Formation Dominates Resorption With Increasing Mineralized Density and Time Postfracture in Cortical but Not Trabecular Bone: A Longitudinal <scp>HRpQCT</scp> Imaging Study in the Distal Radius

Atkins, Penny R.; Stock, Kerstin; Ohs, Nicholas; Collins, Caitlyn J.; Horling, Lukas; Benedikt, Stefan; Degenhart, Gerald; Lippuner, Kurt; Blauth, M.; Christen, Patrik; Müller, Ralph

doi:10.1002/jbm4.10493

Cited by 7 publications

(11 citation statements)

References 39 publications

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“…Combined, these results indicate that both quality and quantity drive formation and resorption volume fractions, however the specifics of this effect are difficult to quantify in this small and heterogenous cohort. Previous studies evaluating bone remodeling have not evaluated results with respect to morphometrics and densitometrics 29,30,36 , but instead found a relationship between remodeling and age 37 . However, since bone quality and quantity often decrease with age, these previous observations may indirectly support our findings.…”

Section: Discussionmentioning

confidence: 98%

“…Further, the ability to track changes in the cortical and trabecular compartments has revealed both age-related [24][25][26] and disease-specific characteristics 6,26-28 not previously realized using regional DXA-based measures. However, the regional and tissue-level measures do not fully capitalize on the capabilities of HR-pQCT, which when combined with a longitudinal imaging protocol include microstructural analysis of bone remodeling 29 through dynamic morphometry which allows for the direct quantification of bone formation and resorption and of the association of this remodeling with the mechanical loading of the bone, i.e. mechanoregulation 30,31 .…”

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confidence: 99%

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Clinical observation of diminished bone quality and quantity through longitudinal HR-pQCT-derived remodeling and mechanoregulation

Collins

Atkins

Ohs

et al. 2022

Sci Rep

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High resolution peripheral quantitative computed tomography (HR-pQCT) provides methods for quantifying volumetric bone mineral density and microarchitecture necessary for early diagnosis of bone disease. When combined with a longitudinal imaging protocol and finite element analysis, HR-pQCT can be used to assess bone formation and resorption (i.e., remodeling) and the relationship between this remodeling and mechanical loading (i.e., mechanoregulation) at the tissue level. Herein, 25 patients with a contralateral distal radius fracture were imaged with HR-pQCT at baseline and 9–12 months follow-up: 16 patients were prescribed vitamin D3 with/without calcium supplement based on a blood biomarker measures of bone metabolism and dual-energy X-ray absorptiometry image-based measures of normative bone quantity which indicated diminishing (n = 9) or poor (n = 7) bone quantity and 9 were not. To evaluate the sensitivity of this imaging protocol to microstructural changes, HR-pQCT images were registered for quantification of bone remodeling and image-based micro-finite element analysis was then used to predict local bone strains and derive rules for mechanoregulation. Remodeling volume fractions were predicted by both average values of trabecular and cortical thickness and bone mineral density (R2 > 0.8), whereas mechanoregulation was affected by dominance of the arm and group classification (p < 0.05). Overall, longitudinal, extended HR-pQCT analysis enabled the identification of changes in bone quantity and quality too subtle for traditional measures.

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Section: Discussionmentioning

confidence: 98%

mentioning

confidence: 99%

Clinical observation of diminished bone quality and quantity through longitudinal HR-pQCT-derived remodeling and mechanoregulation

Collins

Atkins

Ohs

et al. 2022

Sci Rep

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“…Combined, these results indicate that both quality and quantity drive formation and resorption volume fractions, with subtle differences in this effect among the three groups. Previous studies evaluating bone remodeling have not evaluated results with respect to morphometrics and densitometrics 30,31,37 , but instead found a relationship between remodeling and age 38 .…”

Section: Discussionmentioning

confidence: 98%

“…and greatest volume of overlap were used to assess bone formation, resorption, and quiescence. As previously described 30 , the earlier of the two images was transformed using cubic interpolation to be aligned with the imaging coordinate system using the SciPy function library in Python 49,50 . The later of the two images was then rigidly registered and transformed to align with the earlier image using a pyramid-based approach optimized relative to the mean squared error between the two images 51 .…”

