Measuring Drug Therapy Effect on Osteoporotic Fracture Risk by Trabecular Bone Lacunarity: The LOTO Study

Abstract

An MRI method providing one parameter (TBLβ: trabecular-bone-lacunarity-parameter-β) that is sensitive to trabecular bone architecture (TBA) changes with aging and osteoporosis is under study as a new tool in the early diagnosis of bone fragility fracture. A cross-sectional and prospective observational study (LOTO: Lacunarity Of Trabecular bone in Osteoporosis) on over-50s women, at risk for bone fragility fracture, was designed to validate the method. From the baseline data, we observed that in women with prevalent vertebral fractures (VF+), TBA was differently characterized by TBLβ when osteoporosis treatment is considered. Here we verify the potential of TBLβ as an index of osteoporosis treatment efficacy. Untreated (N = 156) and treated (N = 123) women were considered to assess differences in TBLβ related to osteoporosis treatment. Prevalent VFs were found in 31% of subjects, 63% of which were under osteoporosis medications. The results show that TBLβ discriminates between VF+ and VF− patients (p = 0.004). This result is mostly stressed in untreated subjects. Treatment, drug therapy in particular (89% Bisphosphonates), significantly counteracts the difference between VF+ and VF− within and between groups: TBLβ values in treated patients are comparable to untreated VF− and statistically higher than untreated VF+ (p = 0.014) ones. These results highlight the potential role of TBLβ as an index of treatment efficacy.

Fractal features of muscle to quantify fatty infiltration in aging and pathology

“…In fact, only muscle contractile function was previously described by fractal analysis of myographic waveforms [56]. Our results are from the middle axial section of the fourth lumbar vertebra based on our previous studies on vertebral trabecular bone performed in this section [28,30,57,58]. The goodness of our choice is also supported by literature in the field from which it emerges that muscle fatty infiltration generally increases from cranial to caudal, with the highest values observed at L4 and L5 [55,59,60].…”

Fractal Features of Muscle to Quantify Fatty Infiltration in Aging and Pathology

“…In fact, only muscle contractile function was previously described by fractal analysis of myographic waveforms [64]. Our results are from the middle axial section of the fourth lumbar vertebra based on our previous studies on vertebral trabecular bone performed in this section [34,36,65,66]. The goodness of our choice is also supported by the literature in the field, from which it emerges that, generally, fatty infiltration of paraspinal muscle increases from cranial to caudal, and the highest values have been detected at L4 and L5 [63,67,68].…”