Longitudinal bone microarchitectural changes are best detected using image registration

Kemp, Tannis D.; Bakker, Chantal M.J. de; Gabel, Leigh; Hanley, D.A.; Billington, Emma O; Burt, Lauren A; Boyd, Steven K.

doi:10.1007/s00198-020-05449-2

Cited by 22 publications

(25 citation statements)

References 32 publications

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“…We performed three-dimensional (3D) image registration to ensure the same bone volume was assessed at each time point ( figure 1 ). 14 15 Morphological measures included total vBMD (Tt.vBMD; mg HA/cm 3 ) and trabecular vBMD (Tb.vBMD; mg HA/cm 3 ), trabecular bone volume fraction (BV/TV; %), trabecular number (Tb.N; 1/mm), trabecular thickness (Tb.Th; mm) and trabecular separation (Tb.Sp; mm); cortical vBMD (Ct.vBMD; mg HA/cm 3 ), cortical thickness (Ct.Th, mm) and cortical porosity (Ct.Po; %). 11 12 Failure load (F.Load; N) was estimated by finite element analysis on unregistered images (FAIM, V.8.0, Numerics88 Solutions).…”

Section: Methodsmentioning

confidence: 99%

Pre-flight exercise and bone metabolism predict unloading-induced bone loss due to spaceflight

et al. 2021

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ObjectivesBone loss remains a primary health concern for astronauts, despite in-flight exercise. We examined changes in bone microarchitecture, density and strength before and after long-duration spaceflight in relation to biochemical markers of bone turnover and exercise.MethodsSeventeen astronauts had their distal tibiae and radii imaged before and after space missions to the International Space Station using high-resolution peripheral quantitative CT. We estimated bone strength using finite element analysis and acquired blood and urine biochemical markers of bone turnover before, during and after spaceflight. Pre-flight exercise history and in-flight exercise logs were obtained. Mixed effects models examined changes in bone and biochemical variables and their relationship with mission duration and exercise.ResultsAt the distal tibia, median cumulative losses after spaceflight were −2.9% to −4.3% for bone strength and total volumetric bone mineral density (vBMD) and −0.8% to −2.6% for trabecular vBMD, bone volume fraction, thickness and cortical vBMD. Mission duration (range 3.5–7 months) significantly predicted bone loss and crewmembers with higher concentrations of biomarkers of bone turnover before spaceflight experienced greater losses in tibia bone strength and density. Lower body resistance training volume (repetitions per week) increased 3–6 times in-flight compared with pre-spaceflight. Increases in training volume predicted preservation of tibia bone strength and trabecular vBMD and thickness.ConclusionsFindings highlight the fundamental relationship between mission duration and bone loss. Pre-flight markers of bone turnover and exercise history may identify crewmembers at greatest risk of bone loss due to unloading and may focus preventative measures.

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Section: Methodsmentioning

confidence: 99%

Pre-flight exercise and bone metabolism predict unloading-induced bone loss due to spaceflight

et al. 2021

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“…Participants’ non‐dominant radius and left tibia were assessed with HR‐pQCT (nominal isotropic voxel of 60.7 μm, XtremeCT II, Scanco Medical, Bruttisellen, Switzerland), following three‐dimensional image registration ( 9 ) at baseline, 6, 12, 24, and 36 months. At each site, standard variables including trabecular bone volume fraction (Tb.BV/TV, %), trabecular thickness (Tb.Th, mm), trabecular separation (Tb.Sp, mm) and cortical thickness (Ct.Th, mm) were measured.…”

Section: Methodsmentioning

confidence: 99%

Response to High‐Dose Vitamin D Supplementation Is Specific to Imaging Modality and Skeletal Site

et al. 2022

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High-dose vitamin D supplementation (4000 or 10,000 IU/d) in vitamin D-sufficient individuals results in a dose-dependent decrease in radius and tibia total bone mineral density (Tt.BMD) compared with 400 IU/d. This exploratory analysis examined whether the response to high-dose vitamin D supplementation depends on imaging modality and skeletal site. Participants were aged 55 to 70 years, not osteoporotic, with serum 25(OH)D 30 to 125 nM. Participants' radius and tibia were scanned on high-resolution peripheral quantitative computed tomography (HR-pQCT) to measure Tt.BMD, trabecular bone volume fraction (Tb.BV/TV), trabecular separation (Tb.Sp), cortical thickness (Ct.Th), and finite element analysis (FEA) estimated failure load. Three-dimensional image registration was used. Dual-energy X-ray absorptiometry (DXA) scans of the hip, spine, and radius measured areal BMD (aBMD) and trabecular bone score (TBS). Constrained linear mixed-effects models determined treatment group-by-time and treatment group-by-time-by-sex interactions. The treatment group-by-time interaction previously observed for radial Tt.BMD was observed at both ultradistal (UD, p < 0.001) and 33% (p < 0.001) aBMD sites. However, the treatment group-by-time-by-sex interaction observed for radial Tt.BMD was not observed with aBMD at either the UD or 33% site, and the 4000 and 400 groups did not differ. Registered radial FEA results mirrored Tt.BMD. An increase in Tb.Sp and decrease in Ct.Th underpinned dose-dependent changes in radial BMD and strength. We observed no effects in DXA-based aBMD at the hip or spine or TBS. At the tibia, we observed a time-by-treatment group effect for Tb.BV/TV. Given that DXA measures at the radius did not detect sex differences or differences between the 4000 and 400 groups, HR-pQCT at the radius may be more sensitive for examining bone changes after vitamin D supplementation. Although DXA did not reveal treatment effects at the hip or spine, whether that is a true skeletal site difference or a lack of modality sensitivity remains unclear.

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“…However, recent studies have shown that preprocessing of the images using rigid 3D registration provides a more accurate method to assess changes in bone microarchitecture because the same region of interest (ROI) can be analyzed in longitudinally acquired images. ( 8 ) Longitudinal imaging and 3D‐image registration are tools provided in the scanner software, but have yet to be adopted into the standard patient evaluation for HRpQCT images. Although these techniques have allowed for quantification of localized microstructural remodeling in cohorts of 10 or fewer patients with decreased bone quality and disease, ( 9–11 ) the methods used to date in patients have diverged from the methods used to quantify formation and resorption in animal studies ( 12,13 ) and have been inconsistent in the specific parameters used for quantification of remodeling (i.e., mineral density‐based thresholds and noise reduction techniques).…”

Section: Introductionmentioning

confidence: 99%

Formation Dominates Resorption With Increasing Mineralized Density and Time Postfracture in Cortical but Not Trabecular Bone: A Longitudinal HRpQCT Imaging Study in the Distal Radius

et al. 2021

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Longitudinal bone microarchitectural changes are best detected using image registration

Cited by 22 publications

References 32 publications

Pre-flight exercise and bone metabolism predict unloading-induced bone loss due to spaceflight

Pre-flight exercise and bone metabolism predict unloading-induced bone loss due to spaceflight

Response to High‐Dose Vitamin D Supplementation Is Specific to Imaging Modality and Skeletal Site

Formation Dominates Resorption With Increasing Mineralized Density and Time Postfracture in Cortical but Not Trabecular Bone: A Longitudinal HRpQCT Imaging Study in the Distal Radius

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