CT-based visualization and quantification of bone microstructure in vivo

Lenthe, G. Harry van; Müller, Ralph

doi:10.1138/20080348

Cited by 15 publications

(6 citation statements)

References 65 publications

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“…Although bone strength can be quantified accurately in vivo by µFE modeling [19], this may not be practical for large epidemiologic studies. Instead, most such studies have depended on aBMD by DXA as a surrogate.…”

Section: Discussionmentioning

confidence: 99%

Determinants of forearm strength in postmenopausal women

et al. 2011

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Summary Bone strength at the ultradistal radius, quantified by micro-finite element modeling, can be predicted by variables obtained from high-resolution peripheral quantitative computed tomography scans. The specific formula for this bone strength surrogate (−555.2+8.1×[trabecular vBMD]+19.6×[cortical area]+4.2×[total cross-sectional area]) should be validated and tested in fracture risk assessment. Introduction The purpose of this study was to identify key determinants of ultradistal radius (UDR) strength and evaluate their relationships with age, sex steroid levels, and measures of habitual skeletal loading. Methods UDR failure load (~strength) was assessed by micro-finite element (µFE) modeling in 105 postmenopausal controls from an earlier forearm fracture case-control study. Predictors of bone strength obtained by high-resolution peripheral quantitative computed tomography (HRpQCT) in this group were then evaluated in a population-based cohort of 214 postmenopausal women. Sex steroids were measured by mass spectrometry. Results A surrogate variable (−555.2+8.1×[trabecular vBMD]+19.6×[cortical area]+4.2×[total cross-sectional area]) predicted UDR strength modeled by µFE (R2=0.81), and all parameters except total cross-sectional area declined with age. Evaluated cross-sectionally, the 21% fall in predicted bone strength between ages 40–49 years and 80+years more resembled the change in trabecular volumetric bone mineral density (vBMD) (−15%) than that in cortical area (−41%). In multivariable analyses, measures of body composition and physical activity were stronger predictors of UDR trabecular vBMD, cortical area, total cross-sectional area, and predicted bone strength than were sex steroid levels, but bio-available estradiol and testosterone were correlated with body mass. Conclusions Bone strength at the UDR, as quantified by µFE, can be predicted from variables obtained by HRpQCT. Predicted bone strength declines with age with changes in UDR trabecular vBMD and cortical area, related in turn to reduced skeletal loading and sex steroid levels. The predicted bone strength formula should be validated and tested in fracture risk assessment.

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Section: Discussionmentioning

confidence: 99%

Determinants of forearm strength in postmenopausal women

et al. 2011

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“…High-resolution peripheral quantitative computed tomography (HRpQCT) can measure numerous macro- and microstructural variables in the distal radius, along with volumetric BMD (vBMD) of cortical and trabecular bone separately [1]. Indeed, Boutroy and colleagues [2] showed that distal radius vBMD and microstructural parameters better discriminated 35 postmenopausal women with mixed fractures from 78 postmenopausal women without fracture than did areal bone mineral density (aBMD) of the hip or spine by dual-energy X-ray absorptiometry (DXA).…”

Section: Introductionmentioning

confidence: 99%

Assessing forearm fracture risk in postmenopausal women

et al. 2009

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Purpose-To test the clinical utility of approaches for assessing forearm fracture risk.Methods-Among 100 postmenopausal women with a distal forearm fracture (cases) and 105 with no osteoporotic fracture (controls), we measured areal bone mineral density (aBMD) and assessed radius volumetric BMD, geometry and microstructure using high-resolution peripheral QCT; ultradistal radius failure load was evaluated in micro-finite element (μFE) models.Results-Fracture cases had inferior bone density, geometry, microstructure and strength. The most significant determinant of fracture in five categories were: bone density (femoral neck aBMD: odds ratio [OR] per SD, 2.0; 95% CI, 1.4-2.8), geometry (cortical thickness: OR, 1.5; 95% CI, 1.1-2.1), microstructure (structure model index [SMI]: OR, 0.5; 95% CI, 0.4-0.7), and strength (μFE failure load: OR, 1.8; 95% CI, 1.3-2.5); the factor-of-risk (applied load in a forward fall ÷ μFE failure load) was 15% worse in cases (OR, 1.9; 95% CI, 1.4-2.6). Areas under ROC curves (AUC) ranged from 0.62 to 0.68. The predictors of forearm fracture risk that entered a multivariable model were femoral neck aBMD and SMI (combined AUC, 0.71).Conclusions-Detailed bone structure and strength measurements provide insight into forearm fracture pathogenesis, but femoral neck aBMD performs adequately for routine clinical risk assessment.

