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PubMed2001

Torsional testing and peripheral quantitative computed tomography in rat humerus.

Peripheral quantitative computed tomography (pQCT) is a noninvasive method mainly used to evaluate the densitometric and geometric properties of bone. In the present study, we evaluate the different variables provided by pQCT examination and their ability to predict the mechanical strength properties of the rat humerus. Humeri from 68 female rats were utilized. These humeri represented bone with a wide range of mechanical and densitometric properties as well as geometric dimensions. Various characteristics, such as volumetric cortical density, total mineral content, cortical thickness, total cross-sectional area, cortical area, and polar strength strain index (SSI), were measured by pQCT. The reproducibility of these measurements was good, with a coefficient of variation (CV) ranging from 0.8% to 4.9%. Bone composition (e.g., ash weight, water content, and inorganic content) and bone dimensions (e.g., length, waist, and volume) were also determined. The mechanical properties (maximum torque, torsion at failure, and stiffness) were measured by torsional testing. Stepwise multiple linear regression was performed to identify the best explanatory variables for each mechanical parameter. Total cross-sectional area and polar SSI were equally well correlated to stiffness (r = 0.57, p < 0.001), whereas ash weight was superior to the pQCT variables to explain maximum torque (r = 0.42, p < 0.001). No other independent pQCT variable entered the two models in the stepwise regression analysis. It was found to be feasible to measure properties of the rat humerus with pQCT. Cross-sectional area and the polar SSI were shown to be the best explanatory variables for stiffness, whereas ash weight was the best predictor for maximum torque.

Animals↗
PubMed2003

Effects of an excess and a deficiency of endogenous parathyroid hormone on volumetric bone mineral density and bone geometry determined by peripheral quantitative computed tomography in female subjects.

Peripheral quantitative computed tomography (pQCT) is useful for evaluating volumetric bone mineral density (vBMD) as well as bone mineral density (BMD) of cortical and trabecular bones separately. Although PTH affects cortical and trabecular bones differently, the effects of endogenous PTH on vBMD and bone geometry have not previously been examined with pQCT. We, therefore, investigated the effects of an excess and a deficiency of endogenous PTH on bone by employing dual-energy x-ray absorptiometry and pQCT in 36 female patients with primary hyperparathyroidism (hyper), nine female patients with idiopathic or postoperative hypoparathyroidism (hypo), and 100 normal controls matched to age, gender, and body size (cont). Lumbar BMD by dual-energy x-ray absorptiometry was higher in the order: hypo > cont = hyper, and radius-1/3 BMD was significantly higher in the order: hypo > cont > hyper. The area of radius-1/3 was significantly higher in hyper than in cont. As for pQCT, trabecular vBMD was significantly higher in the order: hypo > cont > hyper at the 4% site (hypo, 157.5 +/- 36.7 mg/cm(3); cont, 123.4 +/- 47.5 mg/cm(3); hyper, 98.4 +/- 41.7 mg/cm(3)). Cortical vBMD was higher in the order: hypo > cont > hyper at the 20% site (hypo, 1141.1 +/- 53.1 mg/cm(3); cont, 1090.2 +/- 72.9 mg/cm(3); hyper, 1038.6 +/- 89.1 mg/cm(3)). Total bone area and endosteal and periosteal circumferences were significantly higher in hyper than in cont and hypo. Cortical area and thickness were higher in the order: hypo > cont > hyper. Bone strength indices were not significantly different among the three groups. In conclusion, vBMD evaluation revealed that an excess of endogenous PTH was catabolic for both cortical and trabecular bones, and that bone mass (especially trabecular bone mass) was preserved under a condition of deficient endogenous PTH. An excess of endogenous PTH stimulated periosteal bone formation, which might partly compensate for a decrease in bone strength induced by low BMD.

Absorptiometry, Photon↗
PubMed2000

Differential effects of menopause and metabolic disease on trabecular and cortical bone assessed by peripheral quantitative computed tomography (pQCT).

