Noninvasive axial and peripheral assessment of bone mineral content: A comparison between osteoporotic women and normal subjects

Abstract

We compared different methods of bone densitometry in women with spinal osteoporosis and normal subjects to assess their discriminatory capability. The methods used included: quantitative computed tomography of the spine (QCT) specified as to trabecular (QCTtrab) and cortical bone (QCTcort), dual-photon absorptiometry of the spine (DPAspine), single-photon absorptiometry of the distal and proximal forearm (SPAdist and SPAprox), and quantitative roentgen microdensitometry of the phalanx (QMD). A total of 25 postmenopausal osteoporotic women and 24 healthy comparison subjects matched for age and years since menopause were studied. In the osteoporotic group an average decrement of the axial bone mineral density of -50% (p less than 0.001) and -20% (p less than 0.001) were observed for QCTtrab and QCTcort, respectively. For DPAspine, SPAdist, SPAprox, and QMD the difference between normal and osteoporotic subjects was -20% (p less than 0.001), -12% (p less than 0.05), -7% (NS), and -6% (NS), respectively. With the peripheral measurements (SPA and QMD), alone or in combination, no adequate discrimination between women with or without vertebral compression fractures could be obtained. Although QCTtrab showed the highest diagnostic sensitivity (81%), it appears not to be superior to DPAspine. Combinations of the various axial and peripheral measurements did not result in an essentially better sensitivity. In normal women as well as in osteoporotic individuals the trabecular and cortical QCT measurements showed two opposite trends, suggesting an increase in cortical and a decrease in trabecular density from L1 to L3.

Perspective on post-menopausal osteoporosis: establishing an interdisciplinary understanding of the sequence of events from the molecular level to whole bone fractures

“…A fracture is commonly classified to be osteoporotic if it arises in a patient over 50 and the BMD of the fracture site is sufficiently low (Kanis et al 2001). DEXA is the preferred technology for quantifying BMD (Cummings et al 2002;Leib et al 2004), but other diagnostic tools, including quantitative computed tomography (QCT), absorptiometry, quantitative roentgen micro-densitometry and quantitative ultrasound (QUS), may provide more accurate measures of BMD (Richardson et al 1985;van Berkum et al 1989). Nonetheless, BMD is a poor predictor of fracture risk as changes in bone mass alone do not fully explain susceptibility to bone fracture; for example, only 10-53% of bone fractures that occur in female postmenopausal patients over the age of 65 can be attributed to a BMD level low enough (i.e.…”

Quantitative CT assessment of bone mineral density in dogs with hyperadrenocorticism

“…Therefore, measurement of bone mineral density is an important tool in the diagnostic evaluation of patients suspected of having or suffering from osteoporosis or other skeletal disorders [ 21 ]. In human medicine, it is preferable to measure only trabecular bone because it is thought to be eight times more sensitive to hormonal deficiencies and metabolic disease than cortical bone [ 6 16 37 ].…”

Radiology of Osteoporosis

“…In numerous studies the highest diagnostic sensitivity was found for QCT of the lumbar spine, regarded by many researchers as the diagnostic gold standard (Grampp et al , 2001aPacifi ci et al 1990;Reinbold et al 1986;van Berkum et al 1989;Yu et al 1995). In numerous studies the highest diagnostic sensitivity was found for QCT of the lumbar spine, regarded by many researchers as the diagnostic gold standard (Grampp et al , 2001aPacifi ci et al 1990;Reinbold et al 1986;van Berkum et al 1989;Yu et al 1995).…”