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Osteoporosis International

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01-12-2012 | Original Article

A European multicenter comparison of quantitative ultrasound measurement variables: The OPUS study

Authors: M. A. Paggiosi, R. Barkmann, C. C. Glüer, C. Roux, D. M. Reid, D. Felsenberg, M. Bradburn, R. Eastell

Published in: Osteoporosis International | Issue 12/2012

Abstract

Summary

Quantitative ultrasound (QUS) measurement variables vary between European countries in a different way to hip bone mineral density. Standardization of data can be achieved through statistical approaches to reduce any between-center differences in QUS measurement variables. However, further validation of this method is required before it can be widely applied.

Introduction

European between-center differences in hip bone mineral density (BMD) have been shown to exist; however, little is known about the geographical heterogeneity of QUS measurement variables. We aimed to examine the differences in QUS variables between three different European countries.

Methods

Five calcaneal and phalangeal QUS devices in Sheffield, Aberdeen (UK), Kiel and Berlin (Germany), and three devices in Paris (France) were used to measure QUS variables in younger (n = 463, 20–39 years old) and older (n = 2,399, 55–79 years old) women participating in the European multicenter Osteoporosis and Ultrasound (OPUS) study. Broadband ultrasound attenuation, speed of sound, stiffness index, amplitude-dependent speed of sound, bone transmission time, and ultrasonic bone profiler index data were collected. Between-center differences were examined using ANOVA followed by post hoc Fisher's least significant difference tests, and ANCOVA with linear contrasts. p < 0.05 indicated statistical significance.

Results

Between-center differences in nonstandardized QUS measurement variables existed for younger (p = 0.0023 to p < 0.0001) and older women (p < 0.001). Anthropometric characteristics exerted a significant influence on nonstandardized data (p = 0.045 to p < 0.001). However, following statistical standardization, based on height and weight or based on measurements made in young people, geographical heterogeneity in QUS measurement variables was no longer apparent.

Conclusions

QUS measurement variables vary between European countries in a different way to those for hip BMD. Standardization of data can be achieved through statistical approaches to reduce any between-center differences in QUS measurement variables. However, further validation of this method is required before it can be widely applied.

Paggiosi MA, Glüer C-C, Roux C, Reid DM, Felsenberg D, Barkmann R, Eastell R (2011) International variation in proximal femur bone mineral density. Osteoporos Int 22:721–729PubMedCrossRef

Kaptoge S, da Silva JA, Brixen K, Reid DM, Kroger H, Nielson TL et al (2008) Geographical variation in DXA bone mineral density in young European men and women. Results from the Network in Europe on Male Osteoporosis (NEMO) study. Bone 43:332–339PubMedCrossRef

Lunt M, Felsenberg D, Adams J, Benevolenskaya L, Cannata J, Dequeker J et al (1997) Population-based geographic variations in DXA bone density in Europe: the EVOS study. Osteoporos Int 7:175–189PubMedCrossRef

Pye SR, Devakumar V, Boonen S, Borghs H, Vanderschueren D, Adams JE et al (2010) Influence of lifestyle factors on quantitative heel ultrasound measurements in middle-aged and elderly men. Calcif Tissue Int 86:211–219PubMedCrossRef

Glüer CC, Eastell R, Reid DM, Felsenberg D, Roux C, Barkmann R et al (2004) Association of five quantitative ultrasound devices and bone densitometry with osteoporotic vertebral fractures in a population-based sample: the OPUS study. J Bone Miner Res 19:782–793PubMedCrossRef

O'Neill TW, Felsenberg D, Varlow J, Cooper C, Kanis JA, Silman AJ, European Vertebral Osteoporosis Study Group (1996) The prevalence of vertebral deformity in European men and women: the European Vertebral Osteoporosis Study. J Bone Miner Res 11:1010–1018PubMedCrossRef

Von der Recke P, Hansen MA, Overgaard K, Christiansen C (1996) The impact of degenerative conditions in the spine on bone mineral density and fracture risk prediction. Osteoporos Int 6:43–49PubMedCrossRef

Hans PDD, Downs RW Jr, Duboeuf F, Greenspan S, Jankowski LG, Kiebzak GM, Petak SM (2006) Skeletal sites for osteoporosis diagnosis: the 2005 ISCD official positions. J Clin Densitom 9:15–21PubMedCrossRef

Strelitzki R, Truscott JG (1998) An evaluation of the reproducibility and responsiveness of four ‘state-of-the-art’ ultrasonic heel bone measurement systems using phantoms. Osteoporos Int 8:104–109PubMedCrossRef

10.

Kalender WA, Felsenberg D, Genant HK, Fischer M, Dequeker J, Reeve J (1995) The European Spine Phantom—a tool for standardization and quality control in spinal bone mineral measurements by DXA and QCT. Eur J Radiol 20:83–92PubMedCrossRef

11.

Genant HK, Grampp S, Glüer CC, Faulkner KG, Jergas M, Engelke K et al (1994) Universal standardization for dual x-ray absorptiometry: patient and phantom cross-calibration results. J Bone Miner Res 9:1503–1514PubMedCrossRef

12.

Krieg M-A, Barkmann R, Gonnelli S, Stewart A, Bauer DC, Del Rio BL et al (2008) Quantitative ultrasound in the management of osteoporosis: The 2007 ISCD official positions. J Clin Densitom 11:163–187PubMedCrossRef

13.