The usefulness of peripheral quantitative computed tomography (pQCT) was investigated in the diagnosis of metabolic bone diseases, including osteoporosis, and especially in the different diagnostic values in trabecular and cortical components. The subjects were 460 Japanese women aged 20-86 years, including 318 healthy volunteers, 58 osteoporotics with fracture and 84 patients with diseases including amenorrhoea, steroid-induced osteoporosis, renal osteodystrophy (ROD) and primary hyperparathyroidism. Bone mineral density (BMD) was measured for more than 4 years in 74 of the healthy volunteers. BMD was measured by spinal QCT, dual X-ray absorptiometry (DXA) of the spine, radius, and heel, and pQCT of the radius and tibia. High resolution images were obtained for geometry of the radius. Radial pQCT showed a higher correlation with radial DXA than with spinal QCT, and spinal QCT showed a higher correlation with spinal DXA than with radial pQCT. The annual bone loss rates at predominantly trabecular bone sites were accelerated in both the axial and appendicular skeleton. In the fracture study, radial pQCT showed a higher odds ratio (OR = 4.4) than radial DXA, and cortical area ratio seemed to be a good predictor of fracture risk (OR = 5.2). Amenorrhoea and steroid-induced osteoporosis predominantly affected trabecular bone, ROD predominantly affected cortical bone and hyperparathyroidism affected both components, especially the cortical component. pQCT is useful for assessing both trabecular and cortical bone, to provide information on individual bone changes in metabolic bone disease and to estimate the risk of fracture.

Absorptiometry, Photon↗
PubMed2001

Analysis of cancellous bone turnover by multiple slice analysis at distal radius: a study using peripheral quantitative computed tomography.

We compared the results of peripheral quantitative computed tomography (pQCT) measurements (XCT-900; Stratec) at the 4% site of the distal radius (section 1; slice thickness of 2 mm) and in two proximally adjacent sections (sections 2 and 3). The study population consisted of 138 ambulatory patients (age 16.4 +/- 5.6 yr; mean +/- SD; 71 female) who were referred to a pediatric densitometry unit. Total volumetric bone mineral density (BMD) increased, whereas the area of the radial cross-section decreased in a proximal direction. There was a decrease in bone mineral content between sections 1 and 3, which was more pronounced in subjects under age 16. Cancellous BMD significantly decreased from section 1 to 3 only under the age of 16. In 12 patients under age 17 who suffered from increased bone fragility, cancellous BMD decreased about 2.5 times more between sections 1 and 3 than in age-matched patients who received anticonvulsant therapy but had a normal neurologic and musculoskeletal status (-21.4% +/- 16.9 vs -8.1% +/- 6.3; p = 0.02). This suggests that in the bone fragility group, trabeculae were removed faster during longitudinal growth of the radius. In conclusion, multiple slice analysis may provide information on the dynamic turnover of metaphyseal trabeculae during growth.

Adolescent↗
PubMed2005

Effects of age, grip strength and smoking on forearm volumetric bone mineral density and bone geometry by peripheral quantitative computed tomography: comparisons between female and male.

Peripheral quantitative computed tomography (pQCT) is useful to measure volumetric bone mineral density (vBMD) distinguishing trabecular from cortical bones as well as quantity of bone geometry. In the present study, we examined the effects of age, grip strength and smoking on vBMD, bone geometry and bone strength index (polar strength strain index (SSIp)), and then compared with the differences between female and male by employing pQCT in Japanese 252 female and 230 male subjects. Age was negatively correlated with vBMD, cortical area (Ct.Ar) and cortical thickness (Ct.Th) as well as SSIp in both sexes, and the correlation coefficients were higher in female, compared with those in male. Although age was correlated with endocortical circumferences (En.Le) in both sexes, periosteal circumferences (Ex.Le) were correlated with age only in male. Volumetric BMD, Ct.Ar, Ct.Th and SSIp were significantly lower in the group with vertebral fractures, although En.Le and Ex.Le were similar between subjects with and without vertebral fractures. Grip strength was positively correlated with vBMD, Ct.Ar, Ct.Th as well as SSIp. The extent of correlation was much higher in female, compared with that in male. Ct.vBMD, Ct.Ar, Ct.Th and SSIp, but not trabecular vBMD, were significantly lower in the group with high Brinkman index (number of cigarettes smoked per day) x (duration of smoking (years)) in female. These parameters were not significantly different between groups with high and low Brinkman index in male. In conclusion, the present study demonstrated that age, grip strength and smoking affected forearm vBMD, bone geometry and bone strength index by pQCT. These effects were greater in female, compared with those in male.

Absorptiometry, Photon↗
PubMed2003

Geometry and bone mass in primary hyperparathyroidism assessed by peripheral Quantitative Computed Tomography (pQCT).

