Intra- and inter-observer reliability of the novel vertebral bone quality score

Mierke, Alex; Ramos, Omar; MacNeille, Rhett; Wycliffe, Nathaniel; Cheng, Wayne K.; Danisa, Olumide

doi:10.1007/s00586-021-07096-5

Cited by 15 publications

(6 citation statements)

References 24 publications

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“…In this study, 63 patients were indicated for a DEXA screening for either a history of fracture or having a condition that can impact their bone quality. Ehresman et al laid the foundation for utilizing the novel MRI-based technique to assess bone quality; this technique to obtain a VBQ score has been shown to have great interrater and intrarater reliability [19][20][21][22] and accuracy in predicting osteopenia/osteoporosis [14]. In their study using this technique to assess bone density in operative spine patients with a mean age of 66, a VBQ score of 2.74 (SD 0.60) was reported for healthy bone and 3.31 (SD 0.51) in patients with osteopenia and osteoporosis.…”

Section: Discussionmentioning

confidence: 99%

Association Between Vertebral Bone Quality Score and Dual-Energy X-ray Absorptiometry for the Assessment of Bone Mineral Density in Adolescent Patients

Patel,

Razzouk,

Shin

et al. 2024

Cureus

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Background: The MRI-based vertebral bone quality (VBQ) score is an assessment tool for bone mineral density (BMD) that has been validated in adults against the clinical standard of dual-energy X-ray absorptiometry (DEXA). However, VBQ has yet to be validated against DEXA for use in adolescents. This study evaluated the associations between adolescent VBQ scores, DEXA Z-scores, and BMD values. Methods: The radiographic records of 63 consecutive patients between the ages of 11 and 21 who underwent MRI of the abdomen and pelvis and DEXA of the spine and hip were retrieved. The collected radiographic data consisted of the MRI-based VBQ score, DEXA Z-score, and BMD values of the femoral neck, L1-4 vertebrae, and total body. The VBQ score was calculated by taking the median signal intensity (MSI) from L1-L4 and the SI of the L3 cerebrospinal fluid (CSF). The VBQ score was derived as the quotient of MSI L1-L4 divided by SI CSF . Results: A mean VBQ score of 2.41 ± 0.29 was observed. Strong correlations of -0.749 (p<0.0001) and -0.780 (p<0.0001) were detected between the VBQ score and DEXA femoral neck and spine Z-scores, respectively. Correlations between VBQ score and DEXA femoral neck, spine, and total body BMD scores were -0.559 (p<0.0001), -0.611 (p<0.0001), and -0.516 (p<.0001), respectively. No significant correlations were found between the VBQ score and age, BMI, weight, or height. A mean difference in VBQ score of -0.155 (p=0.035) was observed between sexes. VBQ demonstrated moderate predictive ability for DEXA-derived Z-scores and BMD scores. Conclusions: VBQ scores were strongly correlated with DEXA Z-scores and moderately correlated with BMD values. The VBQ score can also be used by adolescent patients as an accessory tool to assess bone health.

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Section: Discussionmentioning

confidence: 99%

Association Between Vertebral Bone Quality Score and Dual-Energy X-ray Absorptiometry for the Assessment of Bone Mineral Density in Adolescent Patients

Patel,

Razzouk,

Shin

et al. 2024

Cureus

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“…Categorical data were compared using either the chi-square test or Fisher’s exact probability test, depending on appropriateness. Dialysis prescriptions and actual dialysis completion were assessed using ICC, with the following interpretation guidelines: <0.40 (poor), 0.40–0.59 (fair), 0.60–0.74 (good), and 0.75–1.0 (excellent) [ 13 ].…”

Section: Methodsmentioning

confidence: 99%

Comparison of feasibility and effectiveness of tunneled dialysis catheter placement with or without DSA guidance: a propensity score-matched cohort study

