Accuracy errors in longitudinal QCT measurements of cortical thickness bone mineral density and bone mineral content using different segmentation techniques: a simulation study

Gerner, Bastian; Museyko, Oleg; Töpfer, Dominique; Engelke, Klaus

doi:10.1530/boneabs.1.pp71

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“…One outcome of the new analysis was the treatment‐induced increase in cortical vBMD that was not observed in the earlier analysis. The use of global thresholds, which are employed by QCTPro, as well as partial volume artifacts, may falsely result in a measured increase of cortical thickness when in reality cortical vBMD increases . When interpreting QCT data, it is important to keep in mind that partial volume effects cause interactions between true changes in cortical thickness and true changes in cortical vBMD, which effect the resultant measurements.…”

Section: Discussionmentioning

confidence: 99%

Odanacatib Treatment Affects Trabecular and Cortical Bone in the Femur of Postmenopausal Women: Results of a Two-Year Placebo-Controlled Trial

Engelke¹,

Fuerst²,

Dardzinski

et al. 2014

Journal of Bone and Mineral Research

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Odanacatib, a selective cathepsin K inhibitor, increases areal bone mineral density (aBMD) at the spine and hip of postmenopausal women. To gain additional insight into the effects on trabecular and cortical bone, we analyzed quantitative computed tomography (QCT) data of postmenopausal women treated with odanacatib using Medical Image Analysis Framework (MIAF; Institute of Medical Physics, University of Erlangen, Erlangen, Germany). This international, randomized, double-blind, placebo-controlled, 2-year, phase 3 trial enrolled 214 postmenopausal women (mean age 64 years) with low aBMD. Subjects were randomized to odanacatib 50 mg weekly (ODN) or placebo (PBO); all participants received calcium and vitamin D. Hip QCT scans at 24 months were available for 158 women (ODN: n ¼ 78 women; PBO: n ¼ 80 women). There were consistent and significant differential treatment effects (ODN-PBO) for total hip integral (5.4%), trabecular volumetric BMD (vBMD) (12.2%), and cortical vBMD (2.5%) at 24 months. There was no significant differential treatment effect on integral bone volume. Results for bone mineral content (BMC) closely matched those for vBMD for integral and trabecular compartments. However, with small but mostly significant differential increases in cortical volume (1.0% to 1.3%) and thickness (1.4% to 1.9%), the percentage cortical BMC increases were numerically larger than those of vBMD. With a total hip BMC differential treatment effect (ODN-PBO) of nearly 1000 mg, the proportions of BMC attributed to cortical gain were 45%, 44%, 52%, and 40% for the total, neck, trochanter, and intertrochanter subregions, respectively. In postmenopausal women treated for 2 years, odanacatib improved integral, trabecular, and cortical vBMD and BMC at all femur regions relative to placebo when assessed by MIAF. Cortical volume and thickness increased significantly in all regions except the femoral neck. The increase in cortical volume and BMC paralleled the increase in cortical vBMD, demonstrating a consistent effect of ODN on cortical bone. Approximately one-half of the absolute BMC gain occurred in cortical bone.

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Section: Discussionmentioning

confidence: 99%