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Osteoporosis International

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Open Access 01-12-2009 | Original Article

Automated simulation of areal bone mineral density assessment in the distal radius from high-resolution peripheral quantitative computed tomography

Authors: A. J. Burghardt, G. J. Kazakia, T. M. Link, S. Majumdar

Published in: Osteoporosis International | Issue 12/2009

Abstract

Summary

An automated image processing method is presented for simulating areal bone mineral density measures using high-resolution peripheral quantitative computed tomography (HR-pQCT) in the ultra-distal radius. The accuracy of the method is validated against clinical dual X-ray absorptiometry (DXA). This technique represents a useful reference to gauge the utility of novel 3D quantification methods applied to HR-pQCT in multi-center clinical studies and potentially negates the need for separate forearm DXA measurements.

Introduction

Osteoporotic status is primarily assessed by measuring areal bone mineral density (aBMD) using 2D dual X-ray absorptiometry (DXA). However, this technique does not sufficiently explain bone strength and fracture risk. High-resolution peripheral quantitative computed tomography (HR-pQCT) has been introduced as a method to quantify 3D bone microstructure and biomechanics. In this study, an automated method is proposed to simulate aBMD measures from HR-pQCT distal radius images.

Methods

A total of 117 subject scans were retrospectively analyzed from two clinical bone quality studies. The distal radius was imaged by HR-pQCT and DXA on one of two devices (Hologic or Lunar). Areal BMD was calculated by simulation from HR-pQCT images (aBMD_sim) and by standard DXA analysis (aBMD_dxa).

Results

The reproducibility of the simulation technique was 1.1% (root mean-squared coefficient of variation). HR-pQCT-based aBMD_sim correlated strongly to aBMD_dxa (Hologic: R ² = 0.82, Lunar: R ² = 0.87), though aBMD_sim underestimated aBMD_dxa for both DXA devices (p < 0.0001). Finally, aBMD_sim predicted aBMD at the proximal femur and lumbar spine with equal power compared to aBMD_dxa.

Conclusion

The results demonstrate that aBMD can be simulated from HR-pQCT images of the distal radius. This approach has the potential to serve as a surrogate forearm aBMD measure for clinical HR-pQCT studies when axial bone mineral density values are not required.

(1991) Consensus development conference: prophylaxis and treatment of osteoporosis. Am J Med 90:107-110.

Beck TJ, Oreskovic TL, Stone KL, Ruff CB, Ensrud K, Nevitt MC, Genant HK, Cummings SR (2001) Structural adaptation to changing skeletal load in the progression toward hip fragility: the study of osteoporotic fractures. J Bone Miner Res 16:1108–1119CrossRefPubMed

Stone KL, Seeley DG, Lui LY, Cauley JA, Ensrud K, Browner WS, Nevitt MC, Cummings SR (2003) BMD at multiple sites and risk of fracture of multiple types: long-term results from the Study of Osteoporotic Fractures. J Bone Miner Res 18:1947–1954CrossRefPubMed

Black DM, Thompson DE (1999) The effect of alendronate therapy on osteoporotic fracture in the vertebral fracture arm of the Fracture Intervention Trial. Int J Clin Pract Suppl 101:46–50PubMed

Delmas PD, Seeman E (2004) Changes in bone mineral density explain little of the reduction in vertebral or nonvertebral fracture risk with anti-resorptive therapy. Bone 34:599–604CrossRefPubMed

Hildebrand T, Laib A, Muller R, Dequeker J, Ruegsegger P (1999) Direct three-dimensional morphometric analysis of human cancellous bone: microstructural data from spine, femur, iliac crest, and calcaneus. J Bone Miner Res 14:1167–1174CrossRefPubMed

Muller R, Ruegsegger P (1997) Micro-tomographic imaging for the nondestructive evaluation of trabecular bone architecture. Stud Health Technol Inform 40:61–79PubMed

Ulrich D, van Rietbergen B, Laib A, Ruegsegger P (1999) The ability of three-dimensional structural indices to reflect mechanical aspects of trabecular bone. Bone 25:55–60CrossRefPubMed

David V, Laroche N, Boudignon B, Lafage-Proust MH, Alexandre C, Ruegsegger P, Vico L (2003) Noninvasive in vivo monitoring of bone architecture alterations in hindlimb-unloaded female rats using novel three-dimensional microcomputed tomography. J Bone Miner Res 18:1622–1631CrossRefPubMed

10.

Gasser JA, Ingold P, Grosios K, Laib A, Hammerle S, Koller B (2005) Noninvasive monitoring of changes in structural cancellous bone parameters with a novel prototype micro-CT. J Bone Miner Metab 23:90–96 SupplCrossRefPubMed

11.

