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Published in: Osteoporosis International 10/2016

01-10-2016 | Original Article

In vivo assessment of bone structure and estimated bone strength by first- and second-generation HR-pQCT

Authors: S. Agarwal, F. Rosete, C. Zhang, D. J. McMahon, X. E. Guo, E. Shane, K. K. Nishiyama

Published in: Osteoporosis International | Issue 10/2016

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Abstract

Summary

Bone strength is dependent on bone density and microstructure. High-resolution peripheral quantitative computed tomography (HR-pQCT) can measure microstructure but is somewhat limited due to its resolution. We compared a new HR-pQCT scanner to existing technology and found very good agreement for most parameters. This study will be important when interpreting results from different devices.

Introduction

Recently, a second-generation HR-pQCT scanner (XCT2) has been developed with a higher nominal isotropic resolution (61 μm) compared to the first-generation device (XCT1, 82 μm). It is unclear how in vivo measurements from these two devices compare. In this study, we obtained and analyzed in vivo XCT1 and XCT2 measurements of bone microarchitecture and estimated strength.

Methods

We scanned 51 adults (16 men and 35 women, age 44.8 ± 16.0) on both XCT2 and XCT1 on the same day. We first compared XCT1 and XCT2 measurements obtained using their respective standard patient protocols. In XCT1, microarchitecture parameters were derived, while XCT2 measurements were directly measured. We also compared XCT2-D with XCT1 by finding the overlapping regions of interest and using the standard patient protocol for XCT1.

Results

We obtained excellent agreement between XCT1 and XCT2 for most of the volumetric bone mineral density (vBMD), trabecular and cortical measurements (All R 2 > 0.820) except for cortical porosity at the radius (R 2 = 0.638), trabecular number (R 2 = 0.694, 0.787) and trabecular thickness (R 2 = 0.569, 0.527) at both radius and tibia, respectively. XCT1 and XCT2-D measurements also had excellent agreement for most of the measurements (all R 2 > 0.870) except trabecular number (R 2 = 0.524, 0.706), trabecular thickness (R 2 = 0.758, 0.734) at both radius and tibia, respectively, and trabecular separation (R 2 = 0.656) at the radius.

