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Biomedical subjects

A M Laval-Jeantet

Publications and source records attributed to A M Laval-Jeantet.

At least 19 recordsLinked to original sources

A comparison of spinal quantitative computed tomography with dual energy X-ray absorptiometry in European women with vertebral and nonvertebral fractures.

Quantitative computed tomography (QCT) was compared to dual X-ray absorptiometry (DXA) measured in the lumbar spine of 508 European women defined as normal without fracture (NoF), or osteoporotic (OP), with either vertebral fracture (VF), or peripheral fracture (PF). The correlations between QCT and DXA BMD measurements were significantly different in normal and in osteoporotic patients, indicating that the two exams do not measure the same bone aspects. According to ROC curves results, QCT Z-scores separate OP from NoF with better sensitivity than all other measurements. A threshold to differentiate OP from NoF was chosen at Z-score = -1 for DXA-BMD and -1.5 for QCT-BMD. VF patients showed a highly significant decrease in BMD by DXA or QCT. PF patients revealed measurements lower than those of normal subjects but greater than those of VF, calling into question the idea of a diffuse osteoporosis causing nonvertebral fractures that is measurable by spinal DXA or QCT. DXA is weakly dependent upon age, and T-score or Z-score are equivalent for evaluating osteoporosis. QCT depends greatly upon age, and Z-score appears to be more efficient.

Absorptiometry, Photon↗

Distribution of intracortical porosity in human midfemoral cortex by age and gender.

The purpose of this study was to describe the age-specific distribution of midfemoral intracortical porosity throughout the cortical width in males and females. Microradiography and an automated image analysis system were used to study midfemoral cortical bone specimens from 163 white people, including 77 males and 86 females, in a recent anthropological collection covering a broad age range. In each specimen, porosity (percentage of the cortical bone area occupied by pores), pore number, and pore size were measured throughout the entire cortex and in three cortical subregions of equal width labeled the periosteal, midcortical, and endosteal subregions. For each gender, relationships linking age to porosity, pore number, and mean pore size were assessed using regression analysis. In addition, age- and site-related changes in these three variables were tested for significance using two-way analysis of variance (ANOVA). Age explained 52% of the porosity variance in females and 13.5% in males. In each gender, there were significant age- and site-related differences in porosity, pore number, and pore size. In adults aged 60 years or younger, both pore size and pore number increased with increasing age, whereas in adults older than 60 years, pore size continued to increase but pore number decreased. In males, the age-related changes in pore size and pore number were proportionally similar in the three cortical subregions. In females, in contrast, the changes predominated in the endosteal subregion and resulted in significant cortical thinning.

Adolescent↗

CT of the middiaphyseal femur: cortical bone mineral density and relation to porosity.

PURPOSE: To determine whether computed tomography (CT) can be used to quantify age- and site-related changes in cortical bone mineral density (cBMD) at the middiaphyseal femur and whether cBMD differences are related to intracortical porosity. MATERIALS AND METHODS: Cortical bone specimens from 163 femurs were studied with CT and microradiography. Femurs were from 77 males and 86 females in a white anthropologic collection covering a broad age spectrum. In each sample, the cBMD was measured in the entire cortical width and in periosteal, midcortical, and endosteal subregions of interest. Age- and site-related changes in cBMD were tested for significance by using a two-way analysis of variance for both sexes. By using linear regression, cBMD was compared with porosity in the entire cortical width and in each subregion. RESULTS: There were significant age-related differences in cBMD (P <.001 in females, P =.008 in males). In addition, cBMD values were significantly different between the three cortical subregions (P <.001 for both sexes), decreasing from the periosteum to the midcortex to the endosteum. The cBMD values were closely related to porosity, and porosity contributed to 71.6% of the variance in cBMD in the overall population. CONCLUSION: CT is effective in the measurement of age- and site-related changes in cBMD. Decreases in cBMD are closely correlated with increased cortical porosity.

Adolescent↗

Perspectives in three-dimensional analysis of bone samples using synchrotron radiation microtomography.

