Differences in structural geometrical outcomes at the neck of the proximal femur using two-dimensional DXA-derived projection (APEX) and three-dimensional QCT-derived (BIT QCT) techniques

Khoo, Benjamin; Brown, J.K.; Zhu, Kun; Pollock, Marie; Wilson, Kevin E.; Price, Roger I.; Prince, Richard

doi:10.1007/s00198-011-1727-6

Cited by 23 publications

(8 citation statements)

References 12 publications

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“…There are inherent limitations in attempts to assess three‐dimensional structure from two‐dimensional images. Two‐dimensional DXA structural geometrical variables dependent on mass calibration standards and mathematical derivation techniques are different from three‐dimensional QCT variables . However, correlations between measured variables between DXA and QCT range from moderate to high (0.73 to 0.90), substantiating the assumptions underlying the HSA approach and increasing confidence that 2D HSA replicates the 3D measures .…”

Section: Discussionmentioning

confidence: 86%

Does Hormone Replacement Normalize Bone Geometry in Adolescents With Anorexia Nervosa?

DiVasta

Feldman

Beck³

et al. 2013

Journal of Bone and Mineral Research

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Young women with anorexia nervosa (AN) have reduced secretion of dehydroepiandrosterone (DHEA) and estrogen contributing to skeletal deficits. In this randomized, placebo-controlled trial, we investigated the effects of oral DHEA+ combined oral contraceptive (COC) vs. placebo on changes in bone geometry in young women with AN. Eighty women with AN, aged 13-27 yr, received a random, double-blinded assignment to micronized DHEA (50 mg/d) + COC (20μg ethinyl estradiol/0.1mg levonorgestrel) or placebo for 18 mo. Measurements of aBMD at the total hip were obtained by dual-energy X-ray absorptiometry at 0, 6, 12, and 18 mo. We used the Hip Structural Analysis (HSA) Program to determine BMD, cross-sectional area (CSA), and section modulus at the femoral neck and shaft. Each measurement was expressed as a percentage of the age-, height-, and lean mass-specific mean from an independent sample of healthy adolescent females. Over the 18 months, DHEA+COC led to stabilization in femoral shaft BMD (0.0 ± 0.5 % of normal mean for age, height, and lean mass/year) compared with decreases in the placebo group (−1.1 ± 0.5% per year, p=0.03). Similarly, CSA, section modulus, and cortical thickness improved with treatment. In young women with AN, adrenal and gonadal hormone replacement improved bone health and increased cross sectional geometry. Our results indicate that this combination treatment has a beneficial impact on surrogate measures of bone strength, and not only bone density, in young women with AN.

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Section: Discussionmentioning

confidence: 86%

Does Hormone Replacement Normalize Bone Geometry in Adolescents With Anorexia Nervosa?

DiVasta

Feldman

Beck³

et al. 2013

Journal of Bone and Mineral Research

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“…Firstly, the accuracy of describing the bones’ three-dimensional geometric features is restricted by the inherent limitations of DXA technology. Whereas, researches have testified that the geometric features described by using two-dimensional data derived from DXA were highly correlated with a true three-dimensional method [ 38 ]. Secondly, this study had no information about the reproductive factors, i.e.…”

Section: Discussionmentioning

confidence: 99%

Associations of Age, BMI, and Years of Menstruation with Proximal Femur Strength in Chinese Postmenopausal Women: A Cross-Sectional Study

Kang

Chen

Han

et al. 2016

IJERPH

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This study aimed to elucidate the associations of age, BMI, and years of menstruation with proximal femur strength in Chinese postmenopausal women, which may improve the prediction of hip fracture risk. A cross-sectional study was conducted in 1322 Chinese postmenopausal women recruited from communities. DXA images were used to generate bone mineral density (BMD) and geometric parameters, including cross-sectional area (CSA), outer diameter (OD), cortical thickness (CT), section modulus (SM), buckling ratio (BR) at the narrow neck (NN), intertrochanter (IT), and femoral shaft (FS). Relationships of age, BMI, and years of menstruation with bone phenotypes were analyzed with the adjustment of height, age at menarche, total daily physical activity, education, smoking status, calcium tablet intake, etc. Age was associated with lower BMD, CSA, CT, SM, and higher BR (p < 0.05), which indicated a weaker bone strength at the proximal femur. BMI and years of menstruation had the positive relationships with proximal femur strength (p < 0.05). Further analyses showed that the ranges of absolute value of change slope per year, per BMI or per year of menstruation were 0.14%–1.34%, 0.20%–2.70%, and 0.16%–0.98%, respectively. These results supported that bone strength deteriorated with aging and enhanced with higher BMI and longer time of years of menstruation in Chinese postmenopausal women.

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“…Several of these approaches also facilitate geometric and structural analyses of the minimum femoral neck cross section, computing cross-sectional area, estimates of cortical volume and thickness, and moments of inertia for strength estimation. There has also been comparison made of hip structural analysis (HSA) parameters derived by DXA and QCT [40]. However, as has been stated before, the lack of normal data for standardization and the prevailing use of DXA T-scores for diagnostic categorization currently limit these volumetric 3D hip analysis methods to research and clinical trials application.…”

Section: Discussionmentioning

confidence: 99%

CTXA Hip—An Extension of Classical DXA Measurements Using Quantitative CT

et al. 2014

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Bone mineral density (BMD) estimates for the proximal femur using Dual Energy X-ray Absorptiometry (DXA) are currently considered the standard for making a diagnosis of osteoporosis in an individual patient using BMD alone. We have compared BMD results from a commercial Quantitative CT (QCT) BMD analysis system, “CTXA Hip”, which provides clinical data for the proximal femur, to results from DXA. We have also used CTXA Hip to determine cortical and trabecular contributions to total BMD. Sixty-nine patients were scanned using 3D QCT and DXA. CTXA Hip BMD measurements for Total Hip and Femoral Neck were compared to DXA results. Twenty-two women were scanned at 0,1,2 years and CTXA Hip and DXA results analyzed for long-term reproducibility. Long-term reproducibility calculated as root-mean-square averages of SDs in vivo was 0.012 g/cm2 (CV = 1.8%) for CTXA Total Hip and 0.011 g/cm2 (CV = 2.0%) for CTXA Femoral Neck compared to 0.014 g/cm2 (CV = 2.0%) and 0.016 g/cm2 (CV = 2.7%), respectively, for DXA. The correlation of Total Hip BMD CTXA vs. DXA was R = 0.97 and for Femoral Neck was R = 0.95 (SEE 0.044 g/cm2 in both cases). Cortical bone comprised 62±5% (mean ± SD) of total hipbone mass in osteoporotic women. CTXA Hip provides substantially the same clinical information as conventional DXA and in addition provides estimates of BMD in separate cortical and trabecular bone compartments, which may be useful in evaluation of bone strength.

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Differences in structural geometrical outcomes at the neck of the proximal femur using two-dimensional DXA-derived projection (APEX) and three-dimensional QCT-derived (BIT QCT) techniques

Cited by 23 publications

References 12 publications

Does Hormone Replacement Normalize Bone Geometry in Adolescents With Anorexia Nervosa?

Does Hormone Replacement Normalize Bone Geometry in Adolescents With Anorexia Nervosa?

Associations of Age, BMI, and Years of Menstruation with Proximal Femur Strength in Chinese Postmenopausal Women: A Cross-Sectional Study

CTXA Hip—An Extension of Classical DXA Measurements Using Quantitative CT

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