Conclusion

While some caution should be exercised for parameters that are more dependent on image resolution, results from our study indicate that second-generation scans can be compared to more widely available first-generation data and may be beneficial for multicenter and longitudinal studies using both scanner generations.
Literature
2.
go back to reference Hansen S, Shanbhogue V, Folkestad L, Nielsen MMF, Brixen K (2014) Bone microarchitecture and estimated strength in 499 adult Danish women and men: a cross-sectional, population-based high-resolution peripheral quantitative computed tomographic study on peak bone structure. Calcif Tissue Int 94(3):269–281PubMedCrossRef Hansen S, Shanbhogue V, Folkestad L, Nielsen MMF, Brixen K (2014) Bone microarchitecture and estimated strength in 499 adult Danish women and men: a cross-sectional, population-based high-resolution peripheral quantitative computed tomographic study on peak bone structure. Calcif Tissue Int 94(3):269–281PubMedCrossRef
3.
go back to reference Vico L, Zouch M, Amirouche A, Frère D, Laroche N, Koller B, Laib A, Thomas T, Alexandre C (2008) High-resolution pQCT analysis at the distal radius and tibia discriminates patients with recent wrist and femoral neck fractures. J Bone Miner Res 23(11):1741–1750. doi:10.1359/jbmr.080704 PubMedCrossRef Vico L, Zouch M, Amirouche A, Frère D, Laroche N, Koller B, Laib A, Thomas T, Alexandre C (2008) High-resolution pQCT analysis at the distal radius and tibia discriminates patients with recent wrist and femoral neck fractures. J Bone Miner Res 23(11):1741–1750. doi:10.​1359/​jbmr.​080704 PubMedCrossRef
4.
go back to reference Melton LJ, Riggs BL, van Lenthe GH, Achenbach SJ, Müller 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(9):1442–1448. doi:10.1359/jbmr.070514 PubMedCrossRef Melton LJ, Riggs BL, van Lenthe GH, Achenbach SJ, Müller 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(9):1442–1448. doi:10.​1359/​jbmr.​070514 PubMedCrossRef
6.
go back to reference Liu XS, Zhang XH, Sekhon KK, Adams MF, McMahon DJ, Bilezikian JP, Shane E, Guo XE (2010) High-resolution peripheral quantitative computed tomography can assess microstructural and mechanical properties of human distal tibial bone. J Bone Miner Res 25(4):746–756. doi:10.1359/jbmr.090822 PubMed Liu XS, Zhang XH, Sekhon KK, Adams MF, McMahon DJ, Bilezikian JP, Shane E, Guo XE (2010) High-resolution peripheral quantitative computed tomography can assess microstructural and mechanical properties of human distal tibial bone. J Bone Miner Res 25(4):746–756. doi:10.​1359/​jbmr.​090822 PubMed
7.
go back to reference Bacchetta J, Boutroy S, Vilayphiou N, Juillard L, Guebre-Egziabher F, Rognant N, Sornay-Rendu E, Szulc P, Laville M, Delmas PD, Fouque D, Chapurlat R (2009) Early impairment of trabecular microarchitecture assessed with HR-pQCT in patients with stage II-IV chronic kidney disease. J Bone Miner Res 25(4):849–857. doi:10.1359/jbmr.090831 Bacchetta J, Boutroy S, Vilayphiou N, Juillard L, Guebre-Egziabher F, Rognant N, Sornay-Rendu E, Szulc P, Laville M, Delmas PD, Fouque D, Chapurlat R (2009) Early impairment of trabecular microarchitecture assessed with HR-pQCT in patients with stage II-IV chronic kidney disease. J Bone Miner Res 25(4):849–857. doi:10.​1359/​jbmr.​090831
8.
go back to reference Seeman E, Delmas PD, Hanley DA, Sellmeyer D, Cheung AM, Shane E, Kearns A, Thomas T, Boyd SK, Boutroy S, Bogado C, Majumdar S, Fan M, Libanati C, Zanchetta J (2010) Microarchitectural deterioration of cortical and trabecular bone: differing effects of denosumab and alendronate. J Bone Miner Res 25(8):1886–1894. doi:10.1002/jbmr.81 PubMedPubMedCentralCrossRef Seeman E, Delmas PD, Hanley DA, Sellmeyer D, Cheung AM, Shane E, Kearns A, Thomas T, Boyd SK, Boutroy S, Bogado C, Majumdar S, Fan M, Libanati C, Zanchetta J (2010) Microarchitectural deterioration of cortical and trabecular bone: differing effects of denosumab and alendronate. J Bone Miner Res 25(8):1886–1894. doi:10.​1002/​jbmr.​81 PubMedPubMedCentralCrossRef
