducibility ranging around 99% in all the densitometric scan modalities, while the reproducibility of BSI is lower than that of BMD being the CoV found between 0.6 and 1.4% and the LSC about three times higher than that of BMD ( 81 , 82 ).…”

Section: Introductionsupporting

confidence: 54%

Beyond Bone Mineral Density: A New Dual X-Ray Absorptiometry Index of Bone Strength to Predict Fragility Fractures, the Bone Strain Index

Ulivieri

Rinaudo²

2021

Front. Med.

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For a proper assessment of osteoporotic fragility fracture prediction, all aspects regarding bone mineral density, bone texture, geometry and information about strength are necessary, particularly in endocrinological and rheumatological diseases, where bone quality impairment is relevant. Data regarding bone quantity (density) and, partially, bone quality (structure and geometry) are obtained by the gold standard method of dual X-ray absorptiometry (DXA). Data about bone strength are not yet readily available. To evaluate bone resistance to strain, a new DXA-derived index based on the Finite Element Analysis (FEA) of a greyscale of density distribution measured on spine and femoral scan, namely Bone Strain Index (BSI), has recently been developed. Bone Strain Index includes local information on density distribution, bone geometry and loadings and it differs from bone mineral density (BMD) and other variables of bone quality like trabecular bone score (TBS), which are all based on the quantification of bone mass and distribution averaged over the scanned region. This state of the art review illustrates the methodology of BSI calculation, the findings of its in reproducibility and the preliminary data about its capability to predict fragility fracture and to monitor the follow up of the pharmacological treatment for osteoporosis.

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Section: Introductionsupporting

confidence: 54%

Beyond Bone Mineral Density: A New Dual X-Ray Absorptiometry Index of Bone Strength to Predict Fragility Fractures, the Bone Strain Index

Ulivieri

Rinaudo²

2021

Front. Med.

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“…In their editorial, Harvey concludes that the use of DXA-derived lean mass indices still does not provide additional risk information when BMD is also considered; further studies are warranted to understand the role of possible use of ASMMI in the FRAX. The possible introduction of newer DXA based tools for evaluating bone strain together with body composition may even provide additional information for fracture risk prediction (40).…”

Section: Performing a Whole Body Dxa Scan: Practical Pointsmentioning

confidence: 99%

Body composition with dual energy X-ray absorptiometry: from basics to new tools

Messina¹,

Albano²,

Gitto³

et al. 2020

Quant Imaging Med Surg

119

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Dual-energy X-ray absorptiometry (DXA) in nowadays considered one of the most versatile imaging techniques for the evaluation of metabolic bone disorders such as osteoporosis, sarcopenia and obesity. The advantages of DXA over other imaging techniques are the very low radiation dose, its accuracy and simplicity of use. In addition, fat mass (FM) and lean mass (LM) values by DXA shows very good accuracy compared to that of computed tomography and magnetic resonance imaging. In this review we will explain the technical working principles of body composition with DXA, together with the possible limitations and pitfalls that should be avoided in daily routine to produce high-quality DXA examinations.We will also cover the current clinical practical application of whole body DXA values, with particular emphasis on the use of LM indices in the diagnostic workup of reduced muscle mass, sarcopenia and osteosarcopenic obesity according to the most recent guidelines. The possible use of adipose indices will be considered, such as the fat mass index (FMI) or the android/gynoid ratio, as well as lipodystrophy indices and the evaluation of visceral adipose tissue (VAT). Whenever available, we will provide possible cut-off diagnostic values for each of these LM and FM indices, according to current literature and guidelines.

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“…Dual energy x-ray absorptiometry (DXA) is the most widely used technique for quantitative bone assessment in clinical practice. Despite this, DXA is not able to assess volumetric bone mineral density (BMD) or bone geometrical parameters [55], which make it less suitable for estimating material properties for finite element modeling. Thus, alternative techniques have been explored to assess bone properties, such as the use of QCT and HR-QCT.…”

Section: Bone Properties From Qct and High-resolution Ctmentioning

confidence: 99%

Image-based biomechanical models of the musculoskeletal system

et al. 2020

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Finite element modeling is a precious tool for the investigation of the biomechanics of the musculoskeletal system. A key element for the development of anatomically accurate, state-of-the art finite element models is medical imaging. Indeed, the workflow for the generation of a finite element model includes steps which require the availability of medical images of the subject of interest: segmentation, which is the assignment of each voxel of the images to a specific material such as bone and cartilage, allowing for a three-dimensional reconstruction of the anatomy; meshing, which is the creation of the computational mesh necessary for the approximation of the equations describing the physics of the problem; assignment of the material properties to the various parts of the model, which can be estimated for example from quantitative computed tomography for the bone tissue and with other techniques (elastography, T1rho, and T2 mapping from magnetic resonance imaging) for soft tissues. This paper presents a brief overview of the techniques used for image segmentation, meshing, and assessing the mechanical properties of biological tissues, with focus on finite element models of the musculoskeletal system. Both consolidated methods and recent advances such as those based on artificial intelligence are described.

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Bone strain index reproducibility and soft tissue thickness influence: a dual x-ray photon absorptiometry phantom study

Cited by 17 publications

References 22 publications

Beyond Bone Mineral Density: A New Dual X-Ray Absorptiometry Index of Bone Strength to Predict Fragility Fractures, the Bone Strain Index

Beyond Bone Mineral Density: A New Dual X-Ray Absorptiometry Index of Bone Strength to Predict Fragility Fractures, the Bone Strain Index

Body composition with dual energy X-ray absorptiometry: from basics to new tools

Image-based biomechanical models of the musculoskeletal system

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