Chapter 13, Non-invasive Techniques for Bone Mass Measurement

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In line with lower spinal and trabecular radial BMD, MR-derived trabecular bone volume fraction, trabecular spacing and trabecular number showed sig-nificant differences in postmenopausal osteoporotic women with and without fractures when compared with premenopausal healthy controls. Repeated MRI assessment of trabecular microarchitecture at individual regions of the distal radius revealed preservation i. MR can also be used to image cortical bone, specifically the proximal femur.

The ability of MRI to align the image plane perpendicular to the femoral neck is a great advantage as it enables image acquisition with accurate cortical boundary definitions. Thus quantification of cortical bone water could provide a potential indirect surrogate measure of bone porosity without resolving these individual small pores.

In this study, cortical bone water was shown to be a highly sensitive parameter with group differences exceeding those of DXA. Besides high-resolution imaging, MRI can complement bone research by its capability to quantify bone and bone marrow properties on a biochemical level. Using bone marrow spectroscopy, the content of fat, water, and other metabolites can be assessed quantitatively within a defined volume of interest. Although current research focusing on potential clinical applications seems promising, both techniques are still limited to research use.

Conclusions from high-resolution bone imaging studies should only be drawn with recognition of technical caveats. Moreover, quality control should be standardized. Conflicts of interest. Europe PMC requires Javascript to function effectively. Recent Activity. The snippet could not be located in the article text. This may be because the snippet appears in a figure legend, contains special characters or spans different sections of the article.

Ann N Y Acad Sci. Author manuscript; available in PMC Jun 9. PMID: Janina M. Patsch , 1, 2 Andrew J. Burghardt , 1 Galateia Kazakia , 1 and Sharmila Majumdar 1. Andrew J. Address for correspondence: Janina Patsch, M. Copyright notice. See other articles in PMC that cite the published article. Abstract The noninvasive quantification of peripheral compartment-specific bone microarchitecture is feasible with high-resolution peripheral quantitative computed tomography HR-pQCT and high-resolution magnetic resonance imaging HR-MRI.

Introduction The term bone strength describes the ability of the skeleton to resist fractures. High-resolution peripheral quantitative computed tomography High-resolution peripheral quantitative computed tomography HR-pQCT imaging requires a dedicated extremity scanner. HR-pQCT image analysis For the evaluation of quantitative measures, the periosteal contours are drawn in a semiautomatic manner.

Open in a separate window. Figure 1. Comparison with iliac crest biopsies, DXA, and QCT For decades, histology and histomorphometry of iliac crest biopsies have represented the gold-standard techniques for the assessment of bone microarchitecture. Cross-sectional studies Highlighting that noninvasive assessment of bone microarchitecture could add to the refinement of clinical fracture risk prediction, HR-pQCT has been shown to differentiate patients with and without prevalent fragility fractures irrespective of their BMD.

Figure 2. Longitudinal and multicenter HR-pQCT studies As with DXA before it, the utility of HR-pQCT to address important questions related to the epidemiology of osteoporosis, therapeutic antifracture efficacy, and the development of normative databases for clinical assessment of skeletal health requires scalability to standardized multicenter data pools. High-resolution magnetic resonance imaging As opposed to computed tomography, magnetic resonance imaging MRI lacks ionizing radiation.

Figure 3.

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MRI of cortical bone MR can also be used to image cortical bone, specifically the proximal femur. Additional applications of MRI in bone research Besides high-resolution imaging, MRI can complement bone research by its capability to quantify bone and bone marrow properties on a biochemical level. J Austrian Science Fund to J. Footnotes Conflicts of interest The authors declare no conflict of interest. References 1. South Med J. Radiation exposure in X-ray-based imaging techniques used in osteoporosis. Eur Radiol. Laib A, Ruegsegger P. Comparison of structure extraction methods for in vivo trabecular bone measurements.

Comput Med Imaging Graph. Automated simulation of areal bone mineral density assessment in the distal radius from high-resolution peripheral quantitative computed tomography. Osteoporos Int. Bone histomorphometry: standardization of nomenclature, symbols, and units. J Bone Miner Res. Hildebrand T, Ruegsegger P. A new method for the model-independent assessment of thickness in three-dimensional images. J Microsc.

Adolescent Bone Health

In vivo high resolution 3D-QCT of the human forearm. Technol Health Care. Accuracy of high-resolution peripheral quantitative computed tomography for measurement of bone quality. Med Eng Phys. Bone strength at the distal radius can be estimated from high-resolution peripheral quantitative computed tomography and the finite element method. Resolution dependence of the non-metric trabecular structure indices. High-resolution peripheral quantitative computed tomography can assess microstructural and mechanical properties of human distal tibial bone.

Reproducibility of direct quantitative measures of cortical bone microarchitecture of the distal radius and tibia by HR-pQCT. Postmenopausal women with osteopenia have higher cortical porosity and thinner cortices at the distal radius and tibia than women with normal aBMD: an in vivo HR-pQCT study. Hip fractures and the contribution of cortical versus trabecular bone to femoral neck strength.

Age- and gender-related differences in the geometric properties and biomechanical significance of intracortical porosity in the distal radius and tibia. Regional variations of gender-specific and age-related differences in trabecular bone structure of the distal radius and tibia. A longitudinal HR-pQCT study of alendronate treatment in post-menopausal women with low bone density: relations among density, cortical and trabecular microarchitecture, biomechanics, and bone turnover.

Keaveny TM. Biomechanical computed tomography-noninvasive bone strength analysis using clinical computed tomography scans. A new method to determine trabecular bone elastic properties and loading using micromechanical finite-element models. J Biomech. Micro-FE analyses of bone: state of the art.

Adv Exp Med Biol. The effects of parathyroid hormone and alendronate alone or in combination in postmenopausal osteoporosis. N Engl J Med. One year of alendronate after one year of parathyroid hormone 1—84 for osteoporosis. Denosumab improves density and strength parameters as measured by QCT of the radius in postmenopausal women with low bone mineral density. CAVE: 2x.

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Computational finite element bone mechanics accurately predicts mechanical competence in the human radius of an elderly population. Finite element analysis based on in vivo HR-pQCT images of the distal radius is associated with wrist fracture in post-menopausal women. Finite element analysis performed on radius and tibia HR-pQCT images and fragility fractures at all sites in men.

Individual trabeculae segmentation ITS -based morphological analyses of high resolution peripheral quantitative computed tomography images detect abnormal trabecular plate and rod microarchitecture in premenopausal women with idiopathic osteoporosis. Individual trabeculae segmentation ITS -based morphological analysis of micro-scale images of human tibial trabecular bone at limited spatial resolution.

Motion artifacts in high-resolution peripheral quantitative computed tomography of wrist and ankle: usefulness of visual grading to assess image quality.

Automated quan-tification of three-dimensional subject motion to monitor image quality in high-resolution peripheral quantitative computed tomography. AccessEmergency Medicine. Case Files Collection. Clinical Sports Medicine Collection. Davis AT Collection. Davis PT Collection. Murtagh Collection.

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