High-Resolution Imaging Techniques for the Assessment of Osteoporosis

Abstract

SynopsisThe importance of assessing the bone's microarchitectural make-up in addition to its mineral density in the context of osteoporosis has been emphasized in a number of publications. The high spatial resolution required to resolve the bone's microstructure in a clinically feasible scan time is challenging. Currently, the best suited modalities meeting these requirements in vivo are highresolution peripheral quantitative imaging (HR-pQCT) and magnetic resonance imaging (MRI). Whereas HR-pQCT is limited to peripheral skeleton regions like the wrist and ankle, MRI can also image other sites like the proximal femur but usually with lower spatial resolution. In addition Multidetector-CT has been used for high-resolution imaging of trabecular bone structure, however, the radiation dose is a limiting factor. This article provides an overview of the different modalities, technical requirements and recent developments in this emerging field. Details regarding imaging protocols as well as image post-processing methods for bone structure quantification are discussed.

Towards new material biomarkers for fracture risk

“…This has recently led to the investigation of various imaging techniques including high-resolution peripheral quantitative computed tomography (HR-pQCT) and the development of analytical tools such as trabecular bone score (TBS). Unfortunately, HR-pQCT is restricted to peripheral skeletal sites and therefore the lumbar spine or proximal femur (common sites for osteoporotic fragility fractures which are associated with the most significant quality of life burden for patients) cannot be imaged with this technique [15]. TBS, which captures information relating to trabecular microarchitecture by performing novel grey-level texture measurements on DEXA images [16], is undoubtedly promising; however, this tool quantifies the micro architecture of the bone only and does not account for bone chemistry.…”

Untitled

“…To be strong, bones need to be stiff enough to withstand deformation under loading, yet adequately elastic to absorb energy during compression and tension 27 . Recently developed technologies for assessing bone structure include high-resolution peripheral quantitative computed tomography (pQCT) and magnetic resonance imaging that have the advantage of simultaneously assessing trabecular and cortical components of bone separately, in addition to geometric characteristics of the peripheral skeleton 28,29 .…”

Musculoskeletal phenotype through the life course: the role of nutrition

“…QCT is the forerunner in three-dimensional assessment of the axial and peripheral skeleton being the only technique to measure volumetric BMD TOTAL and BMD COMPARTMENT of trabecular and cortical bone. QCT also provides measures of multiple components of cortical and trabecular bone (shape and geometry), which allow the measurement of some parameters of bone strength (29)(30)(31)(32)(33)(34)(35)(36) . The use of QCT to measure the spine and hip is limited due to radiation dose considerations and accessibility of scanners; although radiation dose is considerably less than diagnostic computed tomography (37)(38)(39) .…”

“…The use of QCT to measure the spine and hip is limited due to radiation dose considerations and accessibility of scanners; although radiation dose is considerably less than diagnostic computed tomography (37)(38)(39) . The invention of peripheral (p) QCT and more recently high-resolution pQCT, has led to wider application of QCT to define phenotype including assessment of trabecular microarchitecture and metaphyseal cortical bone (35,36,(40)(41)(42) . The utility of axial and peripheral QCT has been shown in studies investigating differences in bone phenotype related to nutrition, aging, hormone status, chronic disease and treatment, i.e.…”