Section: Dynamic Morphometrymentioning

confidence: 99%

“…Further, the ability to track changes in the cortical and trabecular compartments has revealed both age-related 24–26 and disease-specific characteristics 26–29 not previously realized using regional DXA-based measures. However, the regional and tissue-level measures do not fully capitalize on the capabilities of HR-pQCT, which when combined with a longitudinal imaging protocol include microstructural analysis of bone remodeling 30 and mechanoregulation 31,32 . To date, the ability of such longitudinal, extended HR-pQCT analysis tools to detect clinically relevant changes in bone quality and quantity has yet to be thoroughly investigated.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Observation of Diminished Bone Quality and Quantity through Longitudinal HR-pQCT-derived Remodeling and Mechanoregulation

Collins

Ohs

Blauth

et al. 2022

Preprint

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Current clinical methods used to evaluate bone quality and quantity are insufficient for clinical evaluation of microstructural bone health, which is relevant in early diagnosis of bone disease. High resolution peripheral quantitative computed tomography (HR-pQCT) has recently emerged as a potential clinical tool for quantifying volumetric bone mineral density and microarchitecture. When combined with a longitudinal imaging protocol and finite element analysis, HR-pQCT can be used to assess bone remodeling and mechanoregulation at the tissue level. Herein, 25 patients with a contralateral distal radius fracture were imaged with HR-pQCT at baseline and 9-12 months follow-up: 16 patients were prescribed Calcium and/or Vitamin D supplement with indication of diminishing (n=9) or poor (n=7) bone quantity and 9 were not. To evaluate the sensitivity of this imaging protocol to microstructural changes, HR-pQCT images were registered for quantification of bone remodeling and image-based micro-finite element (micro-FE) analysis was then used to predict local bone strains and derive rules for bone mechanoregulation. Remodeling was predicted by both trabecular and cortical thickness and bone mineral density (R2>0.8), whereas mechanoregulation was affected by dominance of the arm and group classification (p<0.05). Overall, longitudinal HR-pQCT proved value in long-term patient evaluation and management of bone health.

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Image Registration in Longitudinal Bone Assessment Using Computed Tomography

Han

Durongbhan

Davey

et al. 2023

Curr Osteoporos Rep

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Purpose of Review Rigid image registration is an important image processing tool for the assessment of musculoskeletal chronic disease. In this paper, we critically review applications of rigid image registration in terms of similarity measurement methods over the past three years (2019–2022) in the context of monitoring longitudinal changes to bone microstructure and mechanical properties using computed tomography. This review identifies critical assumptions and trade-offs underlying different similarity measurement methods used in image registration and demonstrates the effect of using different similarity measures on registration outcomes. Recent Findings Image registration has been used in recent studies for: correcting positional shifts between longitudinal scans to quantify changes to bone microstructural and mechanical properties over time, developing registration-based workflows for longitudinal assessment of bone properties in pre-clinical and clinical studies, and developing and validating registration techniques for longitudinal studies. Summary In evaluating the recent literature, it was found that the assumptions at the root of different similarity measures used in rigid image registration are not always confirmed and reported. Each similarity measurement has its advantages and disadvantages, as well as underlying assumptions. Breaking these assumptions can lead to poor and inaccurate registration results. Thus, care must be taken with regards to the choice of similarity measurement and interpretation of results. We propose that understanding and verifying the assumptions of similarity measurements will enable more accurate and efficient quantitative assessments of structural changes over time.

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Formation Dominates Resorption With Increasing Mineralized Density and Time Postfracture in Cortical but Not Trabecular Bone: A Longitudinal HRpQCT Imaging Study in the Distal Radius

Abstract: This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process which may lead to differences between this version and the Version of Record. Please cite this article as

Cited by 7 publications

References 39 publications

Clinical observation of diminished bone quality and quantity through longitudinal HR-pQCT-derived remodeling and mechanoregulation

Clinical observation of diminished bone quality and quantity through longitudinal HR-pQCT-derived remodeling and mechanoregulation

Clinical Observation of Diminished Bone Quality and Quantity through Longitudinal HR-pQCT-derived Remodeling and Mechanoregulation

Image Registration in Longitudinal Bone Assessment Using Computed Tomography

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