In this paper we present a methodology based on 3D synchrotron radiation microtomography to analyze non-destructively 3D bone samples. After a technical presentation of the imaging system and the image analysis techniques, we report results on three-dimensional analysis of vertebral samples from women of different ages. The new capabilities of this technique for the investigation of bone are discussed. They include a high spatial resolution down to the micron level, a high density resolution allowing a local quantification of bone mineralization, phase contrast imaging and advances in 3D image analysis.

Adult↗

A synchrotron radiation microtomography system for the analysis of trabecular bone samples.

X-ray computed microtomography is particularly well suited for studying trabecular bone architecture, which requires three-dimensional (3-D) images with high spatial resolution. For this purpose, we describe a three-dimensional computed microtomography (microCT) system using synchrotron radiation, developed at ESRF. Since synchrotron radiation provides a monochromatic and high photon flux x-ray beam, it allows high resolution and a high signal-to-noise ratio imaging. The principle of the system is based on truly three-dimensional parallel tomographic acquisition. It uses a two-dimensional (2-D) CCD-based detector to record 2-D radiographs of the transmitted beam through the sample under different angles of view. The 3-D tomographic reconstruction, performed by an exact 3-D filtered backprojection algorithm, yields 3-D images with cubic voxels. The spatial resolution of the detector was experimentally measured. For the application to bone investigation, the voxel size was set to 6.65 microm, and the experimental spatial resolution was found to be 11 microm. The reconstructed linear attenuation coefficient was calibrated from hydroxyapatite phantoms. Image processing tools are being developed to extract structural parameters quantifying trabecular bone architecture from the 3-D microCT images. First results on human trabecular bone samples are presented.

Aged↗

Micro-CT examinations of trabecular bone samples at different resolutions: 14, 7 and 2 micron level.

Tomographic techniques are attractive for the investigation of trabecular bone architecture. Using either conventional X-ray sources or synchrotron sources currently allows the acquisition of 3D images in a wide range of spatial resolution that may be as small as a few micrometers. Since it is technically possible to examine trabecular architecture at different scales, a question is to know what type of information it is possible to get at each scale. For this purpose, a series of ten vertebrae samples from healthy females of different ages (33 to 90) was imaged at various resolutions on three different micro-CT systems (cubic voxel size respectively 14, 6.7 and 1.4 microm). The comparison of morphometric parameters extracted from the different images is in agreement with simulation results on the influence of spatial resolution on structure parameters. The conclusion is that a 14 microm voxel size gives a reasonably good parameterisation of trabecular architecture. Besides the synchrotron radiation 2 microm level images reveal interesting features on the irregularities and rupture of trabecular surface, and on remodeling zones.

Adult↗

In vitro assessment of the relationship between acoustic properties and bone mass density of the calcaneus by comparison of ultrasound parametric imaging and quantitative computed tomography.

This in vitro study aimed to add new experimental evidence to clarify the relation between acoustic properties of bone and bone mineral density (BMD) of the human calcaneus. Parametric images of normalized broadband ultrasonic attenuation (nBUA) and ultrasound bone velocity (UBV) were compared with quantitative computed tomography (QCT) images of the calcaneus. The experimental protocol was designed to control the different potential sources of error in acoustic measurements, including the shape and thickness of the samples, intervening soft tissues and cortical bone, boundary effects, and variation in location of the regions of interest (ROIs) analyzed by ultrasound and X-ray. The present study was based on bone specimens from calcaneus removed from 15 cadavers (six male and nine female donors ranging from 69 to 89 years of age). Immersion ultrasonic measurements were performed in the through-thickness direction at normal incidence using a pair of focused broad-band 0.5-MHz transducers. QCT of the specimens was performed using standard 10-mm-thick slices with the Cann-Genant calibration standard. Identical, site-matched ROIs were selected for quantitative analysis on the three images. The pattern of acoustic parameters was similar to that of BMD with QCT. The relationships between nBUA and BMD (r2 = 0.75), between UBV and BMD (r2 = 0.88) and between nBUA and UBV (r2 = 0.84) were highly significant (p < 10(-4). From this study, it appears that ultrasound parameters as measured with current transmission techniques reflect mainly bone quantity and only reflect microarchitecture to a small extent and that BUA and UBV reflect the same bone property.