9.
go back to reference Kawalilak C, Johnston J, Olszynski W, Kontulainen S (2014) Characterizing microarchitectural changes at the distal radius and tibia in postmenopausal women using HR-pQCT. Osteoporos Int 25(8):2057–2066PubMedCrossRef Kawalilak C, Johnston J, Olszynski W, Kontulainen S (2014) Characterizing microarchitectural changes at the distal radius and tibia in postmenopausal women using HR-pQCT. Osteoporos Int 25(8):2057–2066PubMedCrossRef
10.
go back to reference Nishiyama KK, Cohen A, Young P, Wang J, Lappe JM, Guo XE, Dempster DW, Recker RR, Shane E (2014) Teriparatide increases strength of the peripheral skeleton in premenopausal women with idiopathic osteoporosis: a pilot HR-pQCT study. J Clin Endocrinol Metab 99(7):2418–2425. doi:10.1210/jc.2014-1041 PubMedPubMedCentralCrossRef Nishiyama KK, Cohen A, Young P, Wang J, Lappe JM, Guo XE, Dempster DW, Recker RR, Shane E (2014) Teriparatide increases strength of the peripheral skeleton in premenopausal women with idiopathic osteoporosis: a pilot HR-pQCT study. J Clin Endocrinol Metab 99(7):2418–2425. doi:10.​1210/​jc.​2014-1041 PubMedPubMedCentralCrossRef
11.
go back to reference Dalzell N, Kaptoge S, Morris N, Berthier A, Koller B, Braak L, van Rietbergen B, Reeve J (2009) Bone micro-architecture and determinants of strength in the radius and tibia: age-related changes in a population-based study of normal adults measured with high-resolution pQCT. Osteoporos Int 20(10):1683–1694. doi:10.1007/s00198-008-0833-6 PubMedCrossRef Dalzell N, Kaptoge S, Morris N, Berthier A, Koller B, Braak L, van Rietbergen B, Reeve J (2009) Bone micro-architecture and determinants of strength in the radius and tibia: age-related changes in a population-based study of normal adults measured with high-resolution pQCT. Osteoporos Int 20(10):1683–1694. doi:10.​1007/​s00198-008-0833-6 PubMedCrossRef
12.
go back to reference 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(3):392–399. doi:10.1359/jbmr.071108 PubMedCrossRef 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(3):392–399. doi:10.​1359/​jbmr.​071108 PubMedCrossRef
13.
go back to reference Müller R, Rüegsegger P (1995) Three-dimensional finite element modelling of non-invasively assessed trabecular bone structures. Med Eng Phys 17(2):126–133PubMedCrossRef Müller R, Rüegsegger P (1995) Three-dimensional finite element modelling of non-invasively assessed trabecular bone structures. Med Eng Phys 17(2):126–133PubMedCrossRef
14.
go back to reference Van Rietbergen B, Weinans H, Huiskes R, Odgaard A (1995) A new method to determine trabecular bone elastic properties and loading using micromechanical finite-element models. J Biomech 28(1):69–81PubMedCrossRef Van Rietbergen B, Weinans H, Huiskes R, Odgaard A (1995) A new method to determine trabecular bone elastic properties and loading using micromechanical finite-element models. J Biomech 28(1):69–81PubMedCrossRef
15.
go back to reference Krause M, Museyko O, Breer S, Wulff B, Duckstein C, Vettorazzi E, Glueer C, Püschel K, Engelke K, Amling M (2014) Accuracy of trabecular structure by HR-pQCT compared to gold standard μCT in the radius and tibia of patients with osteoporosis and long-term bisphosphonate therapy. Osteoporos Int 25(5):1595–1606PubMedCrossRef Krause M, Museyko O, Breer S, Wulff B, Duckstein C, Vettorazzi E, Glueer C, Püschel K, Engelke K, Amling M (2014) Accuracy of trabecular structure by HR-pQCT compared to gold standard μCT in the radius and tibia of patients with osteoporosis and long-term bisphosphonate therapy. Osteoporos Int 25(5):1595–1606PubMedCrossRef
