The Assessment of Skeletal Muscle and Cortical Bone by Second-generation HR-pQCT at the Tibial Midshaft

Hildebrand, Kurt; Sidhu, Karamjot; Gabel, Leigh; Besler, Bryce A.; Burt, Lauren A; Boyd, Steven K.

doi:10.1016/j.jocd.2020.11.001

Cited by 6 publications

(3 citation statements)

References 23 publications

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“…Their conclusion is also supported by our current study, indicating that the HR-pQCT parameters of the muscle density (MD) and intramuscular IMAT% correlated well with age and muscle functions. Recently, Hildebrand et al also demonstrated good precision and repeatability of the HR-pQCT against the more traditional method of pQCT that also supports its potential clinical application [ 40 ]. Furthermore, this is supported with our animal study showing that the IMAT% evaluated by the HR-pQCT had a moderately strong correlation (r 2 = 0.806) with the quantification of intramuscular lipids by Oil Red O histology.…”

Section: Discussionmentioning

confidence: 94%

HR-pQCT for the Evaluation of Muscle Quality and Intramuscular Fat Infiltration in Ageing Skeletal Muscle

Chow

Mourik

Hung

et al. 2022

JPM

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Myosteatosis is the infiltration of fat in skeletal muscle during the onset of sarcopenia. The quantification of intramuscular adipose tissue (IMAT) can be a feasible imaging modality for the clinical assessment of myosteatosis, important for the early identification of sarcopenia patients and timely intervention decisions. There is currently no standardized method or consensus for such an application. The aim of this study was to develop a method for the detection and analysis of IMAT in clinical HR-pQCT images of the distal tibia to evaluate skeletal muscle during the ageing process, validated with animal and clinical experimentation. A pre-clinical model of ovariectomized (OVX) rats with known intramuscular fat infiltration was used, where gastrocnemii were scanned by micro-computed tomography (micro-CT) at an 8.4 μm isotropic voxel size, and the images were analyzed using our modified IMAT analysis protocol. IMAT, muscle density (MD), and muscle volume (MV) were compared with SHAM controls validated with Oil-red-O (ORO) staining. Furthermore, the segmentation and IMAT evaluation method was applied to 30 human subjects at ages from 18 to 81 (mean = 47.3 ± 19.2). Muscle-related parameters were analyzed with functional outcomes. In the animal model, the micro-CT adipose tissue-related parameter of IMAT% segmented at −600 HU to 100 HU was shown to strongly associate with the ORO-positively stained area (r = 0.898, p = 0.002). For the human subjects, at an adjusted threshold of −600 to −20 HU, moderate positive correlations were found between MV and MD (r = 0.642, p < 0.001), and between MV and IMAT volume (r = 0.618, p < 0.01). Moderate negative correlations were detected between MD and IMAT% (r = −0.640, p < 0.001). Strong and moderate associations were found between age and MD (r = −0.763, p < 0.01), and age and IMAT (r = 0.559, p < 0.01). There was also a strong correlation between IMAT% and chair rise time (r = 0.671, p < 0.01). The proposed HR-pQCT evaluation protocol for intramuscular adipose-tissue produced MD and IMAT results that were associated with age and physical performance measures, and were of good predictive value for the progression of myosteatosis or sarcopenia. The protocol was also validated on animal skeletal muscle samples that showed a good representation of histological lipid content with positive correlations, further supporting the clinical application for the rapid evaluation of muscle quality and objective quantification of skeletal muscle at the peripheral for sarcopenia assessment.

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Section: Discussionmentioning

confidence: 94%

HR-pQCT for the Evaluation of Muscle Quality and Intramuscular Fat Infiltration in Ageing Skeletal Muscle

Chow

Mourik

Hung

et al. 2022

JPM

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“…HR-pQCT was recently proposed for the study of skeletal muscle at the tibial midshaft (66% proximal tibia), thanks to the possibility to assess more proximal sites with second-generation scanners. 103 HR-pQCT could achieve good precision, given its higher resolution compared to pQCT, and measures of muscle density were shown to be comparable between HR-pQCT and pQCT. 103 In addition, HR-pQCT has the potential to obtain simultaneous measurements of bone and muscle, providing insight into bone–muscle interactions.Erlandson et al 104 examined the feasibility of using first-generation HR-pQCT to estimate the properties of myotendinous tissue at the distal tibia, showing a moderate correlation with mid-leg muscle density obtained from pQCT.While holding promise for the evaluation of skeletal muscle in research settings, development of standardized protocols for this specific application of HR-pQCT is still ongoing.…”

