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Osteoporosis International

Published in:

01-10-2007 | Original Article

Standardised quantitative morphometry: a modified approach for quantitative identification of prevalent vertebral deformities

Authors: G. Jiang, L. Ferrar, N. A. Barrington, R. Eastell

Published in: Osteoporosis International | Issue 10/2007

Abstract

Summary

Our approach for the quantitative identification of vertebral deformity (standardised quantitative morphometry, SQM) reduces problems associated with obtaining reference intervals from populations with high prevalence of fracture. In women with osteoporosis, agreement with radiological diagnosis (surrogate gold standard) was better for SQM than QM using the Eastell-Melton method.

Introduction

Use of reference intervals for quantitative vertebral morphometry (QM) derived by statistical trimming can be problematic in reference populations with high prevalence of deformity. We have developed a modified approach known as standardised quantitative morphometry (SQM), whereby vertebral height is standardised to eliminate variation between individuals. The aims of this study were to compare SQM to QM (Eastell-Melton method) for identification of prevalent vertebral deformities, using qualitative radiological diagnosis as the gold standard, and automate the process.

Methods

Our study populations were a clinic-based sample of 80 women ages 48 to 87 years with a high prevalence of vertebral deformity and a general practice (GP)-based sample of 372 women ages 50 to 85 years. Agreement with the gold standard was tested for SQM and QM.

Results

Agreement was better for SQM (κ = 0.80) than for QM (κ = 0.14) in the clinic sample using clinic-based reference data. The agreement was improved for QM using the GP-based reference data, κ = 0.63. In the GP population, agreement was good for both SQM and QM (κ = 0.59 and 0.54 respectively).

Conclusions

In our population with a high prevalence of vertebral fracture, SQM performs better than the Eastell-Melton method.

Barnett E, Nordin BEC (1960) The radiologic diagnosis of osteoporosis: a new approach. Clin Radiol 11:166–174PubMedCrossRef

Reshef A, Schwartz A, Ben-Menachem Y et al (1971) Radiologic osteoporosis: Correlation with dietary and biochemical findings. J Am Geriatr Soc 19:391–402PubMed

Jensen KK, Tougaard L (1981) A simple x-ray method for monitoring progress of osteoporosis. Lancet 2:19–20PubMedCrossRef

Minne HW, Leidig G, Wuster C et al (1988) A newly developed spine deformity index (SDI) to quantitate vertebral crush fractures in patients with osteoporosis. Bone Miner 3:335–349PubMed

Hedlund LR, Gallagher JC (1988) Vertebral morphometry in diagnosis of spinal fractures. Bone Miner 5:59–67PubMedCrossRef

Melton LJ III, Kan SH, Frye MA et al (1989) Epidemiology of vertebral fractures in women. Am J Epidemiol 129:1000–1011PubMed

Davies KM, Recker RR, Heaney RP (1989) Normal vertebral dimensions and normal variation in serial measurements of vertebrae. J Bone Miner Res 4:341–349PubMed

Eastell R, Cedel SL, Wahner HW et al (1991) Classification of vertebral fractures. J Bone Miner Res 6:207–215PubMed

Sauer P, Leidig G, Minne H et al (1991) Spine deformity index (SDI) versus other objective procedures of vertebral fracture identification in patients with osteoporosis: a comparative study. J Bone Miner Res 6:227–238PubMed

10.

McCloskey EV, Spector TD, Eyres KS et al (1993) The assessment of vertebral deformity. A method for use in population studies and clinical trials. Osteoporos Int 3:138–147PubMedCrossRef

11.

Hurxthal LM, Vose GP, Dotter WE (1969) Densitometric and visual observations of spinal radiographs. Geriatrics 24:93–106PubMed

12.

Genant HK, Jergas M, Palermo L et al (1996) Comparison of semiquantitative visual and quantitative morphometric assessment of prevalent and incident vertebral fractures in osteoporosis. The Study of Osteoporotic Fractures Research Group. J Bone Miner Res 11:984–996PubMed

13.

Kanis JA, McCloskey EV, Khan S et al (1993) What is a vertebral fracture? In: Christiansen C, Riis B (eds) Proceedings of the Fourth International Symposium on Osteoporosis and Consensus Development Conference. Handelstrykkeriet Aalborg ApS, Aalborg, pp 26–28

14.

Leidig G, Storm T, Genant HK et al (1990) Comparison of two methods to assess vertebral fractures. In: Christiansen C, Overgaard K (eds) Osteoporosis Copenhagen: Osteopress ApS, pp 626–628, 1990

15.

Wu CY, Li J, Jergas M et al (1995) Comparison of semiquantitative and quantitative techniques for the assessment of prevalent and incident vertebral fractures. Osteoporos Int 5:354–370PubMedCrossRef

16.