16.
go back to reference 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(12):6508–6515. doi:10.1210/jc.2005-1258 PubMedCrossRef 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(12):6508–6515. doi:10.​1210/​jc.​2005-1258 PubMedCrossRef
17.
go back to reference Parfitt AM, Mathews CH, Villanueva AR, Kleerekoper M, Frame B, Rao DS (1983) Relationships between surface, volume, and thickness of iliac trabecular bone in aging and in osteoporosis. Implications for the microanatomic and cellular mechanisms of bone loss. J Clin Invest 72(4):1396–1409. doi:10.1172/JCI111096 PubMedPubMedCentralCrossRef Parfitt AM, Mathews CH, Villanueva AR, Kleerekoper M, Frame B, Rao DS (1983) Relationships between surface, volume, and thickness of iliac trabecular bone in aging and in osteoporosis. Implications for the microanatomic and cellular mechanisms of bone loss. J Clin Invest 72(4):1396–1409. doi:10.​1172/​JCI111096 PubMedPubMedCentralCrossRef
18.
go back to reference Laib A, Ruegsegger P (1999) Calibration of trabecular bone structure measurements of in vivo three-dimensional peripheral quantitative computed tomography with 28-micrometer-resolution microcomputed tomography. Bone 24(1):35–39PubMedCrossRef Laib A, Ruegsegger P (1999) Calibration of trabecular bone structure measurements of in vivo three-dimensional peripheral quantitative computed tomography with 28-micrometer-resolution microcomputed tomography. Bone 24(1):35–39PubMedCrossRef
19.
go back to reference Laib A, Ruegsegger P (1999) Comparison of structure extraction methods for in vivo trabecular bone measurements. Comput Med Imaging Graph 23(2):69–74PubMedCrossRef Laib A, Ruegsegger P (1999) Comparison of structure extraction methods for in vivo trabecular bone measurements. Comput Med Imaging Graph 23(2):69–74PubMedCrossRef
20.
go back to reference Manske SL, Zhu Y, Sandino C, Boyd SK (2015) Human trabecular bone microarchitecture can be assessed independently of density with second generation HR-pQCT. Bone 79:213–221PubMedCrossRef Manske SL, Zhu Y, Sandino C, Boyd SK (2015) Human trabecular bone microarchitecture can be assessed independently of density with second generation HR-pQCT. Bone 79:213–221PubMedCrossRef
21.
go back to reference Hildebrand T, Rüegsegger P (1997) A new method for the model-independent assessment of thickness in three-dimensional images. J Microsc 185(1):67–75CrossRef Hildebrand T, Rüegsegger P (1997) A new method for the model-independent assessment of thickness in three-dimensional images. J Microsc 185(1):67–75CrossRef
22.
go back to reference Hildebrand T, Laib A, Müller R, Dequeker J, Rüegsegger 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(7):1167–1174PubMedCrossRef Hildebrand T, Laib A, Müller R, Dequeker J, Rüegsegger 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(7):1167–1174PubMedCrossRef
24.
go back to reference Burghardt AJ, Kazakia GJ, Ramachandran S, Link TM, Majumdar S (2010) Age- and gender-related differences in the geometric properties and biomechanical significance of intracortical porosity in the distal radius and tibia. J Bone Miner Res 25(5):983–993. doi:10.1359/jbmr.091104 PubMed Burghardt AJ, Kazakia GJ, Ramachandran S, Link TM, Majumdar S (2010) Age- and gender-related differences in the geometric properties and biomechanical significance of intracortical porosity in the distal radius and tibia. J Bone Miner Res 25(5):983–993. doi:10.​1359/​jbmr.​091104 PubMed
25.
