Role of Magnetic Resonance for Assessing Structure and Function of Trabecular Bone

Wehrli, Félix W.; Saha, Punam K.; Gomberg, Bryon R.; Song, Hee Kwon; Snyder, Peter J.; Benito, María; Wright, AC; Weening, Richard

doi:10.1097/00002142-200210000-00005

Cited by 184 publications

(132 citation statements)

References 75 publications

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“…It is intuitively obvious that only as long as both structure and intrinsic material properties remain unaltered during bone loss, BMD is an accurate predictor of the bone's mechanical competence. In the laboratory it has been shown that BMD explains, on average, about 60% of bone strength as estimated from a meta-analysis of 38 studies investigating some measure of bone strength (8). The dichotomy between changes in bone volume fraction and its mechanical implication is illustrated in Fig.…”

Section: Disparity Between Bone Density and Architecture As Determinamentioning

confidence: 99%

“…The rapid diffusion of multi-detector CT systems also opens opportunities for TB structure analysis in the axial skeleton (16) although radiation exposure is a concern. However, remarkable progress in high-resolution MRI during the past 10 years now offers a new tool for TB structure assessment [reviews: (8,(17)(18)(19)(20)]. MRI has distinct advantages over CT, chief among these being the absence of ionizing radiation, a generally more favorable point-spread function (PSF) and high innate contrast between bone and marrow.…”

Section: Non-invasive Assessment Of Bone Architecture Mri Versus Ctmentioning

confidence: 99%

“…A further potential motivation is the study of the structural manifestations of metabolic bone disease such as renal osteodystropy (166). Evidence for these developments is the rapid growth of the clinical literature (8,83,84,127,145,165,(167)(168)(169)(170)(171)(172) and also, to a lesser extent, the increased use of CT to characterize TB (14)(15)(16)(173)(174)(175)(176)(177).…”

Section: Clinical Applications Of Trabecular Bone Microstructural Anamentioning

confidence: 99%

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Quantitative MRI for the assessment of bone structure and function

et al. 2006

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Osteoporosis is the most common degenerative disease in the elderly. It is characterized by low bone mass and structural deterioration of bone tissue, leading to morbidity and increased fracture risk in the hip, spine and wrist-all sites of predominantly trabecular bone. Bone densitometry, currently the standard methodology for diagnosis and treatment monitoring, has significant limitations in that it cannot provide information on the structural manifestations of the disease. Recent advances in imaging, in particular MRI, can now provide detailed insight into the architectural consequences of disease progression and regression in response to treatment. The focus of this review is on the emerging methodology of quantitative MRI for the assessment of structure and function of trabecular bone. During the past 10 years, various approaches have been explored for obtaining image-based quantitative information on trabecular architecture. Indirect methods that do not require resolution on the scale of individual trabeculae and therefore can be practiced at any skeletal location, make use of the induced magnetic fields in the intertrabecular space. These fields, which have their origin in the greater diamagnetism of bone relative to surrounding marrow, can be measured in various ways, most typically in the form of R 0 2 , the recoverable component of the total transverse relaxation rate. Alternatively, the trabecular network can be quantified by high-resolution MRI (m-MRI), which requires resolution adequate to at least partially resolve individual trabeculae. Micro-MRI-based structure analysis is therefore technically demanding in terms of image acquisition and algorithms needed to extract the structural information under conditions of limited signal-to-noise ratio and resolution. Other requirements that must be met include motion correction and image registration, both critical for achieving the reproducibility needed in repeat studies. Key clinical applications targeted involve fracture risk prediction and evaluation of the effect of therapeutic intervention.

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Section: Disparity Between Bone Density and Architecture As Determinamentioning

confidence: 99%

Section: Non-invasive Assessment Of Bone Architecture Mri Versus Ctmentioning

confidence: 99%

Section: Clinical Applications Of Trabecular Bone Microstructural Anamentioning

confidence: 99%

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Quantitative MRI for the assessment of bone structure and function

et al. 2006

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“…An additional motivation was to determine whether the detected changes were significant enough to require normalization when used in future studies as a metric to evaluate the implications of cortical bone on hip fracture incidence. Toward these goals ten women, ages 46-73 years (mean 56 years), were randomly selected from a prior study (37). The subjects, who had DXA BMD T-scores of the femoral neck of −1.19±1.39 (mean ± SD) underwent the cortical hip analysis protocol described above.…”