Boutroy S, Bouxsein ML, Munoz F, Delmas PD (2005) In vivo assessment of trabecular bone microarchitecture by high-resolution peripheral quantitative computed tomography. J Clin Endocrinol Metab 90:6508–6515CrossRefPubMed

12.

Khosla S, Riggs BL, Atkinson EJ, Oberg AL, McDaniel LJ, Holets M, Peterson JM, Melton LJ 3rd (2006) Effects of sex and age on bone microstructure at the ultradistal radius: a population-based noninvasive in vivo assessment. J Bone Miner Res 21:124–131CrossRefPubMed

13.

Macneil JA, Boyd SK (2007) Accuracy of high-resolution peripheral quantitative computed tomography for measurement of bone quality. Med Eng Phys 29(10):1096–1105CrossRefPubMed

14.

Kazakia GJ, Hyun B, Burghardt AJ, Krug R, Newitt DC, de Papp AE, Link TM, Majumdar S (2008) In vivo determination of bone structure in postmenopausal women: a comparison of HR-pQCT and high-field MR imaging. J Bone Miner Res 23:463–474CrossRefPubMed

15.

Chavassieux P, Asser Karsdal M, Segovia-Silvestre T, Neutzsky-Wulff AV, Chapurlat R, Boivin G, Delmas PD (2008) Mechanisms of the anabolic effects of teriparatide on bone: insight from the treatment of a patient with pycnodysostosis. J Bone Miner Res 23:1076–1083CrossRefPubMed

16.

Boutroy S, Van Rietbergen B, Sornay-Rendu E, Munoz F, Bouxsein ML, Delmas PD (2008) Finite element analysis based on in vivo HR-pQCT images of the distal radius is associated with wrist fracture in postmenopausal women. J Bone Miner Res 23:392–399CrossRefPubMed

17.

Sornay-Rendu E, Boutroy S, Munoz F, Delmas PD (2007) Alterations of cortical and trabecular architecture are associated with fractures in postmenopausal women, partially independent of decreased BMD measured by DXA: the OFELY study. J Bone Miner Res 22:425–433CrossRefPubMed

18.

Melton LJ 3rd, Riggs BL, van Lenthe GH, Achenbach SJ, Muller R, Bouxsein ML, Amin S, Atkinson EJ, Khosla S (2007) Contribution of in vivo structural measurements and load/strength ratios to the determination of forearm fracture risk in postmenopausal women. J Bone Miner Res 22:1442–1448CrossRefPubMed

19.

Shepherd JA, Cheng XG, Lu Y, Njeh C, Toschke J, Engelke K, Grigorian M, Genant HK (2002) Universal standardization of forearm bone densitometry. J Bone Miner Res 17:734–745CrossRefPubMed

20.

(1994) Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO Study Group. World Health Organ Tech Rep Ser 843:1-129

21.

Feldkamp LA, Davis LC, Kress JW (1984) Practical cone-beam algorithm. J Opt Soc Am A 1:612–619CrossRef

22.

Burghardt AJ, Kazakia GJ, Laib A, Majumdar S (2008) Quantitative assessment of bone tissue mineralization with polychromatic micro-computed tomography. Calcif Tissue Int 83:129–138CrossRefPubMed

23.

Laib A, Hauselmann HJ, Ruegsegger P (1998) In vivo high resolution 3D-QCT of the human forearm. Technol Health Care 6:329–337PubMed

24.

Prevrhal S, Lu Y, Genant HK, Toschke JO, Shepherd JA (2005) Towards standardization of dual X-ray absorptiometry (DXA) at the forearm: a common region of interest (ROI) improves the comparability among DXA devices. Calcif Tissue Int 76:348–354CrossRefPubMed

25.

Khoo BC, Brown K, Cann C, Zhu K, Henzell S, Low V, Gustafsson S, Price RI, Prince RL (2008) Comparison of QCT-derived and DXA-derived areal bone mineral density and T scores. Osteoporos Int doi:10.1007/00198-008-0820-y

26.

Augat P, Fuerst T, Genant HK (1998) Quantitative bone mineral assessment at the forearm: a review. Osteoporos Int 8:299–310CrossRefPubMed

27.

Nieves JW, Cosman F, Mars C, Lindsay R (1992) Comparative assessment of bone mineral density of the forearm using single photon and dual X-ray absorptiometry. Calcif Tissue Int 51:352–355CrossRefPubMed

Title: Automated simulation of areal bone mineral density assessment in the distal radius from high-resolution peripheral quantitative computed tomography
Authors: A. J. Burghardt
G. J. Kazakia
T. M. Link
S. Majumdar
Publication date: 01-12-2009
Publisher: Springer-Verlag
Published in: Osteoporosis International / Issue 12/2009
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-009-0907-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Automated simulation of areal bone mineral density assessment in the distal radius from high-resolution peripheral quantitative computed tomography

Abstract

Summary

Introduction

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Summary

Introduction

Methods

Results

Conclusion

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