go back to reference McCalden RW, McGeough JA, Barker MB, Court-Brown CM (1993) Age-related changes in the tensile properties of cortical bone. The relative importance of changes in porosity, mineralization, and microstructure. J Bone Joint Surg Am 75(8):1193–1205PubMed McCalden RW, McGeough JA, Barker MB, Court-Brown CM (1993) Age-related changes in the tensile properties of cortical bone. The relative importance of changes in porosity, mineralization, and microstructure. J Bone Joint Surg Am 75(8):1193–1205PubMed
26.
go back to reference Currey JD (1988) The effect of porosity and mineral content on the Young’s modulus of elasticity of compact bone. J Biomech 21(2):131–139PubMedCrossRef Currey JD (1988) The effect of porosity and mineral content on the Young’s modulus of elasticity of compact bone. J Biomech 21(2):131–139PubMedCrossRef
27.
go back to reference Schaffler MB, Burr DB (1988) Stiffness of compact bone: effects of porosity and density. J Biomech 21(1):13–16PubMedCrossRef Schaffler MB, Burr DB (1988) Stiffness of compact bone: effects of porosity and density. J Biomech 21(1):13–16PubMedCrossRef
28.
go back to reference Wachter NJ, Krischak GD, Mentzel M, Sarkar MR, Ebinger T, Kinzl L, Claes L, Augat P (2002) Correlation of bone mineral density with strength and microstructural parameters of cortical bone in vitro. Bone 31(1):90–95PubMedCrossRef Wachter NJ, Krischak GD, Mentzel M, Sarkar MR, Ebinger T, Kinzl L, Claes L, Augat P (2002) Correlation of bone mineral density with strength and microstructural parameters of cortical bone in vitro. Bone 31(1):90–95PubMedCrossRef
29.
go back to reference Ural A, Vashishth D (2007) Effects of intracortical porosity on fracture toughness in aging human bone: a micro-CT-based cohesive finite element study. J Biomech Eng 129(5):625–631PubMedCrossRef Ural A, Vashishth D (2007) Effects of intracortical porosity on fracture toughness in aging human bone: a micro-CT-based cohesive finite element study. J Biomech Eng 129(5):625–631PubMedCrossRef
30.
go back to reference Tjong W, Nirody J, Burghardt AJ, Carballido-Gamio J, Kazakia GJ (2014) Structural analysis of cortical porosity applied to HR-pQCT data. Med Phys 41(1):013701PubMedCrossRef Tjong W, Nirody J, Burghardt AJ, Carballido-Gamio J, Kazakia GJ (2014) Structural analysis of cortical porosity applied to HR-pQCT data. Med Phys 41(1):013701PubMedCrossRef
31.
go back to reference Tjong W, Kazakia GJ, Burghardt AJ, Majumdar S (2012) The effect of voxel size on high-resolution peripheral computed tomography measurements of trabecular and cortical bone microstructure. Med Phys 39(4):1893–1903PubMedPubMedCentralCrossRef Tjong W, Kazakia GJ, Burghardt AJ, Majumdar S (2012) The effect of voxel size on high-resolution peripheral computed tomography measurements of trabecular and cortical bone microstructure. Med Phys 39(4):1893–1903PubMedPubMedCentralCrossRef
32.
go back to reference Macdonald HM, Nishiyama KK, Kang J, Hanley DA, Boyd SK (2011) Age-related patterns of trabecular and cortical bone loss differ between sexes and skeletal sites: a population-based HR-pQCT study. J Bone Miner Res 26(1):50–62. doi:10.1002/jbmr.171 PubMedCrossRef Macdonald HM, Nishiyama KK, Kang J, Hanley DA, Boyd SK (2011) Age-related patterns of trabecular and cortical bone loss differ between sexes and skeletal sites: a population-based HR-pQCT study. J Bone Miner Res 26(1):50–62. doi:10.​1002/​jbmr.​171 PubMedCrossRef
33.
go back to reference Cohen A, Stein EM, Recker RR, Lappe JM, Dempster DW, Zhou H, Cremers S, McMahon DJ, Nickolas TL, Müller R, Zwahlen A, Young P, Stubby J, Shane E (2013) Teriparatide for idiopathic osteoporosis in premenopausal women: a pilot study. J Clin Endocrinol Metab 98(5):1971–1981. doi:10.1210/jc.2013-1172 PubMedPubMedCentralCrossRef Cohen A, Stein EM, Recker RR, Lappe JM, Dempster DW, Zhou H, Cremers S, McMahon DJ, Nickolas TL, Müller R, Zwahlen A, Young P, Stubby J, Shane E (2013) Teriparatide for idiopathic osteoporosis in premenopausal women: a pilot study. J Clin Endocrinol Metab 98(5):1971–1981. doi:10.​1210/​jc.​2013-1172 PubMedPubMedCentralCrossRef
