In Vivo High Resolution MRI of the Calcaneus: Differences in Trabecular Structure in Osteoporosis Patients

Link, Thomas M.; Majumdar, Sharmila; Augat, Peter; Lin, John C.; Newitt, David C.; Lü, Ying; Lane, Nancy E.; Genant, Harry K.

doi:10.1359/jbmr.1998.13.7.1175

Cited by 277 publications

(169 citation statements)

References 32 publications

(37 reference statements)

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“…methods, including high-spatial-resolution peripheral quantitative (HR-pQ) computed tomography (CT) (13-15) and high-spatial-resolution magnetic resonance (MR) imaging (16)(17)(18). Previously, studies of bone microarchitecture were performed invasively with iliac crest biopsy (19,20).…”

Section: Discussionmentioning

confidence: 99%

Finite Element Analysis Applied to 3-T MR Imaging of Proximal Femur Microarchitecture: Lower Bone Strength in Patients with Fragility Fractures Compared with Control Subjects

Chang¹,

Honig²,

Brown³

et al. 2014

Radiology

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Purpose:To determine the feasibility of using finite element analysis applied to 3-T magnetic resonance (MR) images of proximal femur microarchitecture for detection of lower bone strength in subjects with fragility fractures compared with control subjects without fractures. Materials and Methods:This prospective study was institutional review board approved and HIPAA compliant. Written informed consent was obtained. Postmenopausal women with (n = 22) and without (n = 22) fragility fractures were matched for age and body mass index. All subjects underwent standard dual-energy x-ray absorptiometry. Images of proximal femur microarchitecture were obtained by using a high-spatialresolution three-dimensional fast low-angle shot sequence at 3 T. Finite element analysis was applied to compute elastic modulus as a measure of strength in the femoral head and neck, Ward triangle, greater trochanter, and intertrochanteric region. The Mann-Whitney test was used to compare bone mineral density T scores and elastic moduli between the groups. The relationship (R 2 ) between elastic moduli and bone mineral density T scores was assessed. Results:Patients with fractures showed lower elastic modulus than did control subjects in all proximal femur regions (femoral head, 8.51-8.73 GPa vs 9.32-9.67 GPa; P = .04; femoral neck, 3.11-3.72 GPa vs 4.39-4.82 GPa; P = .04; Ward triangle, 1.85-2.21 GPa vs 3.98-4.13 GPa; P = .04; intertrochanteric region, 1.62-2.18 GPa vs 3.86-4.47 GPa; P = .006-.007; greater trochanter, 0.65-1.21 GPa vs 1.96-2.62 GPa; P = .01-.02), but no differences in bone mineral density T scores. There were weak relationships between elastic moduli and bone mineral density T scores in patients with fractures (R 2 = 0.25-0.31, P = .02-.04), but not in control subjects. Conclusion:Finite element analysis applied to high-spatial-resolution 3-T MR images of proximal femur microarchitecture can allow detection of lower elastic modulus, a marker of bone strength, in subjects with fragility fractures compared with control subjects. MR assessment of proximal femur strength may provide information about bone quality that is not provided by dual-energy x-ray absorptiometry.q RSNA, 2014

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Section: Discussionmentioning

confidence: 99%

Finite Element Analysis Applied to 3-T MR Imaging of Proximal Femur Microarchitecture: Lower Bone Strength in Patients with Fragility Fractures Compared with Control Subjects

Chang¹,

Honig²,

Brown³

et al. 2014

Radiology

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“…Osteoporosis patients with and without fractures compared to individuals without osteoporosis have been evaluated for different MRI-derived texture parameters of bone, and differences between these groups were demonstrated at the distal radius and calcaneus (91)(92)(93).…”

Section: Mrimentioning

confidence: 99%

Quantitative imaging methods in osteoporosis

Oei

Koromani

Rivadeneira

et al. 2016

Quant. Imaging Med. Surg.

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“…A further potential motivation is the study of the structural manifestations of metabolic bone disease such as renal osteodystropy (166). Evidence for these developments is the rapid growth of the clinical literature (8,83,84,127,145,165,(167)(168)(169)(170)(171)(172) and also, to a lesser extent, the increased use of CT to characterize TB (14)(15)(16)(173)(174)(175)(176)(177).…”

Section: Clinical Applications Of Trabecular Bone Microstructural Anamentioning

confidence: 99%

Quantitative MRI for the assessment of bone structure and function

et al. 2006

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Osteoporosis is the most common degenerative disease in the elderly. It is characterized by low bone mass and structural deterioration of bone tissue, leading to morbidity and increased fracture risk in the hip, spine and wrist-all sites of predominantly trabecular bone. Bone densitometry, currently the standard methodology for diagnosis and treatment monitoring, has significant limitations in that it cannot provide information on the structural manifestations of the disease. Recent advances in imaging, in particular MRI, can now provide detailed insight into the architectural consequences of disease progression and regression in response to treatment. The focus of this review is on the emerging methodology of quantitative MRI for the assessment of structure and function of trabecular bone. During the past 10 years, various approaches have been explored for obtaining image-based quantitative information on trabecular architecture. Indirect methods that do not require resolution on the scale of individual trabeculae and therefore can be practiced at any skeletal location, make use of the induced magnetic fields in the intertrabecular space. These fields, which have their origin in the greater diamagnetism of bone relative to surrounding marrow, can be measured in various ways, most typically in the form of R 0 2 , the recoverable component of the total transverse relaxation rate. Alternatively, the trabecular network can be quantified by high-resolution MRI (m-MRI), which requires resolution adequate to at least partially resolve individual trabeculae. Micro-MRI-based structure analysis is therefore technically demanding in terms of image acquisition and algorithms needed to extract the structural information under conditions of limited signal-to-noise ratio and resolution. Other requirements that must be met include motion correction and image registration, both critical for achieving the reproducibility needed in repeat studies. Key clinical applications targeted involve fracture risk prediction and evaluation of the effect of therapeutic intervention.

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In Vivo High Resolution MRI of the Calcaneus: Differences in Trabecular Structure in Osteoporosis Patients

Cited by 277 publications

References 32 publications

Finite Element Analysis Applied to 3-T MR Imaging of Proximal Femur Microarchitecture: Lower Bone Strength in Patients with Fragility Fractures Compared with Control Subjects

Finite Element Analysis Applied to 3-T MR Imaging of Proximal Femur Microarchitecture: Lower Bone Strength in Patients with Fragility Fractures Compared with Control Subjects

Quantitative imaging methods in osteoporosis

Quantitative MRI for the assessment of bone structure and function

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