Prediction of bone strength at the distal tibia by HR-pQCT and DXA

Popp, Albrecht; Windolf, Markus; Senn, Christoph; Tami, Andrea; Richards, R. Geoff; Brianza, Stefano; Schiuma, Damiano

doi:10.1016/j.bone.2011.10.033

Cited by 19 publications

(19 citation statements)

References 22 publications

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“…A more proximal region of interest with thicker and more homogeneous cortices, such as the T-DIA, has a simple geometric structure, similar to a hollow cylinder. The combination of the aBMD at the T-DIA and the structural parameters derived from DXA scans and confirmed by HR-pQCT can improve the prediction of local bone strength ex vivo [19]. It is unknown whether this combination of material and structural competence can be confirmed by both of the techniques in a standardized procedure in vivo.…”

Section: Introductionmentioning

confidence: 99%

Microstructural Parameters of Bone Evaluated Using HR-pQCT Correlate with the DXA-Derived Cortical Index and the Trabecular Bone Score in a Cohort of Randomly Selected Premenopausal Women

et al. 2014

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Background Areal bone mineral density is predictive for fracture risk. Microstructural bone parameters evaluated at the appendicular skeleton by high-resolution peripheral quantitative computed tomography (HR-pQCT) display differences between healthy patients and fracture patients. With the simple geometry of the cortex at the distal tibial diaphysis, a cortical index of the tibia combining material and mechanical properties correlated highly with bone strength ex vivo. The trabecular bone score derived from the scan of the lumbar spine by dual-energy X-ray absorptiometry (DXA) correlated ex vivo with the micro architectural parameters. It is unknown if these microstructural correlations could be made in healthy premenopausal women. Methods Randomly selected women between 20–40 years of age were examined by DXA and HR-pQCT at the standard regions of interest and at customized sub regions to focus on cortical and trabecular parameters of strength separately. For cortical strength, at the distal tibia the volumetric cortical index was calculated directly from HR-pQCT and the areal cortical index was derived from the DXA scan using a Canny threshold-based tool. For trabecular strength, the trabecular bone score was calculated based on the DXA scan of the lumbar spine and was compared with the corresponding parameters derived from the HR-pQCT measurements at radius and tibia. Results Seventy-two healthy women were included (average age 33.8 years, average BMI 23.2 kg/m2). The areal cortical index correlated highly with the volumetric cortical index at the distal tibia (R = 0.798). The trabecular bone score correlated moderately with the microstructural parameters of the trabecular bone. Conclusion This study in randomly selected premenopausal women demonstrated that microstructural parameters of the bone evaluated by HR-pQCT correlated with the DXA derived parameters of skeletal regions containing predominantly cortical or cancellous bone. Whether these indexes are suitable for better predictions of the fracture risk deserves further investigation.

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Section: Introductionmentioning

confidence: 99%

Microstructural Parameters of Bone Evaluated Using HR-pQCT Correlate with the DXA-Derived Cortical Index and the Trabecular Bone Score in a Cohort of Randomly Selected Premenopausal Women

et al. 2014

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“…For these anatomical locations, the development, progression, and regional distribution of the cortical and trabecular bone have already been evaluated in various studies [6,[8][9][10][11][12][13]. The results clearly demonstrate that the cortical bone, especially its porosity and thickness, has significant impact on the loss of bone mass and mechanical stability [5,14,15].…”

Section: Introductionmentioning

confidence: 89%

“…Calculation of structural indices from HR-pQCT was performed as previously described and validated in several studies [14,[18][19][20]. Briefly, the bone volume (BV) was calculated using a tetrahedron meshing technique generated with the marching cubes method and total volume (TV) being identical to the defined VOI.…”