Shang,

Pan,

Jin

et al. 2024

Renal Failure

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“…18,32 Using the VBQ score to assess bone health as opposed to other modalities offers distinct advantages with respect to providing easily reproducible methodology and rapid, accurate results unaffected by patient characteristics that normally confound DEXA-derived values. 13,15,35 While imaging such as DEXA is not often available or routinely performed before surgery, the VBQ score takes advantage of the MRI already ordered in standard preoperative patient workup. Accordingly, this tool can contribute both effectively and efficiently to the FRS calculation without any addition of considerable time or cost.…”

Section: Diagnosticsmentioning

confidence: 99%

“…14 This method has been shown to have excellent interrater and interrater reliability. 13,15 The vertebral bone quality (VBQ) score has been validated and shown to correlate with DEXA-measured BMD scores and quantitative computed tomography (QCT), 13,16 predict reoperation in patients undergoing lumbar fusion, 17 and pedicle screw loosening after lumbar spine fusion. 18 The purpose of this study is to evaluate whether the ability of the FRS to predict postoperative complications is improved by the addition of bone health as assessed by the MRI-based VBQ score.…”

mentioning

confidence: 99%

“…Ehresman et al 13 described a novel magnetic resonance imaging (MRI)–based technique to assess bone quality based on previous evidence showing higher T1 signal intensity in osteoporosis due to trabecular atrophy and fatty infiltration of bone 14 . This method has been shown to have excellent interrater and interrater reliability 13,15 . The vertebral bone quality (VBQ) score has been validated and shown to correlate with DEXA-measured BMD scores and quantitative computed tomography (QCT), 13,16 predict reoperation in patients undergoing lumbar fusion, 17 and pedicle screw loosening after lumbar spine fusion 18 …”

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confidence: 99%

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Adding Vertebral Bone Quality to the Fusion Risk Score

Ramos,

Razzouk,

Beauchamp

et al. 2024

Spine

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Study design/setting: Retrospective review of prospectively collected data. Objective: The current study evaluates whether the addition of the Vertebral Bone Quality (VBQ) score to the Fusion Risk Score (FRS) improves its ability to predict perioperative outcomes. Summary of Background Data: The FRS was developed to assess preoperative risk in patients undergoing thoracic and lumbar fusions. It includes patient-derived and surgical variables, but it does not include one that directly accounts for bone health. The VBQ score allows assessment of bone quality and has been shown to correlate to DEXA-measured bone mineral density (BMD) scores. Methods: The VBQ score was weighted based on a regression model and then added to the FRS (FRS/VBQ). The ability of the two scores to predict the outcomes was then assessed using the area under the curve (AUC). Patient sample: Patients undergoing elective thoracic and lumbar spinal fusion from January 2019 to June 2020 were included. Outcome measures: The study evaluated various perioperative adverse outcomes, including major and minor adverse events, discharge other than home, extended length of stay, 90-day emergency department visits, 90-day readmission, 90-day and 2-year reoperation rates. Results: 353 met the inclusion and exclusion criteria. The FRS/VBQ demonstrated improved predictive ability compared to the FRS alone when evaluating 90-day reoperation. Both scores showed fair predictive ability for any adverse event, major adverse events, minor adverse events, and 2-year reoperation rates, with AUCs ranging from 0.700 to 0.737. Both had poor predictive ability for the other outcomes. Conclusion: Adding VBQ to the FRS significantly enhances its predictive accuracy for reoperation rate. This updated risk score provides a more comprehensive understanding of a patient’s preoperative risk profile, aiding both patients and physicians in assessing surgical risks and optimizing outcomes through preoperative risk stratification.

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Intra- and inter-observer reliability of the novel vertebral bone quality score

Cited by 15 publications

References 24 publications

Association Between Vertebral Bone Quality Score and Dual-Energy X-ray Absorptiometry for the Assessment of Bone Mineral Density in Adolescent Patients

Association Between Vertebral Bone Quality Score and Dual-Energy X-ray Absorptiometry for the Assessment of Bone Mineral Density in Adolescent Patients

Comparison of feasibility and effectiveness of tunneled dialysis catheter placement with or without DSA guidance: a propensity score-matched cohort study

Adding Vertebral Bone Quality to the Fusion Risk Score

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