PURPOSE: Non-invasive measurement by peripheral quantitative computed tomography (pQCT) of bone geometry, biomechanics, and mineral content in patients (pts) with primary hyperparathyroidism (PHPT). MATERIALS AND METHODS: Total, trabecular and cortical mineral density (totBMD, cortBMD, trab BMD), bone geometrical properties (total area, trabecular area, cortical area, cortical/total area) and cortical thickness as biomechanical parameters, were assessed by pQCT at distal radius in 38 (32 F; 6 M) consecutive patients with PHPT (mean age: 62 yrs; range: 30-77). In a subgroup of 12 patients, bone mineral density (BMD) was also measured by means of dual X-ray absorptiometry (DXA) at the lumbar spine (L2-L4). RESULTS: Serum biochemical characteristics were: iPTH (269+/-214 pg/ml; range: 107-1438, normal: 30-65), Calcium (11.4+/-1.1 mg/dl; range: 10.6-13.5, normal: 8.1-10.4) and Alkaline Phosphatase (398+/- 392 U/L; range:173-1174, normal: 98-279). Compa-red with 87 healthy age-matched subjects, total, trabecular and cortical bone densities were reduced in all patients (TotBMD: 216+/-92 mg/cm(3) vs ctr 342+/-94, -37%, p<0.05; TrabBMD: 93+/-51 mg/cm(3) vs ctr 140+/-54, -34%, p <0.01; CorBMD: 711+/-178 mg/cm(3) vs ctr 802+/-175, -11%, p<0.02), such as cortical thickness (0.143+/-0.02 cm vs ctr 0.157+/-0.03, -9%, p<0.02). Among geometrical parameters, only cortical/total area was significant different in the two groups (0,29 vs 0.31; p<0.04). A strong correlation was found between peripheral trabecular bone density assessed by pQCT and axial bone mineral density measured by DXA at L2-L4 (r=0.80; p<0.01). CONCLUSIONS: pQCT measurements in PHPT showed: 1) osteopoenia in all bone compartments partly related to age and menopause; 2) reduced cortical density and cortical thickness consistent with "cancellization" of the inner cortex and lower ability of bone to absorb loading forces. DXA measurements showed osteopoenia also at the lumbar spine, a site rich in trabecular bone. PQCT allowing selective assessment of true volumetric cortical and trabecular bone density such as bone geometry, is proposable in clinical practice, in order to evaluate presurgical bone "status" and to monitor the response to parathyroidectomy.

Absorptiometry, Photon↗
PubMed2002

Patient-specific microarchitecture of vertebral cancellous bone: a peripheral quantitative computed tomographic and histological study.

This study directly compares peripheral quantitative computed tomography (pQCT) and histology for the assessment of 11 morphological parameters. Sixty-eight cylindrical cancellous bone samples were cored from the thoracic (T-9) thoracolumbar (T-12 or L-1), and lumbar (L-4) vertebral bodies of nine autopsy subjects (aged 44-88 years). Four transverse slices were acquired by pQCT from the bottom to the top of each cylinder. Slice thickness was 300 microm and pixel size was 70 x 70 microm. Thin sections (5 microm) were obtained at the same location in the samples, stained with Von Kossa, and photographed. Classical morphological parameters and strut analysis parameters were measured on all images (272 pQCT and 272 matched histological sections). Because of the partial volume effect and specific thresholding procedure, pQCT overestimated the absolute value of the bone volume fraction (BV/TV) and trabecular thickness (Tb.Th) by a factor 2. The trabecular number (Tb.N), trabecular spacing (Tb.Sp), and total strut length (TSL) were correctly estimated. However, the direct correlation between pQCT and histology was excellent (r2 > 0.85, p < 0.001) for BV/TV, Tb.N, Tb.Sp, TSL, and star surface. For Tb.Th, number of nodes, and number of free ends, the correlation was also good (r(2) > 0.6, p < 0.001). Using a random regression model, we also explored the ability of these parameters to add structural information to the readily available BV/TV or apparent density. The model identified significant (p < 0.001) differences between subjects. For a given BV/TV, some patients had more trabeculae (Tb.N) that were thinner (Tb.Th) and more disconnected (higher free ends and star). This was observed for both histology and pQCT morphometrical data. Our analysis demonstrates the capacity of both histology and pQCT to detect subjects with specific structural patterns in vertebral cancellous bone.

Adult↗
PubMed1996

Accuracy and precision study in vitro for peripheral quantitative computed tomography.

