Challenges in longitudinal measurements with HR-pQCT: Evaluation of a 3D registration method to improve bone microarchitecture and strength measurement reproducibility

Ellouz, Rafaa; Chapurlat, Roland; Rietbergen, B. van; Christen, Patrik; Pialat, Jean‐Baptiste; Boutroy, Stéphanie

doi:10.1016/j.bone.2014.03.001

Cited by 77 publications

(64 citation statements)

References 52 publications

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“…They found that the short-and long-term reproducibility error for the stiffness calculated from micro-FE analyses at the radius was less than 2.4%, whereas for the tibia this was less than 3.6%. This is in good agreement with results for a recent publication that investigated the short term reproducibility for 15 subjects scanned three times (Ellouz et al, 2014). In that study a reproducibility error in the stiffness of less than 3.6% was found for the radius and of less than 2.3% for the tibia.…”

Section: How Reproducible Are the Results?supporting

confidence: 91%

A survey of micro-finite element analysis for clinical assessment of bone strength: The first decade

Rietbergen

Ito

2015

Journal of Biomechanics

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Section: How Reproducible Are the Results?supporting

confidence: 91%

A survey of micro-finite element analysis for clinical assessment of bone strength: The first decade

Rietbergen

Ito

2015

Journal of Biomechanics

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“…To remove noise, only changes leading to a cluster of a minimum of 30 voxels were included. The threshold and cluster size parameters were chosen based on running the image analysis on the in vivo shortterm reproducibility dataset in such a way that the resorption and formation were below 2.5% of the total number of bone voxels at baseline, which is consistent with the reproducibility of in vivo HR-pQCT 37 . The image-processing algorithm was implemented using Image Processing Language (IPL, Scanco Medical AG).…”

Section: Discussionmentioning

confidence: 81%

“…First, the method to identify sites of bone remodelling might as well include differences between baseline and follow-up images that are not due to bone remodelling but due to movement artefacts of the scanning or registration inaccuracies. The high reproducibility of in vivo HR-pQCT 37 , however, indicates that microstructural changes can be identified well. And second, tissue loading is calculated based on an estimated loading history.…”

Section: Discussionmentioning

confidence: 99%

“…1b). It was recently investigated that the presented three-dimensional registration method provides accurate results based on in vivo HR-pQCT images 37 . Individual voxel densities of the common region of the registered images were subtracted voxel by voxel and a change in density below or above 225 mg HA per ccm was defined as resorption and formation, respectively.…”

Section: Discussionmentioning

confidence: 99%

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Bone remodelling in humans is load-driven but not lazy

et al. 2014

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During bone remodelling, bone cells are thought to add and remove tissue at sites with high and low loading, respectively. To predict remodelling, it was proposed that bone is removed below and added above certain thresholds of tissue loading and within these thresholds, called a 'lazy zone', no net change in bone mass occurs. Animal experiments linking mechanical loading with changes in bone density or microstructure support load-adaptive bone remodelling, while in humans the evidence for this relationship at the micro-scale is still lacking. Using new high-resolution CT imaging techniques and computational methods, we quantify microstructural changes and physiological tissue loading in humans. Here, we show that bone remodelling sites in healthy postmenopausal women strongly correlate with tissue loading following a linear relationship without a 'lazy zone' providing unbiased evidence for load-driven remodelling in humans. This suggests that human and animal bones both react to loading induced remodelling in a similar fashion.

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“…The high subject-specific ICCs between 0.98 and 0.99 are, however, comparable to these in vitro studies (table 1). In vivo reproducibility of morphometric parameters and stiffness were reported to be less than 4.5% [18,20,41] and 3.5% [20,41], respectively. For the load estimation algorithm, we found in vivo PEs between 3.6% and 10.2%, showing comparable values to these previous in vivo studies for one load case and higher values for the other two load cases (table 2 and figure 4).…”

Section: Discussionmentioning

confidence: 99%

Voxel size dependency, reproducibility and sensitivity of an in vivo bone loading estimation algorithm

Christen

Schulte

Zwahlen

et al. 2016

J. R. Soc. Interface.

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ResearchCite this article: Christen P et al. 2016 Voxel size dependency, reproducibility and sensitivity of an in vivo bone loading estimation algorithm. J. R. Soc. A bone loading estimation algorithm was previously developed that provides in vivo loading conditions required for in vivo bone remodelling simulations. The algorithm derives a bone's loading history from its microstructure as assessed by high-resolution (HR) computed tomography (CT). This reverse engineering approach showed accurate and realistic results based on micro-CT and HR-peripheral quantitative CT images. However, its voxel size dependency, reproducibility and sensitivity still need to be investigated, which is the purpose of this study. Voxel size dependency was tested on cadaveric distal radii with micro-CT images scanned at 25 mm and downscaled to 50, 61, 75, 82, 100, 125 and 150 mm. Reproducibility was calculated with repeated in vitro as well as in vivo HR-pQCT measurements at 82 mm. Sensitivity was defined using HR-pQCT images from women with fracture versus non-fracture, and low versus high bone volume fraction, expecting similar and different loading histories, respectively. Our results indicate that the algorithm is voxel size independent within an average (maximum) error of 8.2% (32.9%) at 61 mm, but that the dependency increases considerably at voxel sizes bigger than 82 mm. In vitro and in vivo reproducibility are up to 4.5% and 10.2%, respectively, which is comparable to other in vitro studies and slightly higher than in other in vivo studies. Subjects with different bone volume fraction were clearly distinguished but not subjects with and without fracture. This is in agreement with bone adapting to customary loading but not to fall loads. We conclude that the in vivo bone loading estimation algorithm provides reproducible, sensitive and fairly voxel size independent results at up to 82 mm, but that smaller voxel sizes would be advantageous.

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Challenges in longitudinal measurements with HR-pQCT: Evaluation of a 3D registration method to improve bone microarchitecture and strength measurement reproducibility

Cited by 77 publications

References 52 publications

A survey of micro-finite element analysis for clinical assessment of bone strength: The first decade

A survey of micro-finite element analysis for clinical assessment of bone strength: The first decade

Bone remodelling in humans is load-driven but not lazy

Voxel size dependency, reproducibility and sensitivity of an in vivo bone loading estimation algorithm

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