Human trabecular bone microarchitecture can be assessed independently of density with second generation HR-pQCT

Manske, Sarah L.; Zhu, Ying; Sandino, Clara; Boyd, Steven K.

doi:10.1016/j.bone.2015.06.006

Cited by 142 publications

(118 citation statements)

References 36 publications

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“…For XCTII, we calculated Tb.BV/TV (%) as the ratio of voxels in the mineralized bone phase to the total number of voxels in the trabecular region. We assessed Tb.Th (mm) and Tb.Sp (mm) directly using voxel‐based measurements using the distance transformation . We also calculated trabecular BMD (Tb.BMD, mgHA/cm 3 ) and trabecular area (Tb.Ar, mm 2 ).…”

Section: Methodsmentioning

confidence: 99%

“…Over the last decade, high‐resolution peripheral quantitative computed tomography (HR‐pQCT) has been increasingly used in clinical research to assess three‐dimensional bone macro‐ and microarchitecture as well as density in monitoring bone quality and predicting bone strength of the ultradistal radius and tibia. We recently found that the improved spatial resolution second‐generation HR‐pQCT (XtremeCTII, Scanco Medical, Bruttisellen, Switzerland) with nominal isotropic voxel sizes of 60.7 μm allows accurate, direct assessment of trabecular microarchitecture . In contrast, one of the major limitations with the first‐generation scanner was the requirement to derive trabecular microarchitecture because of its nominal isotropic resolution (82 μm) .…”

Section: Introductionmentioning

confidence: 99%

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The Estimation of Second-Generation HR-pQCT From First-Generation HR-pQCT Using In Vivo Cross-Calibration

Manske

Davison

Burt

et al. 2017

Journal of Bone and Mineral Research

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Second-generation high-resolution peripheral quantitative computed tomography (HR-pQCT) provides the highest resolution in vivo to assess bone density and microarchitecture in 3D. Although strong agreement of most outcomes measured with first- (XCTI) and second- (XCTII) generation HR-pQCT has been demonstrated, the ability to use the two systems interchangeably is unknown. From in vivo measurements, we determined the limits of estimating XCTII data from XCTI scans conducted in vivo and whether that estimation can be improved by linear cross-calibration equations. These data are crucial as the research field transitions to the new technology. Our study design established cross-calibration equations by scanning 62 individuals on both systems on the same day and then tested those cross-calibrations on the same cohort 6 months later so that estimated (denoted as XCTII*) and "true" XCTII parameters could be compared. We calculated the generalized least-significant change (GLSC) for those predictions. There was strong agreement between both systems for density (R > 0.94), macroarchitecture (R > 0.95), and most microarchitecture outcomes with the exception of trabecular thickness (Tb.Th, R = 0.51 to 0.67). Linear regression equations largely eliminated the systematic error between XCTII and XCTII* and produced a good estimation of most outcomes, with individual error estimates between 0.2% and 3.4%, with the exception of Tt.BMD. Between-system GLSC was similar to within-XCTI LSC (eg, 8.3 to 41.9 mg HA/cm for density outcomes). We found that differences between outcomes assessed with XCTI and XCTII can be largely eliminated by cross-calibration. Tb.Th is poorly estimated because it is measured more accurately by XCTII than XCTI. It may be possible to use cross-calibration for most outcomes when both scanner generations are used for multicenter and longitudinal studies. © 2017 American Society for Bone and Mineral Research.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Estimation of Second-Generation HR-pQCT From First-Generation HR-pQCT Using In Vivo Cross-Calibration

Manske

Davison

Burt

et al. 2017

Journal of Bone and Mineral Research

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“…Clinical QCT is expensive, associated with a relatively high radiation dose, and cannot account for important aspects of bone quality including changes to trabecular microarchitecture and cortical porosity. Peripheral QCT shares similar benefits to DXA in terms of cost and radiation exposure and high-resolution peripheral scanners, which have not yet been widely used in SCI research and have the capability for direct microstructural measurements [89,90]. The most recent high-resolution peripheral scanner (XtremeCTII; Scanco Medical) has a field of view and gantry length that would theoretically allow for measurements of bone mass, architecture, and strength at the knee, the most clinically relevant site for skeletal fracture in the SCI population.…”