35.
go back to reference Laib A, Häuselmann HJ, Rüegsegger P (1998) In vivo high resolution 3D-QCT of the human forearm. Technol Health Care 6:329–337PubMed Laib A, Häuselmann HJ, Rüegsegger P (1998) In vivo high resolution 3D-QCT of the human forearm. Technol Health Care 6:329–337PubMed
37.
go back to reference Nishiyama KK, Macdonald HM, Buie HR, Hanley DA, Boyd SK (2010) Postmenopausal women with osteopenia have higher cortical porosity and thinner cortices at the distal radius and tibia than women with normal aBMD: an in vivo HR-pQCT study. J Bone Miner Res 25(4):882–890. doi:10.1359/jbmr.091020 PubMed Nishiyama KK, Macdonald HM, Buie HR, Hanley DA, Boyd SK (2010) Postmenopausal women with osteopenia have higher cortical porosity and thinner cortices at the distal radius and tibia than women with normal aBMD: an in vivo HR-pQCT study. J Bone Miner Res 25(4):882–890. doi:10.​1359/​jbmr.​091020 PubMed
40.
go back to reference Pistoia W, van Rietbergen B, Lochmüller E-M, Lill CA, Eckstein F, Rüegsegger P (2002) Estimation of distal radius failure load with micro-finite element analysis models based on three-dimensional peripheral quantitative computed tomography images. Bone 30(6):842–848PubMedCrossRef Pistoia W, van Rietbergen B, Lochmüller E-M, Lill CA, Eckstein F, Rüegsegger P (2002) Estimation of distal radius failure load with micro-finite element analysis models based on three-dimensional peripheral quantitative computed tomography images. Bone 30(6):842–848PubMedCrossRef
41.
go back to reference Bland JM, Altman DG (1999) Measuring agreement in method comparison studies. Stat Methods Med Res 8(2):135–160PubMedCrossRef Bland JM, Altman DG (1999) Measuring agreement in method comparison studies. Stat Methods Med Res 8(2):135–160PubMedCrossRef
42.
go back to reference Shrout PE, Fleiss JL (1979) Intraclass correlations: uses in assessing rater reliability. Psychol Bull 86(2):420–428PubMedCrossRef Shrout PE, Fleiss JL (1979) Intraclass correlations: uses in assessing rater reliability. Psychol Bull 86(2):420–428PubMedCrossRef
43.
go back to reference Pialat J, Burghardt A, Sode M, Link T, Majumdar S (2012) Visual grading of motion induced image degradation in high resolution peripheral computed tomography: impact of image quality on measures of bone density and micro-architecture. Bone 50(1):111–118PubMedCrossRef Pialat J, Burghardt A, Sode M, Link T, Majumdar S (2012) Visual grading of motion induced image degradation in high resolution peripheral computed tomography: impact of image quality on measures of bone density and micro-architecture. Bone 50(1):111–118PubMedCrossRef
45.
go back to reference Feldkamp LA, Goldstein SA, Parfitt AM, Jesion G, Kleerekoper M (1989) The direct examination of three-dimensional bone architecture in vitro by computed tomography. J Bone Miner Res 4(1):3–11PubMedCrossRef Feldkamp LA, Goldstein SA, Parfitt AM, Jesion G, Kleerekoper M (1989) The direct examination of three-dimensional bone architecture in vitro by computed tomography. J Bone Miner Res 4(1):3–11PubMedCrossRef
Metadata
Title
In vivo assessment of bone structure and estimated bone strength by first- and second-generation HR-pQCT
Authors
S. Agarwal
F. Rosete
C. Zhang
D. J. McMahon
X. E. Guo
E. Shane
K. K. Nishiyama
Publication date
01-10-2016
Publisher
Springer London
Published in
Osteoporosis International / Issue 10/2016
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-016-3621-8

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