Precision of dual x-ray absorptiometry and peripheral computed tomography using mobile densitometry units

Wapniarz, M.; Lehmann, R.; Randerath, O.; Baedeker, S.; John, W; Klein, Klaus Ulrich; Allolio, Bruno

doi:10.1007/bf00301682

Cited by 42 publications

(16 citation statements)

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“…Whereas available data indicate that the short-term reproducibility of these measurements is excellent (10,11), positioning is critical, and due to the variability of trabecular bone density throughout the metaphysis, any offset in the location to be scanned would significantly influence the values obtained (12). Additionally, the large range of metaphyseal morphology among subjects, diseases, and ages limits comparative cross-sectional studies and interpretation of the same scan location in longitudinal examinations (13).…”

Section: T He Development Of Precise Noninvasive Methodsmentioning

confidence: 99%

Limitations of Peripheral Quantitative Computed Tomography Metaphyseal Bone Density Measurements

Lee

Gilsanz

Wren

2007

The Journal of Clinical Endocrinology &Amp; Metabolism

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Context: Peripheral quantitative computed tomography (pQCT) measurements are frequently obtained to assess cancellous bone density in the appendicular skeleton. Large variations in bone morphology associated with skeletal development may limit the interpretation of pediatric pQCT studies based on a single slice. Objective:The objective of the study was to characterize the variability in trabecular bone density values along the length of the metaphysis. Design:The design was an analysis of pQCT bone density data. Setting:The study was conducted at a hospital radiology department. Patients:The study included 35 children with cerebral palsy aged 6 -12 yr.Main Outcome Measure: Variations in cancellous bone density along the length of the proximal tibial metaphysis were measured. Results:The patterns of decay in metaphyseal trabecular bone density were different in all subjects, and the density changed from the physis to the shaft at a rate of 16.8 Ϯ 8.2% per 1 mm (range 8.6-37.9% per 1 mm). The slopes of the density curve drastically changed in some children over a short period of 6 months. Even with a high correlation (r 2 ϭ 0.88) between the density of a slice located a fixed distance from the growth plate and the overall mean metaphysis density, the respective changes in density over 6 months were only moderately correlated (r 2 ϭ 0.58). Conclusions:These results underscore the difficulty in interpreting metaphyseal pQCT bone density measurements from a single slice and highlight the need for developing pQCT acquisition techniques that provide more representative bone density determinations in the appendicular skeleton of children. T HE DEVELOPMENT OF precise noninvasive methods for measuring bone has significantly improved our ability to study the influence of genetic and environmental factors influencing the attainment of bone in children (1). Currently the most commonly used quantitative radiologic method to assess bone mass is dual-energy x-ray absorptiometry (2). However, dual-energy x-ray absorptiometry is limited by a two-dimensional interpretation of a threedimensional structure. In contrast, peripheral quantitative computed tomography (pQCT) provides three-dimensional images, allowing for volumetric density measures, an evaluation of bone morphology, and an independent assessment of trabecular and cortical bone in the appendicular skeleton (3).Because of its porosity and large surface area, trabecular bone has greater turnover and is a better indicator of bone remodeling than cortical bone. Trabecular bone density determinations by pQCT are commonly obtained by a single scan at a relative location, such as 4 or 8% length of the radius or tibia (4 -8), or a fixed location, such as 10 mm from the end of the growth plate (9).Whereas available data indicate that the short-term reproducibility of these measurements is excellent (10, 11), positioning is critical, and due to the variability of trabecular bone density throughout the metaphysis, any offset in the location to be scanned would significantly influen...

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Section: T He Development Of Precise Noninvasive Methodsmentioning

confidence: 99%

Limitations of Peripheral Quantitative Computed Tomography Metaphyseal Bone Density Measurements

Lee

Gilsanz

Wren

2007

The Journal of Clinical Endocrinology &Amp; Metabolism

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“…The non significant differences among ROC-analyses showed that pQCT performed equally well in discrimation of fracture cases (hip and spine) as did all other densitometry techniques. Peripheral QCT there-G. Guglielmi et al: Quantitative CT at the skeleton S 37 [87] 0.8-1.5 SCT900 in vivo Hosie [67] 1.26 SCT900 in vivo Grampp [88] 0.9-2.1 XCT960 in vivo Hangartner [89] 0.57 Prototyp in vivo Hosie [67] 0.5 OSCAR in vivo Wapniarz [90] 0.9 XCT900 in vitro Guglielmi [91] 0 fore may be the method of choice when evaluating generalized bone loss [74]. The ROC curves for the pQCT are very similar to the recent results of Takagi et al [75].…”