Section: Fracture Risk Assessment After Scimentioning

confidence: 99%

Bone Imaging and Fracture Risk after Spinal Cord Injury

Edwards

Schnitzer²

2015

Curr Osteoporos Rep

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Spinal cord injury (SCI) is characterized by marked bone loss and an increased risk of fracture with high complication rate. Recent research based on advanced imaging analysis, including quantitative computed tomography (QCT) and patient-specific finite element (FE) modeling, has provided new and important insights into the magnitude and temporal pattern of bone loss, as well as the associated changes to bone structure and strength, following SCI. This work has illustrated the importance of early therapeutic treatment to prevent bone loss after SCI and may someday serve as the basis for a clinical fracture risk assessment tool for the SCI population. This review provides an update on the epidemiology of fracture after SCI and discusses new findings and significant developments related to bone loss and fracture risk assessment in the SCI population based on QCT analysis and patient-specific FE modeling.

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“…All of these feature maps have the potential to be incorporated into uni-parametric or multi-parametric SPM analyses. Furthermore, the improved resolution performance of the second generation HR-pQCT scanner has increased the number of direct 3D measures of bone structure, including 3D trabecular thickness and separation 27 , adding new features that can be investigated locally by SPM in the future.…”

Section: Discussionmentioning

confidence: 99%

Statistical Parametric Mapping of HR-pQCT Images: A Tool for Population-Based Local Comparisons of Micro-Scale Bone Features

et al. 2016

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HR-pQCT enables in-vivo multi-parametric assessments of bone microstructure in the distal radius and distal tibia. Conventional HR-pQCT image analysis approaches summarize bone parameters into global scalars, discarding relevant spatial information. In this work, we demonstrate the feasibility and reliability of statistical parametric mapping (SPM) techniques for HR-pQCT studies, which enable population-based local comparisons of bone properties. We present voxel-based morphometry (VBM) to assess trabecular and cortical bone voxel-based features, and a surface-based framework to assess cortical bone features both in cross-sectional and longitudinal studies. In addition, we present tensor-based morphometry (TBM) to assess trabecular and cortical bone structural changes. The SPM techniques were evaluated based on scan-rescan HR-pQCT acquisitions with repositioning of the distal radius and distal tibia of 30 subjects. For VBM and surface-based SPM purposes, all scans were spatially normalized to common radial and tibial templates, while for TBM purposes, rescans (follow-up) were spatially normalized to their corresponding scans (baseline). VBM was evaluated based on maps of local bone volume fraction (BV/TV), homogenized volumetric bone mineral density (vBMD), and homogenized strain energy density (SED) derived from micro-finite element analysis; while the cortical bone framework was evaluated based on surface maps of cortical bone thickness, vBMD, and SED. Voxel-wise and vertex-wise comparisons of bone features were done between the groups of baseline and follow-up scans. TBM was evaluated based on mean square errors of determinants of Jacobians at baseline bone voxels. In both anatomical sites, voxel- and vertex-wise uni- and multi-parametric comparisons yielded non-significant differences, and TBM showed no artefactual bone loss or apposition. The presented SPM techniques demonstrated robust specificity thus warranting their application in future clinical HR-pQCT studies.

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Human trabecular bone microarchitecture can be assessed independently of density with second generation HR-pQCT

Cited by 142 publications

References 36 publications

The Estimation of Second-Generation HR-pQCT From First-Generation HR-pQCT Using In Vivo Cross-Calibration

The Estimation of Second-Generation HR-pQCT From First-Generation HR-pQCT Using In Vivo Cross-Calibration

Bone Imaging and Fracture Risk after Spinal Cord Injury

Statistical Parametric Mapping of HR-pQCT Images: A Tool for Population-Based Local Comparisons of Micro-Scale Bone Features

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