Glüer C-C, Vahlensieck M, Faulkner KG, Engelke K, Black D, Genant HK (1992) Site-matched calcaneal measurements of broad-band ultrasound attenuation and single x-ray absorptiometry: do they measure different skeletal properties? J Bone Miner Res 7:1071–1079PubMedCrossRef

14.

Kang C, Speller R (1998) Comparison of ultrasound and dual-energy x-ray absorptiometry measurements in the calcaneus. Br J Radiol 71:861–867PubMed

15.

Glüer C-C, Wu CY, Jergas M, Goldstein SA, Genant HK (1994) Three quantitative ultrasound parameters reflect bone structure. Calcifi Tissue Intl 55:46–52CrossRef

16.

Hans D, Wu C, Njeh CF, Zhao S, Augat P, Newitt D et al (1999) Ultrasound velocity of trabecular cubes reflects mainly bone density and elasticity. Calcif Tissue Int 64:18–23PubMedCrossRef

17.

Kang C, Paley M, Ordidge R, Speller R (1999) In vivo MRI measurements of bone quality in the calcaneus: a comparison with DXA and ultrasound. Osteoporos Int 9:65–74PubMedCrossRef

18.

Bouxsein ML, Radloff SE (1997) Quantitative ultrasound of the calcaneus reflects the mechanical properties of calcaneal trabecular bone. J Bone Miner Res 12:839–849PubMedCrossRef

19.

Sakata S, Barkmann R, Lochmüller E-M, Keller M, Glüer C-C (2004) Assessing bone status beyond BMD: evaluation of bone geometry and porosity by quantitative ultrasound of human finger phalanges. J Bone Miner Res 19:924–930PubMedCrossRef

20.

Tothill P, Pye DW (1992) Errors due to non-uniform distribution of fat in dual x-ray absorptiometry of the lumbar spine. Br J Radiol 65:807–813PubMedCrossRef

21.

Tothill P, Avenell A (1994) Errors in dual-energy X-ray absorptiometry of the lumbar spine owing to fat distribution and soft tissue thickness during weight change. Br J Radiol 67:71–75PubMedCrossRef

22.

Bolotin HH, Sievanen H, Grashuis JL (2003) Patient-specific DXA bone mineral density inaccuracies: quantitative effects of nonuniform extraosseous fat distribution. J Bone Miner Res 18:1020–1027PubMedCrossRef

23.

Kotzki PO, Buyck D, Hans D, Thomas E, Bonnel F, Favier F et al (1994) Influence of fat on ultrasound measurements of the os calcis. Calcif Tissue Int 54:91–95PubMedCrossRef

24.

Chappard C, Camus E, Lefebvre F, Guillot G, Bittoun J, Berger G, Laugier P (2000) Evaluation of error bounds on calcaneal speed of sound caused by surrounding soft tissue. J Clin Densitom 3:121–131PubMedCrossRef

25.

Cheng S, Njeh CF, Fan B, Cheng X, Hans D, Wang L et al (2002) Influence of region of interest and bone size on calcaneal BMD: implications for the accuracy of quantitative ultrasound assessments at the calcaneus. B J Radiol 75:59–68

26.

Hans D, Schott AM, Arlot ME, Sornay E, Delmas PD, Meunier PJ (1995) Influence of anthropometric parameters on ultrasound measurements in the os calcis. Osteoporos Int 5:371–376PubMedCrossRef

27.

Damilakis J, Perisinakis K, Vagios E, Tsinikas D, Gourtosoyiannis N (1998) Effect of region of interest location on ultrasound measurements of the calcaneus. Calcif Tissue Int 63:300–305PubMedCrossRef

28.

Diessel E, Fuerst T, Njeh CF, Hans D, Cheng S, Genant HK (2000) Comparison of an imaging heel quantitative ultrasound device (DTU-One) with densitometric and ultrasound measurements. B J Radiol 73:23–30

29.

Cheng S, Suominen H, Ollikainen S, Goll J, Sipilä S, Taaffe D et al (1999) Comparison of ultrasound and bone mineral density assessment of the calcaneus with different regions of interest in healthy early menopausal women. J Clin Densitom 2:117–126PubMedCrossRef

30.

Stewart A, Felsenberg D, Eastell R, Roux C, Glüer CC, Reid DM (2006) Relationship between risk factors and QUS in a European population: the OPUS Study. Bone 39:609–615PubMedCrossRef

31.

Hans D, Schott AM, Chapuy MC, Benamar M, Kotzki PD, Cormier C et al (1994) Ultrasound measurements on the os calcis in a prospective multicenter study. Calcif Tissue Int 55:94–99PubMedCrossRef

32.

Clowes JA, Peel NF, Eastell R (2006) Device-specific thresholds to diagnose osteoporosis at the proximal femur: an approach to interpreting peripheral bone measurements in clinical practice. Osteoporos Int 17:1293–1302PubMedCrossRef

Title: A European multicenter comparison of quantitative ultrasound measurement variables: The OPUS study
Authors: M. A. Paggiosi
R. Barkmann
C. C. Glüer
C. Roux
D. M. Reid
D. Felsenberg
M. Bradburn
R. Eastell
Publication date: 01-12-2012
Publisher: Springer-Verlag
Published in: Osteoporosis International / Issue 12/2012
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-012-1912-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

A European multicenter comparison of quantitative ultrasound measurement variables: The OPUS study

Abstract

Summary

Introduction

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Summary

Introduction

Methods

Results

Conclusions

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