Rationale, design and clinical performance of the mechanical response tissue analyser: a non-invasive technology for measurement of long bone bending stiffness

Abstract

Prediction of osteoporotic fractures is currently an imperfect science and new tools are desperately needed to identify at-risk patients at an earlier stage in the disease process. The mechanical response tissue analyser (MRTA) is a novel, non-invasive, radiation-free device that measures the bending stiffness of long bones in vivo, an indicator of a bone's ability to resist deformation under a given load and a strong predictor of long bone structural integrity and strength. Bone bending stiffness measured with the MRTA has been consistently shown to be a stronger predictor of post-mortem and ex vivo bone breaking strength compared to bone mineral measured with dual-energy X-ray absorptiometry. Bone bending stiffness measured with MRTA also decreases with advanced age and disease states and increases with chronic physical activity, independent of bone mineral changes. The MRTA measures different parameters than DXA (bone quality vs bone mineral content and density) and may be a more robust tool for identifying those at risk for fracture. Research initiatives focused on improving long-term repeatability and optimizing the signal-to-noise ratio of the measurement are currently underway to further advance the clinical usefulness of this technology.

Improvements to mechanical response tissue analysis

“…MRTA was a dynamic 3-point bending test for measuring the mechanical properties of long bones in living people. It had been extensively utilized [3], but had acquired a reputation for inaccuracy [4,5] and irreproducibility [6]. Because current clinical methods do not predict fractures well [[7], [8], [9], [10]], and because MRTA presented a theoretical potential for direct measurement of skeletal fragility, we undertook to discover the major sources of error in MRTA and, if possible, to correct them.…”

Accuracy and reproducibility of bending stiffness measurements by mechanical response tissue analysis in artificial human ulnas

“…MRTA has been used for research (Miller et al, 2013), but little has been published about its accuracy. To begin investigating this, we compared MRTA and QMT measurements of the bending stiffness of artificial human ulna bones.…”

Fracture discrimination capability of ulnar flexural rigidity measured via Cortical Bone Mechanics Technology: study protocol for The STRONGER Study

“…Bone strength can be quickly and painlessly assayed non-invasively, without the use of radiation, using a 3-point bend test performed with multifrequency vibration analysis to measure the resonance response of the bone (for reviews, see 13 , 31 ). More than 25 yr ago, initial efforts were made to develop and commercialize a vibration analysis device for bone strength assessment, known as mechanical response tissue analysis or MRTA.…”