Pak CYC, Ho A, Poindexter J et al (1996) Quantitation of incident spinal fractures: comparison of visual detection with quantitative morphometry. Bone 18:349–353PubMedCrossRef

17.

Ross PD, Davis JW, Epstein RS et al (1992) Ability of vertebral dimensions from a single radiograph to identify fractures. Calcif Tissue Int 51:95–99PubMedCrossRef

18.

Davies KM, Recker RR, Heaney RP (1993) Revisable criteria for vertebral deformity. Osteoporos Int 3:265–270PubMedCrossRef

19.

Hedlund LR, Gallagher JC, Meeger C et al (1989) Change in vertebral shape in spinal osteoporosis. Calcif Tissue Int 44:168–172PubMedCrossRef

20.

Adami S, Gatti D, Rossini M et al (1992) The radiological assessment of vertebral osteoporosis. Bone 13:S33–S36PubMedCrossRef

21.

Banna M (1985) Clinical radiology of the spine and spinal cord. Aspen Systems Corporation, Maryland, p 388

22.

Leidig-Bruckner G, Limberg B, Felsenberg D et al (2000) Sex difference in the validity of vertebral deformities as an index of prevalent vertebral osteoporotic fractures: a population survey of older men and women. Osteoporosis Int 11(2):102–119CrossRef

23.

Melton LJ, Lane AW, Cooper C et al (1993) Prevalence and incidence of vertebral deformities. Osteoporos Int 3:113–119PubMedCrossRef

24.

Black DM, Cummings SR, Stone K et al (1991) A new approach to defining normal vertebral dimensions. J Bone Miner Res 6:883–892PubMed

25.

Black DM, Palermo L, Nevitt MC et al (1995) Comparison of methods for defining prevalent vertebral deformities: the study of osteoporotic fractures. J Bone Miner Res 10:890–902PubMed

26.

Jiang G, Barrington NA, Eastell R (1999) Endplate angle approach for the quantitative identification of minor endplate vertebral deformities. J Bone Miner Res 14(Suppl 1):S496

27.

Osman AA, Bassiouni H, Koutri R et al (1994) Aging of the thoracic spine: distinction between wedging in osteoarthritis and fracture in osteoporosis- a cross-sectional and longitudinal study. Bone 15(4):437–442CrossRef

28.

Zebaze RM, Maalouf G, Wehbe J et al (2004) The varying distribution of intra- and inter-vertebral height ratios determines the prevalence of vertebral fractures. Bone 35(2):348–356PubMedCrossRef

29.

Cummings SR et al (1995) National Osteoporosis Foundation Working Group on Vertebral Fractures. Report: assessing vertebral fractures. J Bone Miner Res 10:518–523

30.

Genant K, Wu CY, Kuijk CV et al (1993) Vertebral fracture assessment using a semiquantitative technique. J Bone Miner Res 8:1137–1148PubMed

31.

Melton LJ 3rd, Wenger DE, Atkinson EJ et al (2006) Influence of baseline deformity definition on subsequent vertebral fracture risk in postmenopausal women. Osteoporos Int 17(7):978–985PubMedCrossRef

32.

O’Neill TW, Felsenberg D, Varlow J (1996) The prevalence of vertebral deformity in European men and women: the European Vertebral Osteoporosis Study. J Bone Miner Res 11:1010–1018PubMedCrossRef

33.

Peel NFA, Johnson A, Smith TWD et al (1993) Impact of anomalous vertebral segmentation on measurements of bone mineral density. J Bone Miner Res 8:719–723PubMed

34.

Ferrar L, Jiang G, Barrington NA et al (2000) Identification of vertebral deformities in women: comparison of radiological assessment and quantitative morphometry using morphometric radiography and morphometric x-ray absorptiometry. J Bone Miner Res 15(3):575–585PubMedCrossRef

35.

Altman DG (1991) Practical statistics for medical research. Chapman and Hall, London, UK

36.

Jiang G, Eastell R, Barrington NA et al (2004) Comparison of methods for the visual identification of prevalent vertebral fracture in osteoporosis. Osteoporos Int 15(11):887–896, NovPubMedCrossRef

Title: Standardised quantitative morphometry: a modified approach for quantitative identification of prevalent vertebral deformities
Authors: G. Jiang
L. Ferrar
N. A. Barrington
R. Eastell
Publication date: 01-10-2007
Publisher: Springer-Verlag
Published in: Osteoporosis International / Issue 10/2007
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-007-0376-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Standardised quantitative morphometry: a modified approach for quantitative identification of prevalent vertebral deformities

Abstract

Summary

Introduction

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Summary

Introduction

Methods

Results

Conclusions

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