Acoustic Stimulation↗

Dual-energy X-ray absorptiometry of the calcaneus: comparison with vertebral dual-energy X-ray absorptiometry and quantitative computed tomography.

The purpose of this study was to determine the efficacy of using bone mineral measurements of the calcaneus to evaluate osteoporosis. Dual energy X-ray absorptiometry (DXA) of the calcaneus was compared with posteroanterior lumbar absorptiometry (DXA) and vertebral quantitative computed tomography (QCT) measurements in 171 white women (78 normal and 93 osteoporotic). DXA measurement of os calcis mineralization decreased significantly in osteoporosis, but to a lesser extent than in vertebral sites. In normal subjects, good correlations were observed between calcaneal and lumbar DXA (0.69) and QCT (0.56). In subjects with vertebral fractures, there was also good correlation between calcaneal DXA and QCT (0.59-0.69). This suggests that trabecular bone in calcaneus and vertebrae have related involution in cases of vertebral osteoporosis. However, the extent of bone loss is less marked in the calcaneus than in the vertebrae and is not sufficient to be accurately measured over time. We conclude, therefore, that although the global densitometric measurement at this site is not sufficiently sensitive for general use, it can be useful as a epidemiological research tool.

Absorptiometry, Photon↗

European semi-anthropomorphic spine phantom for the calibration of bone densitometers: assessment of precision, stability and accuracy. The European Quantitation of Osteoporosis Study Group.

Up to now it has not been possible to reliably cross-calibrate dual-energy X-ray absorptiometry (DXA) densitometry equipment made by different manufacturers so that a measurement made on an individual subject can be expressed in the units used with a different type of machine. Manufacturers have adopted various procedures for edge detection and calibration, producing various normal ranges which are specific to each individual manufacturer's brand of machine. In this study we have used the recently described European Spine Phantom (ESP, prototype version), which contains three semi-anthropomorphic "vertebrae" of different densities made of stimulated cortical and trabecular bone, to calibrate a range of DXA densitometers and quantitative computed tomography (QCT) equipment used in the measurement of trabecular bone density of the lumbar vertebrae. Three brands of QCT equipment and three brands of DXA equipment were assessed. Repeat measurements were made to assess machine stability. With the large majority of machines which proved stable, mean values were obtained for the measured low, medium and high density vertebrae respectively. In the case of the QCT equipment these means were for the trabecular bone density, and in the case of the DXA equipment for vertebral body bone density in the posteroanterior projection. All DXA machines overestimated the projected area of the vertebral bodies by incorporating variable amounts of transverse process. In general, the QCT equipment gave measured values which were close to the specified values for trabecular density, but there were substantial differences from the specified values in the results provided by the three DXA brands. For the QCT and Norland DXA machines (posteroanterior view), the relationships between specified densities and observed densities were found to be linear, whereas for the other DXA equipment (posteroanterior view), slightly curvilinear, exponential fits were found to be necessary to fit the plots of observed versus specified densities. From these plots, individual calibration equations were derived for each machine studied. For optimal cross-calibration, it was found to be necessary to use an individual calibration equation for each machine. This study has shown that it is possible to cross-calibrate DXA as well as QCT equipment for the measurement of axial bone density. This will be of considerable benefit for large-scale epidemiological studies as well as for multi-site clinical studies depending on bone densitometry.

Absorptiometry, Photon↗

Dual X-ray absorptiometry--cross-calibration and normative reference ranges for the spine: results of a European Community Concerted Action.

