Trabecular Bone Score: A Noninvasive Analytical Method Based Upon the DXA Image

Silva, Barbara C.; Leslie, William D.; Resch, Heinrich; Lamy, Olivier; Lesnyak, Olga; Binkley, Neil; McCloskey, Eugène; Kanis, John А.; Bilezikian, John P.

doi:10.1002/jbmr.2176

Cited by 706 publications

(559 citation statements)

References 88 publications

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“…The DXA scans of vertebrae L1-L4 obtained to assess lumbar spine BMD can also be used to generate TBS, thereby producing complementary skeletal information from the same examination [6]. TBS has been shown to be significantly associated with direct measurements of bone microarchitecture and mechanical behavior [5,[8][9][10] and is predictive of current [6,[11][12][13][14][15][16] and future [17][18][19] fragility fractures in postmenopausal women with primary osteoporosis [19,20]. TBS can also be used to assess fracture risk in patients with specific causes of secondary osteoporosis such as hyperparathyroidism, diabetes, and glucocorticoid treatment [21,22].…”

Section: Introductionmentioning

confidence: 99%

Effect of denosumab on trabecular bone score in postmenopausal women with osteoporosis

McClung¹,

Lippuner²,

Brandi³

et al. 2017

Osteoporos Int

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Summary Trabecular bone score (TBS) assesses bone quality in the lumbar spine using dual-energy X-ray absorptiometry (DXA) scans. In postmenopausal women with osteoporosis, denosumab significantly improved TBS independently of bone mineral density (BMD). This practical technique may have a role in managing patients with osteoporosis. Introduction TBS, a gray-level texture index determined from lumbar spine DXA scans, correlates with bone microarchitecture and enhances assessment of vertebral fracture risk independently of BMD. In the FREEDOM study, denosumab increased BMD and reduced new vertebral fractures in postmenopausal women with osteoporosis. This retrospective analysis explored the effect of denosumab on TBS and the association between TBS and BMD in FREEDOM. Methods Postmenopausal women with lumbar spine or total hip BMD T-score <−2.5 and −4.0 or higher at both sites received placebo or denosumab 60 mg subcutaneously every 6 months. TBS indices were determined from DXA scans at baseline and months 12, 24, and 36 in a subset of 285 women (128 placebo, 157 denosumab) who had TBS values at baseline and ≥1 postbaseline visit. Results Baseline characteristics were comparable between treatment groups; mean (SD) lumbar spine BMD T-score was −2.79 (0.64), and mean (standard deviation [SD]) TBS was 1.200 (0.101) overall. In the placebo group, BMD and TBS increased by ≤0.2% or decreased from baseline at each visit. In the denosumab group, progressive increases from baseline at 12, 24, and 36 months were observed for BMD (5.7, 7.8, and 9.8%) and TBS (1.4, 1.9, and 2.4%). Percentage changes in TBS were statistically significant compared with baseline (p < 0.001) and placebo (p ≤ 0.014). TBS was largely unrelated to BMD, regardless of treatment, either at baseline or for annual changes from baseline (all r 2 ≤ 0.06). Conclusions In postmenopausal women with osteoporosis, denosumab significantly improved TBS independently of BMD.

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Section: Introductionmentioning

confidence: 99%

Effect of denosumab on trabecular bone score in postmenopausal women with osteoporosis

McClung¹,

Lippuner²,

Brandi³

et al. 2017

Osteoporos Int

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“…A low TBS value is associated with fewer, less well-connected and more widely distributed trabeculae, while high TBS va lues are correlated with better trabecular structure (11). TBS can be readily applied to a DXA image through the use of a specific software, and has an attractive feature which is the possibility of being retrospectively calculated from an existing DXA image without the need for further imaging (12).…”

Section: Introductionmentioning

confidence: 99%

Trabecular bone score: perspectives of an imaging technology coming of age

Silva

Bilezikian

2014

Arq Bras Endocrinol Metab

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The trabecular bone score (TBS) is a new method to describe skeletal microarchitecture from the dual energy X-ray absorptiometry (DXA) image of the lumbar spine. While TBS is not a direct physical measurement of trabecular microarchitecture, it correlates with micro-computed tomography (µCT) measures of bone volume fraction, connectivity density, trabecular number, and trabecular separation, and with vertebral mechanical behavior in ex vivo studies. In human subjects, TBS has been shown to be associated with trabecular microarchitecture and bone strength by high resolution peripheral quantitative computed tomography (HRpQCT). Cross--sectional and prospective studies, involving a large number of subjects, have both shown that TBS is associated with vertebral, femoral neck, and other types of osteoporotic fractures in postmenopausal women. Data in men, while much less extensive, show similar findings. TBS is also associated with fragility fractures in subjects with secondary causes of osteoporosis, and preliminary data suggest that TBS might improve fracture prediction when incorporated in the fracture risk assessment system known as FRAX. In this article, we review recent advances that have helped to establish this new imaging technology. Arq Bras Endocrinol Metab. 2014;58(5):493-503 Keywords Trabecular bone score; osteoporosis; fracture risk; bone mineral density; microarchitecture RESUMO TBS (do inglês, "trabecular bone score") é um novo método que estima a microarquitetura óssea a partir de uma imagem de densitometria óssea (DXA) da coluna lombar. Apesar de o TBS não ser uma medida física direta da microarquitetura trabecular, ele correlaciona-se com o volume ósseo, densidade da conectividade trabecular, número de trabéculas e separação trabecular medidos por microtomografia computadorizada (µCT), e com medidas mecânicas da resistência óssea vertebral em estudos ex vivo. Estudos em humanos confirmaram que o TBS associa-se a microarquitetura trabecular e resistência óssea medidas por tomografia computadorizada quantitativa periférica de alta resolução (HRpQCT). Estudos transversais e prospectivos, envolvendo um grande número de indivíduos, mostraram que o TBS é associado com fratura vertebral, de colo de fêmur e com outros tipos de fraturas osteoporóticas em mulheres na pós-menopausa. Dados em homens, apesar de escassos, mostram resultados semelhantes. Além disso, o TBS foi associado a fraturas por fragilidade em indivíduos com diversas causas secundárias de osteoporose e, dados preliminares, sugerem que o uso do TBS pode melhorar a previsão de fratura quando incorporado ao sistema de avaliação de risco de fratura (FRAX). Este artigo faz uma revisão de avanços recentes que têm ajudado a estabelecer esse novo mé-todo de imagem. Arq Bras Endocrinol Metab. 2014;58(5):493-503 Descritores

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“…We also measured change in trabecular bone score (TBS), an indirect measure of lumbar spine bone microarchitecture and independent predictor of fracture risk. 7 TBS was determined for L1-L4: TBS ⩾ 1.350 normal; 1.200-1.350 partially degraded; o1.200 degraded trabecular microarchitecture. 7 Throughout the transplant period, patients were prescribed 1200 mg elemental calcium, and 2000 IU vitamin D daily.…”

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confidence: 99%

“…7 TBS was determined for L1-L4: TBS ⩾ 1.350 normal; 1.200-1.350 partially degraded; o1.200 degraded trabecular microarchitecture. 7 Throughout the transplant period, patients were prescribed 1200 mg elemental calcium, and 2000 IU vitamin D daily. Cyclosporine and short course methotrexate or mycophenolate mofetil were used for prevention of GvHD.…”

mentioning

confidence: 99%