Comparative Assessment of Bone Mineral Measurements Using Dual X-ray Absorptiometry and Peripheral Quantitative Computed Tomography

Formica, Carmelo; Nieves, Jeri W.; Cosman, Felicia; Garrett, Patricia; Lindsay, Robert

doi:10.1007/s001980050092

Cited by 51 publications

(33 citation statements)

References 51 publications

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“…All were greater than the AUCs for BD (0.62 + 0.08) and TBD (0.62 + 0.07) measured using pQCT [43]. This is not in good agreement with the results of our investigation, in which the AUCs for pQCT (Table 4) were similar to those for DXA measurement [43]. This can be partly explained by the difference in the selection criteria of the subjects.…”

Section: Discussioncontrasting

confidence: 74%

Cut-off Values Determined for Vertebral Fracture by Peripheral Quantitative Computed Tomography in Japanese Women

Gorai

Nonaka²,

Kishimoto

et al. 2001

Osteoporos Int

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In spite of the benefits of bone mass measurement by dual-energy X-ray absorptiometry (DXA), the use of DXA has limitations. It is unable to assess a true bone density, and cannot discriminate between the trabecular and cortical bone compartments. Ultradistal radius bone density was measured using peripheral quantitative computed tomography (pQCT) to determine reference values for total bone density (BD), trabecular bone density (TBD), polar strength strain index (pSSI), total bone mineral content (BC), trabecular bone mineral content (TBC), cortical bone density (CBD), cortical bone mineral content (CBC) and polar cross-sectional moment of inertia (pCSMI) in the Japanese female population, and to ascertain the cut-off values of the measured indicators that could most efficiently discriminate osteoporotic subjects with vertebral fractures. A total of 5266 healthy Japanese women aged 20-89 years were included in this study to determine Japanese reference values. Additionally, 621 who had undergone radiographic examination of the thoracic and lumbar spine at the time of pQCT measurement were selected to determine the cut-off values of BD, TBD, pSSI and other indicators for vertebral fractures. All the healthy subjects were divided into 5 year age groups. The BD showed nonsignificant changes from the 20-24 year age group to the 45-49 year age group, and fell significantly thereafter. The TBD maintained a plateau until the 40-44 year group, which corresponds to the young adult mean (YAM) values of the lumbar spine, femoral neck and radius BMDs measured using DXA. The TBD decreased significantly thereafter. The pSSI did not change significantly from the 20-24 year age group to the 45-49 year age group, and decreased slightly in the 50-54 year age group and markedly after 55-59 years. The cut-off values for the discrimination of vertebral fractures were obtained by the calculation of sensitivities, specificities and the area under the curves obtained using age-adjusted receiver operating characteristics (ROC) analysis. Odds ratios and 95% confidence limits (CL) were calculated using age-adjusted logistic analysis. The cut-off values for vertebral fractures, the area under the ROC curves (AUC) and odds ratios were 270.1 mg/cm3 (-2.2 SD, 66.6% of YAM), 0.689+/-0.025, 2.10 (1.63, 2.70) for BD, 104.8 mg/cm3 (-2.2 SD, 53.5% of YAM), 0.699+/-0.023, 2.17 (1.69, 2.77) for TBD and 192.8 mm3 (-1.9 SD, 59.8% of YAM), 0.631+/-0.028, 1.72 (1.34, 2.21) for pSSI, respectively. These findings suggest that ultradistal radius BMD measured using pQCT can be used to discriminate women with vertebral fractures.

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Section: Discussioncontrasting

confidence: 74%

Cut-off Values Determined for Vertebral Fracture by Peripheral Quantitative Computed Tomography in Japanese Women

Gorai

Nonaka²,

Kishimoto

et al. 2001

Osteoporos Int

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“…Quantitative radiographic evaluation using x-rays is used to assess bone structure and mechanical properties indirectly. In particular, quantitative computed tomography (CT), and peripheral CT are used in humans for monitoring and treatment of metabolic diseases, skeletal status, and osteoporosis (7,8). Micro-CT yields more information about bone mass and microstructure, and is used for studies of bone metabolism in animal models (9-11).…”

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confidence: 99%

Bone Regeneration of Hydroxyapatite with Granular Form or Porous Scaffold in Canine Alveolar Sockets