Section: Femoral Neck Pilot Studymentioning

confidence: 99%

Method for Cortical Bone Structural Analysis From Magnetic Resonance Images1

Gomberg¹,

Saha²,

Wehrli³

2005

Academic Radiology

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Rationale-Quantitative evaluation of cortical bone architecture as a means to assess bone strength is typically accomplished on the basis of images obtained by dual-energy X-ray absorptiometry (DXA) or computed tomography (CT). Magnetic resonance imaging (MRI) has potential advantages for this task in that it allows imaging in arbitrary scan planes at high spatial resolution. However, several hurdles have to be overcome in order to make this approach practical, including resolution of issues related to nonlinear receive coil sensitivity, variations in marrow composition and the presence periosteal isointense tissues which all complicate segmentation. Objectives-To develop MR acquisition and analysis methods optimized for detection of cortical boundaries in complex geometries such as the femoral neck.Materials and Methods-Cortical boundary detection is achieved by radially tracing intensity profiles that intersect the bone's periosteal and endosteal boundary. The profiles are subsequently normalized to the intensity of the marrow signal, processed with morphologic image operators and binarized. The resulting boundaries are then mapped back onto the spatial image and erroneous boundary points removed. From the detected cortical boundaries cortical cross-sectional area and thickness are computed. The method was evaluated on cortical bone specimens and human volunteers on the basis of high-resolution images acquired at 1.5 Tesla field strength. To assess whether the method is sensitive to detect the expected dependencies of cortical parameters in weight-bearing bone on overall habitus, ten women ages 46-73 years (mean 56 years) underwent the cortical imaging protocol in the proximal femur and the results were compared with DXA BMD parameters of the hip and spine.Results-Reproducibility was on the order of 2%. Double oblique images of the femoral neck in the ten women studied showed cortical cross-sectional area to correlate strongly with height (r = 0.88, p = 0.0008) while cortical diameter versus age approached significance (r = 0.61, p = 0.06). Measurements in specimens of some cortical parameters indicated a resolution dependence. It is to be noted, however, that parameter rank remained constant across all specimens studied. Conclusion-The data suggest the new method to be robust and applicable on standard clinical MR scanners at arbitrary anatomic locations to yield clinically meaningful quantitative results.

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“…Analyses of MRI and QCT scans can yield information about bone microarchitecture, such as trabec-ular bone volume fraction (BVTV), trabecular number (Tb.N), trabecular separation (Tb.Sp), and trabecular thickness (Tb.Th) (14). While bone microarchitecture measurements obtained from MRI and high-resolution peripheral QCT (pQCT) are highly related, the advantage of utilizing MRI for the image-based assessment of trabecular bone microarchitecture is the superior signal-to-noise ratio between bone and bone marrow, as well as the lack of radiation associated with scans (15,16). In addition, small dedicated radio frequency coils are used in MRI scanning for enhanced image resolution.…”

Section: Introductionmentioning

confidence: 99%

Association of larger holes in the trabecular bone at the distal radius in postmenopausal women with type 2 diabetes mellitus compared to controls

Pritchard¹,

Giangregorio²,

Atkinson³

et al. 2011

Arthritis Care & Research

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Objective. Adults with type 2 diabetes mellitus (DM) have an elevated fracture risk despite normal areal bone mineral density (aBMD). The study objective was to compare trabecular bone microarchitecture of postmenopausal women with type 2 DM and women without type 2 DM.Methods. An extremity 1T magnetic resonance imaging system was used to acquire axial images (195 ؋ 195 ؋ 1,000 m 3 voxel size) of the distal radius of women recruited from outpatient clinics or by community advertisement. Image segmentation yielded geometric, topologic, and stereologic outcomes, i.e., number and size of trabecular bone network holes (marrow spaces), endosteal area, trabecular bone volume fraction, nodal and branch density, and apparent trabecular thickness, separation, and number. Lumbar spine (LS) and proximal femur BMD were measured with dual x-ray absorptiometry. Microarchitectural differences were assessed using linear regression and adjusted for percent body fat, ethnicity, timed up-and-go test, Charlson Index, and calcium and vitamin D intake; aBMD differences were adjusted for body mass index (BMI). Results. Women with type 2 DM (n ‫؍‬ 30, mean ؎ SD age 71.0 ؎ 4.8 years) had larger holes (؉13.3%; P ‫؍‬ 0.001) within the trabecular bone network than women without type 2 DM (n ‫؍‬ 30, mean ؎ SD age 70.7 ؎ 4.9 years). LS aBMD was greater in women with type 2 DM; however, after adjustment for BMI, LS aBMD did not differ between groups. Conclusion. In women with type 2 DM, the average hole size within the trabecular bone network at the distal radius is greater compared to controls. This may explain the elevated fracture risk in this population.

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Role of Magnetic Resonance for Assessing Structure and Function of Trabecular Bone

Cited by 184 publications

References 75 publications

Quantitative MRI for the assessment of bone structure and function

Quantitative MRI for the assessment of bone structure and function

Method for Cortical Bone Structural Analysis From Magnetic Resonance Images1

Association of larger holes in the trabecular bone at the distal radius in postmenopausal women with type 2 diabetes mellitus compared to controls

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