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“…When comparing different size of granules, Arbez et al (2019) demonstrated that small granules provided scaffolds with low interconnected pores and may not be favourable for vascular invasion in situ when grafted in a bone defect, whereas the large granules (i.e., 1000-2000 µm) provided 3D scaffolds with interconnectivity well suitable for osteoconduction. XCT also allows for a 3D representation of the pore size within the scaffold (van Lenthe & Müller, 2008;Chappard et al, 2015) and to examine the time-dependent structural characteristics and the in vitro dissolution behaviour of different bioglasess (Westhauser et al, 2017).…”

Section: Xct Characterisation Of Scaffolds and Biomaterialsmentioning

confidence: 99%

“…In addition to scaffold microstructure, high-resolution XCT enables the assessment of newly formed bone and biomaterial degradation in animal models (Gauthier et al, 2005;van Lenthe & Müller, 2008;Boerckel et al, 2014;Kerckhofs et al, 2016;Sweedy et al, 2017). Certainly, bone defect animal models remain essential for preclinical research of novel biomaterials (Hulsart-Billström et al, 2016), overcoming limitations of in vitro studies due to the reduced complexity of the environment.…”

Section: Bone Regeneration Xct Analysismentioning

confidence: 99%

Applications of X‐ray computed tomography for the evaluation of biomaterial‐mediated bone regeneration in critical‐sized defects

Fernández

Witte²,

Tozzi

2019

Journal of Microscopy

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Bone as such displays an intrinsic regenerative potential following fracture; however, this capacity is limited with large bone defects that cannot heal spontaneously. The management of critical‐sized bone defects remains a major clinical and socioeconomic need with osteoregenerative biomaterials constantly under development aiming at promoting and enhancing bone healing. X‐ray computed tomography (XCT) has become a standard and essential tool for quantifying structure–function relationships in bone and biomaterials, facilitating the development of novel bone tissue engineering strategies. This paper presents recent advancements in XCT analysis of biomaterial‐mediated bone regeneration. As a noninvasive and nondestructive technique, XCT allows for qualitative and quantitative evaluation of three‐dimensional (3D) scaffolds and biomaterial microarchitecture, bone growth into the scaffold as well as the 3D characterisation of biomaterial degradation and bone regeneration in vitro and in vivo. Furthermore, in combination with in situ mechanical testing and digital volume correlation (DVC), XCT demonstrated its potential to better understand the bone–biomaterial interactions and local mechanics of bone regeneration during the healing process in relation to the regeneration achieved in vivo, which will likely provide valuable knowledge for the development and optimisation of novel osteoregenerative biomaterials. Lay Description Bone, being a dynamically adaptable material, displays excellent regenerative properties following fracture. However, the self‐healing capacity of bone becomes more difficult with large bone defects. Those defects are common and occur in many clinical situations; hence, biomaterials are mostly used to restore both bone structure and function in the defect site. X‐ray computed tomography (XCT) is a powerful tool to evaluate bone regeneration in critical‐sized defects after the implantation of biomaterials, allowing to an improved understanding of the regeneration process following different bone tissue engineering approaches. This paper focuses on recent advancements in XCT analysis to characterise biomaterial‐mediated bone regeneration in critical‐sized defects. XCT supports three‐dimensional (3D) analysis of biomaterials, scaffolds and regenerated bone microarchitecture, as well as bone ingrowth into the scaffold. As a nondestructive technique, XCT allows for a 3D characterisation of biomaterial degradation and bone regeneration over time. In addition, XCT combined with in situ mechanical experiments and digital volume correlation (DVC) provides a 3D evaluation and quantification of bone–biomaterial interactions and deformation mechanisms during the regeneration process. This remains essential for the development and enhancement of novel biomaterials able to produce bone that is comparable with the native tissue they aim to replace.

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CT-based visualization and quantification of bone microstructure in vivo

Cited by 15 publications

References 65 publications

Determinants of forearm strength in postmenopausal women

Determinants of forearm strength in postmenopausal women

Assessing forearm fracture risk in postmenopausal women

Applications of X‐ray computed tomography for the evaluation of biomaterial‐mediated bone regeneration in critical‐sized defects

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