Jang

Kim

Han

et al. 2017

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Abstract. This study was undertaken to assess bone regeneration using hydroxyapatite (HA) Hydroxyapatite (HA) is an alloplastic material commonly used as a bone graft substitute due to inherent bioactive properties that support osteo-conduction. However, a weakness of HA-based biomaterials is their slow degradation and absorption in vivo. The granulated form of calcium phosphate ceramics has a regenerative effect within an alveolar bone defect (1). HA is highly crystalline because of the sintering process and has a larger particle size than bone apatite due to grain growth. These large particles are highly resistant to biodegradation in the body, their osteo-conduction is very low, and they cannot be degraded by osteoclasts (2). The porous HA (pHA) scaffold has good bone regeneration in in vivo performance (3-5). This form of material requires proper size and three-dimensional porosity for demonstrating its intrinsic osteo-conductivity and osteogenic potential within limited and exiguous sites such as dental sockets. An HA scaffold with interconnected pore 300 μm in diameter has the most appropriate osteo-conductive capacity (6). Therefore, we hypothesized that HA types and crystallinity influence the rate of bone healing around alveolar sockets.Bone-filling materials undergo radiological evaluation through determination of the bone mineral density (BMD) and information about bone change. Quantitative radiographic evaluation using x-rays is used to assess bone structure and mechanical properties indirectly. In particular, quantitative computed tomography (CT), and peripheral CT are used in humans for monitoring and treatment of metabolic diseases, skeletal status, and osteoporosis (7,8). Micro-CT yields more information about bone mass and microstructure, and is used for studies of bone metabolism in animal models (9-11). Bone formation and mineralization will affect bone strength; mechanical stability depends on the amount and density of bone (12).The bone-regeneration ability of each bone substitute is evaluated compared to bone metabolic disorders model by BMD, percentage bone volume, and other bone structural parameters. Our study evaluated bone substitutes in the alveolar socket of mandibles of beagle dogs to determine BMD levels by CT and bone parameter values by micro-CT at different time points.In this study, osteogenic potential was compared, focusing on alveolar socket healing and restoration using granular HA (gHA) forms and porous HA (pHA) scaffolds. Tissue engineering methods were assessed by manufacturing functional, aesthetic HAs that would not affect adjacent tooth structures. 335

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“…It appears clear from the work of Grampp et al [21] that the strength of association of bone density with fracture risk varies with the site scanned. However, receiver operator characteristic curve analyses suggest that the variations between techniques at different sites are clinically insigni®cant [22]. Bone density measurements at the potential site of fracture are most strongly predictive of fracture.…”

Section: Discussionmentioning

confidence: 97%

Identification of Women with Reduced Bone Density at the Lumbar Spine and Femoral Neck using BMD at the Os Calcis

Fordham¹,

Chinn

Kumar³

2000

Osteoporosis International

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We assessed the clinical usefulness of bone density measurements at the os calcis as a screening tool to identify patients with low bone density at the lumbar spine and femoral neck. Bone mineral density (BMD) was recorded in 443 women (mean age 60 years) referred to a bone densitometry service. Measurements were made at the lumbar spine and femoral neck using a Lunar DPXL and at the right os calcis using a Peripheral Instantaneous X-ray Imaging (PIXI) dual-energy X-ray absorptiometry system. Average T-scores derived using the manufacturer's data were: 1.59 for the lumbar spine, -1.41 for the femoral neck and -0.87 for the os calcis. The prevalence of osteoporosis using WHO criteria (T-scores of -2.5 or less) was 36% for the lumbar spine or femoral neck but only 9.7% for the os calcis. BMD of the os calcis correlated with that at the lumbar spine (r = 0.69, p < 0.001) and femoral neck (r = 0.67, p < 0.001). The area under the receiver operator characteristics curve was 0.836 (standard error 0.020) for the os calcis related to osteoporosis at the lumbar spine or femoral neck. Optimal accuracy was obtained at a T-score of < or = -1.3 (BMD 0.39 g/cm2) when the sensitivity was 69.6% (95% confidence interval 65.3, 73.9%) and specificity 82.6% (95% confidence interval 79.1, 86.1%). However, the probability of diagnosing low bone density from a given BMD at the os calcis varied by age and site scanned. Accordingly, for informing management strategies, the choice of a single cutoff BMD at the os calcis may not be appropriate and several thresholds may be adopted based on age, the site of interest (lumbar spine or femoral neck) and consideration of associated clinical features. Thus, the use of heel bone density scanners could reduce the number of axial bone density measurements required. The advantages of portability, low cost and shorter scan times should reduce the cost of detection and provide a greater opportunity for identification of women at risk of fracture.

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Comparative Assessment of Bone Mineral Measurements Using Dual X-ray Absorptiometry and Peripheral Quantitative Computed Tomography

Cited by 51 publications

References 51 publications

Cut-off Values Determined for Vertebral Fracture by Peripheral Quantitative Computed Tomography in Japanese Women

Cut-off Values Determined for Vertebral Fracture by Peripheral Quantitative Computed Tomography in Japanese Women

Bone Regeneration of Hydroxyapatite with Granular Form or Porous Scaffold in Canine Alveolar Sockets

Identification of Women with Reduced Bone Density at the Lumbar Spine and Femoral Neck using BMD at the Os Calcis

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