Section: Clinical Evaluation Of the Pqct Technologymentioning

confidence: 99%

Quantitative computed tomography at the axial and peripheral skeleton

et al. 1997

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“…Peripheral quantitative computed tomography (pQCT) has been proposed as an adjunct to conventional densitometry [6,7]. BMD determination with pQCT at the site of the distal radius is a method of high precision and low radiation [8]. In addition, pQCT is the only noninvasive assessment of bone mineral to measure a true-dimensional density (as opposed to an areal density by standard methods) and to allow separate determination of cortical and trabecular bone density [9].…”

mentioning

confidence: 99%

Factors Associated with Cortical and Trabecular Bone Loss as Quantified by Peripheral Computed Tomography (pQCT) at the Ultradistal Radius in Aging Women

et al. 1997

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Abstract. Peripheral quantitative computed tomography (pQCT) allows the separate determination of cortical and trabecular bone mineral density in the peripheral skeleton. This cross-sectional study was designed to examine the effects of healthy aging on pQCT measurements at the ultradistal radius. In a well-defined sample of 129 community-based women, aged 70-87 years, the differences in cortical and trabecular density over the age range were equivalent to losses of −0.41% and −0.65% per year, respectively. To investigate the mechanism of this agerelated decline, we assessed relationships between both parameters and height, weight, body mass index, dietary calcium intake, grip strength, and serum concentrations of insulin-like growth factor-I (IGF-I), calcidiol (25(OH)D 3 ), calcitriol (1,25(OH) 2 D 3 ), parathyroid hormone (PTH), and sex hormone binding globulin (SHBG). Multiple regression was used to adjust for potential confounders. Age was not significant after controlling for other covariables. Body mass index, grip strength, serum IGF-I, 25(OH)D 3 , and PTH (1-84) were found to be independent predictors of total bone density. Including (total or free) 1,25(OH) 2 D 3 did not improve the model precision. These findings provide evidence that, among other factors, the activity of the growth hormone-IGF-I-axis is of importance for skeletal integrity. Grip strength, serum IGF-I, and PTH (1-84) were discovered to be significantly related to cortical but not to trabecular density, suggesting that different mechanisms may be involved in compact and cancellous bone loss.Key words: Peripheral quantitative computed tomography (pQCT) -Age-related bone loss -Growth hormone -IGF-I.Low bone mass, as estimated by decreased bone mineral density (BMD), is an established predictor of osteoporotic fractures. Although fracture prediction by bone density is partially site-dependent [1], numerous reports have shown that fractures at all skeletal sites are significantly related to low bone mass at the distal forearm [2][3][4][5]. In all of these studies, BMD was assessed with single-photon absorptiometry. Peripheral quantitative computed tomography (pQCT) has been proposed as an adjunct to conventional densitometry [6,7]. BMD determination with pQCT at the site of the distal radius is a method of high precision and low radiation [8]. In addition, pQCT is the only noninvasive assessment of bone mineral to measure a true-dimensional density (as opposed to an areal density by standard methods) and to allow separate determination of cortical and trabecular bone density [9].Studies have indicated that bone loss in elderly women shows no evidence for an age-related leveling off [10][11][12][13]. Even at advanced ages, interventions to preserve or to enhance bone mass may therefore be an effective approach to prevention of fractures. However, the mechanisms leading to age-related bone loss remain poorly defined. Moreover, whether cortical and trabecular bone losses are mediated by differential mechanisms is virtually unknown. In the pres...

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Precision of dual x-ray absorptiometry and peripheral computed tomography using mobile densitometry units

Cited by 42 publications

References 16 publications

Limitations of Peripheral Quantitative Computed Tomography Metaphyseal Bone Density Measurements

Limitations of Peripheral Quantitative Computed Tomography Metaphyseal Bone Density Measurements

Quantitative computed tomography at the axial and peripheral skeleton

Factors Associated with Cortical and Trabecular Bone Loss as Quantified by Peripheral Computed Tomography (pQCT) at the Ultradistal Radius in Aging Women

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