Section: Bone Mineral Density Cortical and Trabecular Bone Analysismentioning

confidence: 99%

High-Resolution Tomography-Based Quantification of Cortical Porosity and Cortical Thickness at the Surgical Neck of the Humerus During Aging

et al. 2017

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Fractures of the proximal humerus are highly related to age and osteoporotic bone remodeling. Previous studies have highlighted the cortex as a major side of the bone loss, but the microstructural changes of the humerus have not been evaluated entirely. Sixty-four (n = 64) humeri of a representative collective (18-100 years) were scanned with high-resolution peripheral quantitative computed tomography (82 µm). Bone mineral density (BMD), trabecular bone volume fraction (Tb.BV/TV), cortical thickness (Ct.Th), and cortical porosity (Ct.Po) were determined with respect to four age groups. The BMD (r = -0.42), Ct.Th (r = 0.57), and Tb.BV/TV (r = 0.68) showed an age group-related decrease, while the Ct.Po increased (r = -0.55). The oldest group (80-100 years) revealed an extensively higher Ct.Po of +87% compared to the youngest group (18-44 years), while the Ct.Th and Tb.BV/TV were significantly lower by -35 and -49% (p < 0.05). The main cortical bone loss occurred after 65 years with the Ct.Th (-34%) and Tb.BV/TV (-40%) being clearly lower and the Ct.Po (+93%) clearly higher compared to the youngest group. In summary, osteoporosis leads to an age-related higher Ct.Po and reduced Ct.Th at the humeral cortex of the surgical neck. The bone loss of the cortex predominantly occurs around the age of 65 years and is very likely to reduce the mechanical strength and highly increases the fracture risk.

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“…These early investigations eventually led to the introduction of hospital-based CT scanners in the 1970s and the subsequent award of the 1979 Nobel Prize for Physiology or Medicine to Allan Cormack and Godfrey Hounsfield. At the time of writing, in 2016, whole-body clinical CT scanners commonly achieve resolutions ranging from 1 mm to 250 µm, whereas higher resolution limb-extremity CT scanners can resolve features that measure 40 µm (Popp et al, 2012). In common with these clinical CT machines, laboratorybased microCT instruments construct 3D volumes by computationally processing a large number (hundreds or thousands) of 2D radiographs taken at sequential angles.…”

Section: Optical and Electron Microscopy In Three Dimensionsmentioning

confidence: 99%

Three-dimensional visualisation of soft biological structures by X-ray computed micro-tomography

Shearer

Bradley

Hidalgo‐Bastida

et al. 2016

Journal of Cell Science

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Whereas the two-dimensional (2D) visualisation of biological samples is routine, three-dimensional (3D) imaging remains a time-consuming and relatively specialised pursuit. Current commonly adopted techniques for characterising the 3D structure of non-calcified tissues and biomaterials include optical and electron microscopy of serial sections and sectioned block faces, and the visualisation of intact samples by confocal microscopy or electron tomography. As an alternative to these approaches, X-ray computed micro-tomography (microCT) can both rapidly image the internal 3D structure of macroscopic volumes at sub-micron resolutions and visualise dynamic changes in living tissues at a microsecond scale. In this Commentary, we discuss the history and current capabilities of microCT. To that end, we present four case studies to illustrate the ability of microCT to visualise and quantify: (1) pressure-induced changes in the internal structure of unstained rat arteries, (2) the differential morphology of stained collagen fascicles in tendon and ligament, (3) the development of Vanessa cardui chrysalises, and (4) the distribution of cells within a tissue-engineering construct. Future developments in detector design and the use of synchrotron X-ray sources might enable real-time 3D imaging of dynamically remodelling biological samples.

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Prediction of bone strength at the distal tibia by HR-pQCT and DXA

Cited by 19 publications

References 22 publications

Microstructural Parameters of Bone Evaluated Using HR-pQCT Correlate with the DXA-Derived Cortical Index and the Trabecular Bone Score in a Cohort of Randomly Selected Premenopausal Women

Microstructural Parameters of Bone Evaluated Using HR-pQCT Correlate with the DXA-Derived Cortical Index and the Trabecular Bone Score in a Cohort of Randomly Selected Premenopausal Women

High-Resolution Tomography-Based Quantification of Cortical Porosity and Cortical Thickness at the Surgical Neck of the Humerus During Aging

Three-dimensional visualisation of soft biological structures by X-ray computed micro-tomography

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