Section: Further Applicationsmentioning

confidence: 97%

“…Given the intimate relationship existing between skeletal muscle and bone, a complete assessment of musculoskeletal health must include the evaluation of skeletal muscle. 103 Several different imaging modalities can be used to study skeletal muscle, including DXA, ultrasound, MRI, CT, and peripheral quantitative CT (pQCT). HR-pQCT was recently proposed for the study of skeletal muscle at the tibial midshaft (66% proximal tibia), thanks to the possibility to assess more proximal sites with second-generation scanners.…”

Section: Further Applicationsmentioning

confidence: 99%

High-resolution peripheral quantitative computed tomography: research or clinical practice?

Gazzotti

Gómez

Schileo

et al. 2023

The British Journal of Radiology

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High-resolution peripheral quantitative computed tomography (HR-pQCT) is a low-dose three-dimensional imaging technique, originally developed for in vivo assessment of bone microarchitecture at the distal radius and tibia in osteoporosis. HR-pQCT has the ability to discriminate trabecular and cortical bone compartments, providing densitometric and structural parameters. At present, HR-pQCT is mostly used in research settings, despite evidence showing that it may be a valuable tool in osteoporosis and other diseases. This review summarizes the main applications of HR-pQCT and addresses the limitations that currently prevent its integration into routine clinical practice. In particular, the focus is on the use of HR-pQCT in primary and secondary osteoporosis, chronic kidney disease (CKD), endocrine disorders affecting bone, and rare diseases. A section on novel potential applications of HR-pQCT is also present, including assessment of rheumatic diseases, knee osteoarthritis, distal radius/scaphoid fractures, vascular calcifications, effect of medications, and skeletal muscle. The reviewed literature seems to suggest that a more widespread implementation of HR-pQCT in clinical practice would offer notable opportunities. For instance, HR-pQCT can improve the prediction of incident fractures beyond areal bone mineral density provided by dual-energy X-ray absorptiometry. In addition, HR-pQCT may be used for the monitoring of anti osteoporotic therapy or for the assessment of mineral and bone disorder associated with CKD. Nevertheless, several obstacles currently prevent a broader use of HR-pQCT and would need to be targeted, such as the small number of installed machines worldwide, the uncertain cost-effectiveness, the need for improved reproducibility, and the limited availability of reference normative datasets.

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Application of imaging methods and the latest progress in sarcopenia

Li,

Huang,

Wang

et al. 2024

Chin J Acad Radiol

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Sarcopenia is a syndrome described as a progressive and generalized loss of muscle mass and strength, with decrease in physical performance. It is related to an increased risk of many adverse events, such as falls, fractures, osteoporosis, major postoperative complications, loss of quality of life, prolonged hospital stay, disability, and even death. Although sarcopenia can also be assessed using a handheld dynamometer and a short physical performance battery (SPPB); it has lower accuracy, sensitivity, and specificity. Previous studies confirmed that imaging methods can serve as an important tool in the assessment of muscle mass and quality, and can even detect microscopic changes in muscle, achieving an early diagnosis of sarcopenia. Therefore, this article reviews the advantages and disadvantages of clinical and imaging assessment methods, specific applications, and the development of imaging techniques for the assessment of sarcopenia, including the currently unresolved problems.

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The Assessment of Skeletal Muscle and Cortical Bone by Second-generation HR-pQCT at the Tibial Midshaft

Cited by 6 publications

References 23 publications

HR-pQCT for the Evaluation of Muscle Quality and Intramuscular Fat Infiltration in Ageing Skeletal Muscle

HR-pQCT for the Evaluation of Muscle Quality and Intramuscular Fat Infiltration in Ageing Skeletal Muscle

High-resolution peripheral quantitative computed tomography: research or clinical practice?

Application of imaging methods and the latest progress in sarcopenia

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