Bone density measurements by dual X-ray absorptiometry (DXA) of the spine can now be made precisely, but there is no uniformity in reporting results and in presenting reference data. A European Union Concerted Action therefore devised a uniform procedure for cross-calibrating and standardizing instruments, using the European spine phantom (ESP) prototype. This phantom differs in a number of respects from the final version of the ESP. Eighteen centers in nine countries obtained 1619 records (1035 women) from Caucasian subjects, aged 20-80 years, drawn from normal populations. The DXA machines used were made by the Hologic, Lunar, and Norland companies. Highly statistically significant differences were evident between populations, both in apparent rates of bone loss with age and in the spread of values about the age-adjusted means. There were small residual differences in the results obtained with the three machine brands which could have been due to the relatively large between-center population differences we observed. The alternative or additional explanation that they were attributable, in part, to the design differences between the ESP prototype and the definitive ESP, which became available after this study was completed, was shown to be a valid possibility. Results from postmenopausal women reported in relation to the years that have elapsed since menopause showed reduced population variance when compared with conventional reporting in relation to age. After cross-calibration, the center with the highest age-adjusted normal density value averaged 23% more than the center with the lowest. It is therefore crucially important to select appropriate reference data in clinical and epidemiological studies.(ABSTRACT TRUNCATED AT 250 WORDS)

Absorptiometry, Photon↗

European semi-anthropomorphic phantom for the cross-calibration of peripheral bone densitometers: assessment of precision accuracy and stability.

A semi-anthropomorphic 'distal radius like' phantom, developed by Kalender and Ruegsegger for use in peripheral bone densitometry using single photon (DPA) dual X-ray (DXA) and quantitative computed tomography (QCT) machines, has been studied with a view to cross-calibrating different types and brands of densitometers in current use. In the context of an EU 'Concerted Action' (second Framework Programme) the phantom was repeatedly measured on six SPA machines, three DXA machines and nine QCT machines (545 measurements). Linear regression equations were derived, individual to each machine, which allowed the derivation of 'standardized densities'. In this way we converted measurements made by machines of the same modality to a common scale of measurements. Two machines (one DXA, one SPA) showed statistically significant instability over time emphasising the need for rigorous quality control in the application of densitometry. In other respects these results provide an encouraging basis for the derivation of standardized normative ranges and the more effective use of peripheral densitometry in future clinical and epidemiological studies.

Absorptiometry, Photon↗

3D display of high resolution vertebral structure images.

In this paper we present a methodology for three-dimensional representation of vertebral structures. A set of X-ray CT images is obtained on a specific high resolution acquisition system. The images are then segmented in order to separate trabecular and cortical structures. Finally, the complex 3D surfaces are visualized using a volume rendering technique.

Humans↗

[Measurement of vertebral bone density. Quantitative tomodensitometry or dual-photon absorptiometry?].

We have compared vertebral bone density measurements (QCT and DXA) in women in the postmenopausal period who underwent both examinations. Our aim was to study the results and to define the respective indications of QCT and DXA in various clinical pictures of osteoporosis. The subjects of the study were distributed into various groups according to the presence or absence of vertebral collapse and/or peripheral fractures. The results of the measurements were expressed as Z-scores (deviation from age-normal average) to suppress the age effect and to make comparison between both methods possible. The values of both measurements are significantly lower in case of vertebral involvement. QCT is more sensitive than DXA to discriminate vertebral collapse. A vertebral fragility threshold was defined at a Z-score of -1 with DXA and -1.25 with QCT, corresponding to the best sensitivity for an acceptable specificity. The results of densitometry suggest that there is a peripheral osteoporosis, different from vertebral osteoporosis, as early as the postmenopausal period. Since DXA is easy to implement, it can be used to screen osteoporosis. When the vertebral measurement with DXA is normal although osteoporosis is obvious (previous collapse or fracture), QCT must be used as it is more sensitive.

Absorptiometry, Photon↗

CT image analysis of the vertebral trabecular network in vivo.

A method of computed tomography (CT) image analysis of lumbar vertebrae has been developed, providing a visualization of the trabecular network as it is represented in a 1.5 mm-thick CT image. We measured the length of the network and the number of discontinuities found in the image. The ratio of these measurements was called the "trabecular fragmentation index" (TFI). CT images from 71 women between the ages of 50 and 59, and 94 women between the ages of 60 and 69 were divided into three groups according to quantitative computed tomography (QCT) vertebral density and to the presence or absence of crushing and fractures. The measure of the network length versus the vertebral area was significantly higher in normal subjects than in osteoporotics. A TFI threshold at 0.195 could separate the normal subjects, regardless of the decade, from osteoporotic ones. In females between 50 and 69 years of age, TFI was 0.166 (SD = 0.031) for the normal group and 0.248 (SD = 0.082) for osteoporotics. The osteopenic group without fractures but low bone mineral density (BMD) showed an intermediate TFI of 0.195 (SD = 0.05), placing this population on both sides of the threshold. Correlation between TFI and BMD was only -0.60. TFI could provide new information in vivo about the state of trabecular structure, particularly in the osteopenic group.

