The X‐ray attenuation characteristics and density of human calcaneal marrow do not change significantly during adulthood

Abstract

Changes in the material characteristics of bone marrow with aging ciiii be a significant source of error in measurements of bone density when using X-ray and LiltrasoLuid iinaging modalities. In the context of computed tomography, dual-energy computed techiiiqiies have been used to correct for changes in marrow composition. However, dual-energy quantitative computed toinogrnpliy (DE-QCT) protocols, while iiicreasing the accur~icy of the measurement. reduce the precision and increase the radiation dose to the patient in coniparison to siiigle-enei.gy quantitative computed tomography (SE-QCT) protocols. If thc attenuation properties of tlic iiiarrow [or ;I particular bone can be shown to be relatively constant with age. it sliotild be possible to use single-energy techniqties without experiencing errors caused by unknown marrow composition.Marrow was extracted by centrifiigation from 10 iiim thick frontal sections of 34 adult cadaver calcaiiei (28 males, 6 females, ages 17-65 years). The density and energy-dependent linear X-ray nttcnuation coeficieut of each inarrow sample were determincd. For p i i r p o~e~ of comparing our results, we then computed iiii elrective CT number at two G E CTli scan voltages (SO and 120 kVp) for each specirnen. The coelljcients of variation for the density, CT number at SO kVp and CT number a t 120 kVp were each less than IY,~, and the paraineters did not change siguificantly with age ( p > 0.2, 1. ' < 0.02, power > 0.8 where the minimum acceptable = 0.21 6). We could demonstrate no significant gender-associated diflercnces in these relationships. These data suggest that calcaneal bone marrow X-ray attenuation properties and marrow density are essentially constant from the third through sixth d e c d e s of life.

Effective radiation dose of a MSCT, two CBCT and one conventional radiography device in the ankle region

“…According to McGlamry et al [ 35 ], the proximal tibia has been the most frequently used location to extract bone marrow in volumes between 30–40 cc. Moreover, Les et al [ 25 ] extracted up to 6 cc bone marrow from the calcaneus and, according to Schweinberger et al [ 36 ], the calcaneus and proximal tibial metaphysis offer a significant amount of bone marrow. In contrast to Ludlow’s study, our study included the bone marrow, which was the major contributor to the effective dose.…”

“…According to their calculations, it was estimated that 100 mm sections of tibia and fibula contained 0.7% of whole body mass bone marrow. Furthermore, Les et al [ 25 ] calculated the bone marrow content of the foot and ankle region using human cadavers and estimated that the structures contained 0.4% of the whole body mass bone marrow. When combining the results of both studies, a total of 1.1% of the bone marrow mass is contained in the ankle area of the examined phantom.…”

“…Bone marrow is one of the largest anatomical structures in the body and represents 4% of the total body mass [23]. The bone marrow mass fraction used in this study was based on the results of two previous studies by Fuller et al [24] and Les et al [25]. Fuller et al measured the bone marrow volume in the thigh and calf area using MRI data.…”

Hand‐wrist, knee, and foot‐ankle dosimetry and image quality measurements of a novel extremity imaging unit providing CBCT and 2D imaging options

“…As noted by Les and co‐authors in their review of the literature, the conversion of bone marrow from hematopoietic to adipose cellularity occurs first in the periphery of the appendicular skeleton, moves toward the axial skeleton, and is essentially complete in these peripheral sites by the end of the second decade . Based on the number of studies supporting this observation, the active marrow fractions used Koivisto and co‐authors appear to be high.…”

“…10 As noted by Les and co-authors in their review of the literature, the conversion of bone marrow from hematopoietic to adipose cellularity occurs first in the periphery of the appendicular skeleton, moves toward the axial skeleton, and is essentially complete in these peripheral sites by the end of the second decade. 24 Based on the number of studies supporting this observation, the active marrow fractions used Koivisto and co-authors appear to be high. The range of marrow fractions calculated for different age groups in this study encompass those used by Koivisto and co-authors but occur in the 10-15 yr age range rather than at the adult end of the age spectrum.…”