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Skeletal Radiology
Published in: Skeletal Radiology 7/2019

Open Access 01-07-2019 | Scientific Article

Assessing the effects of long-term osteoporosis treatment by using conventional spine radiographs: results from a pilot study in a sub-cohort of a large randomized controlled trial

Authors: Hans Peter Dimai, Richard Ljuhar, Davul Ljuhar, Benjamin Norman, Stefan Nehrer, Andreas Kurth, Astrid Fahrleitner-Pammer

Published in: Skeletal Radiology | Issue 7/2019

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Abstract

Objective

To evaluate the clinical applicability of a software tool developed to extract bone textural information from conventional lumbar spine radiographs, and to test it in a subset of postmenopausal women treated for osteoporosis with the fully human monoclonal antibody denosumab.

Methods

The software was developed based on the principles of a fractal model using pixel grey-level variations together with a specific machine-learning algorithm. The obtained dimensionless parameter, termed bone structure value (BSV), was then tested and compared to bone mineral density (BMD) in a sub-cohort of postmenopausal women with osteoporosis who were treated with the monoclonal antibody denosumab, within the framework of a large randomized controlled trial and its open-label extension phase.

Results

After 3 years and after 8 years of treatment with denosumab, mean lumbar spine BMD as well as mean lumbar BSV were significantly higher compared to study entry (one-way repeated measures ANOVA for DXA: F = 108.2, p < 0.00001; and for BSV: F = 84.3, p < 0.00001). The overall increase in DXA-derived lumbar spine BMD at year 8 was + 42% (mean ± SD; 0.725 ± 0.038 g/cm2 to 1.031 ± 0.092 g/cm2; p < 0.0001), and the overall increase of BSV was 255% (mean ± SD; 0.076 ± 0.022 to 0.270 ± 0.09, p < 0.0001). Overall, BMD and BSV were significantly correlated (R = 0.51; p < 0.0001).

Conclusions

This pilot study provides evidence that lumbar spine BSV as obtained from conventional radiographs constitutes a useful means for the assessment of bone-specific treatment effects in postmenopausal women with osteoporosis.
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Metadata
Title
Assessing the effects of long-term osteoporosis treatment by using conventional spine radiographs: results from a pilot study in a sub-cohort of a large randomized controlled trial
Authors
Hans Peter Dimai
Richard Ljuhar
Davul Ljuhar
Benjamin Norman
Stefan Nehrer
Andreas Kurth
Astrid Fahrleitner-Pammer
Publication date
01-07-2019
Publisher
Springer Berlin Heidelberg
Published in
Skeletal Radiology / Issue 7/2019
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-018-3118-y

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