Aged↗

Measurement of anisotropic vertebral trabecular bone loss during aging by quantitative image analysis.

Age-dependent variations in the architecture of vertebral trabeculae in both the vertical and horizontal planes were characterized by quantitative image analysis. Images were obtained from autopsy specimens of the third lumbar vertebrae in 61 subjects (30 men and 31 women) whose ages ranged between 33 and 89 years). All subjects had died acutely either after trauma or illnesses unrelated to the skeleton. Using mathematical morphology techniques, we measured total bone area and perimeter, and the width of trabecular particles and medullary spaces in each slice. Between the age intervals 33-49 and 80-89 years: total bone loss in the vertical and horizontal planes was 51 and 64% for women, and 38 and 29% for men, respectively. Mean trabecular width (MTW) in the vertical plane decreased from 172 to 128 micron in women and from 181 to 144 micron in men; MTW in the horizontal plane fell from 144 to 112 micron in women and remained at 114 micron in men. Maximum trabecular width decreased with age in both planes in both sexes. The mode for trabecular width was 111 micron in both sexes for all ages and in both planes. The total number of trabeculae decreased only for women in the vertical plane. Intertrabecular spaces enlarged reciprocally as the trabeculae became thinner, but the widening of spaces was much greater than that expected with trabecular thinning alone. We conclude that age-related bone loss is comprised of two processes: reduction of MTW and fragmentation and complete loss of some trabeculae. We found no evidence of vertical trabeculae thickening during normal aging.

Adult↗

[Contribution of microradiography in search of calcifications of valvular bioprostheses].

Implantation of a valvular bioprosthesis is one of the best treatments for valvular disease, particularly in children. Unfortunately, their use is limited as calcifications develop over time. Prevention of these calcifications is still an unresolved problem that is under study by Professor Carpentier and coworkers. These investigators have developed an experimental model in which accelerated development of calcifications occurs: fragments of porcine valves implanted under the skin of rats become calcified in a few days. Prior to implantation, the fragments are pretreated in an attempt to delay or prevent the development of calcifications. Two, four, six and eight months after implantation, the fragments are removed and calcifications are looked for using microradiography. Two hundred fragments have been studied. The material and technique used in our study are described. Results are semi-quantitative, based on the volume of calcifications. We conclude that microradiography is faster and more reliable than histology (the only technique used up till now) as it allows to study the entire fragments.

Animals↗

Importance of measurement of spongious vertebral bone mineral density in the assessment of osteoporosis.

Quantitative computed tomography (QCT) measurements of bone mineral density, volume, and content were made of the spongious and compact portions of a vertebral body and of the total vertebral body in 19 osteoporotic patients (13 women and 6 men) and 20 normal (control) age- and sex-matched patients. Specifically, CT scans of 10mm thick transverse sections of L2 or L3 of each osteoporotic and control patient were subjected to QCT bone measurement with the use of K2HPO4 calibration for converting CT values into units (mg/ml) equivalent to bone mineral density. In every instance, a significant difference was found in the spongious vertebral bone mineral density (and content) between the osteoporotic and the paired normal groups. Even when the total vertebral bone mineral content was normal, the spongious vertebral bone mineral density was significantly less in the osteoporotic patients. Only in the osteoporotic men was a difference in compact bone density (and content) found; the osteoporotic men had a significantly lower compact bone mineral than did the normal male patients. This study shows that QCT can be applied to measurement of bone mineral density (and content) of both the anterior spongious and the more dense compact vertebral bone from a single section of a lumbar vertebra and that it is the anterior, spongious, vertebral bone rather than the compact vertebral bone that exhibits the more severe decrease in bone mineral density (and content) due to osteoporosis.

Adult↗