We evaluated the accuracy and precision of a peripheral quantitative computed tomography (pQCT) scanner, the Stratec XCT-960, using 12 human cadaveric forearms. The accuracy was determined by comparing the total bone mineral content (BMC) with the ash weight (AW). We scanned and ashed three consecutive slices (thickness 2.5 mm) at the standard position (s-position) and at 2.5 mm both proximal and distal to the s-position. The correlation coefficient between the AW and total BMC using slices at the s-position was r = 0.87 with an accuracy error (random component) of 15.5%. The correlation coefficient using all slices was r = 0.90 with an accuracy error of 14.3%. The correlation coefficient improved to r = 0.95 with an accuracy error of 9.7% after averaging the results of all three slices for each forearm. The short-term precision error expressed as the coefficient of variation (CV) of bone mineral density (BMD) and BMC was determined by measuring the forearms five times either with repositioning or without repositioning. The CVs with repositioning were 2.77 and 1.15 for total BMD and BMC, 1.85 for trabecular BMD; without repositioning they were 0.29, 0.58 and 0.69 respectively. To further evaluate the influence of positioning, additional scans were performed at 1, 2 and 5 mm proximal, and 1 and 2 mm distal to the s-position. BMD and BMC were greatly influenced by the scan location; for example, the percentage differences in trabecular BMD 1 mm distal and proximal relative to the s-position were 2.5% +/- 5.1% and 0.18% +/- 6.3%, respectively. The Stratec XCT-960 appears to be a moderately accurate and highly precise scanner with potential usefulness for evaluating BMC and BMD of ultradistal radius.

Bone Density↗
PubMed1996

Regional analysis of bone mineral density in the distal femur and proximal tibia using peripheral quantitative computed tomography in the rat In vivo.

The use of peripheral quantitative computed tomography (pQCT) was investigated for the measurement of volumetric bone mineral density (BMD) in mg x cm-3. Two studies were undertaken. In the first study, the precision of pQCT in vivo and ex vivo was tested at 14 weeks postovariectomy (OVX). In the second study, the efficacy of a standard antiresorptive treatment, 17beta-estradiol (E2), was tested 6 weeks post-OVX. The precision for total (compact plus trabecular) BMD was 1.3-1.9%, and that for trabecular BMD was 2.4-2. 7%. There was excellent agreement between trabecular BMD measurements in vivo and ex vivo (r = 0.91). Significant reductions in trabecular BMD were observed in vivo at 14 and 6 weeks following ovariectomy in the femur, in each study. The loss of trabecular BMD depended on slice location, and varied from 0 to 22% at 6 weeks, and from 0 to 26% at 14 weeks (P < 0.001, at the affected locations). The antiresorptive effect of treatment was demonstrated in the 6-week study: there was no significant difference in BMD between sham-operated and E2-treated OVX rats.

Animals↗
PubMed1999

Peripheral quantitative computed tomography of the femoral neck in 60 Japanese women.

Peripheral quantitative computed tomography (pQCT) is able to evaluate trabecular and cortical bone separately, and to determine geometric properties from cross-sectional images for noninvasive assessments of mechanical strength. In order to assess the diagnostic value of pQCT of the femoral neck, 60 healthy women were examined with a new pQCT machine, XCT-3000 (Norland-Stratec, Germany), which is suitable for direct measurement of the hip. The region of interest chosen was the center of the femoral neck. pQCT of the distal radius and dual energy X-ray absorptiometry (DXA) of the lumbar spine and femoral neck were also performed. The study demonstrated that total bone mineral density (BMD) (femoral MD) and trabecular BMD (femoral-TBD) decreased with advancing age. Percent cortical area showed a small but significant decrease with advancing age and % trabecular area increased slightly. Both the endosteal perimeter and the periosteal perimeter were relatively constant with aging. Bone strength index (BSI) and stress-strain index (SSI), which reflect the mechanical strength of bone, declined with advancing age, especially after menopause. Femoral TBD correlated strongly with femoral neck BMD by DXA and L2-L4 BMD by DXA but femoral-CBD did not correlate with femoral neck BMD by DXA. Volumetric BMD of the femoral neck and distal radius were closely correlated. It is concluded that (1) cortical thinning occurs with aging by endocortical resorption and loss of femoral-TBD; (2) loss of femoral-CBD occurred at a slower rate than radial CBD, perhaps due to the weight-bearing effect; (3) biomechanical parameters such as the BSI and SSI may reflect increasing fragility of the femoral neck in pre- and postmenopausal women; (4) pQCT of the femoral neck had diagnostic value at least equivalent to that of DXA or pQCT of the distal radius.

Absorptiometry, Photon↗
PubMed2001

Predictive value of bone mineral density and morphology determined by peripheral quantitative computed tomography for cancellous bone strength of the proximal femur.

Peripheral quantitative computed tomography (pQCT) is an established diagnostic method for assessment of bone mineral density in the diagnosis of osteoporosis. However, the capacity of structural parameters of cancellous bone measured by high-resolution computed tomography remains to be explored. In 33 patients, bone mineral density (BMD) of the proximal femur was measured in vitro by pQCT using cylindrical biopsies from the intertrochanteric region harvested before the implantation of an artificial hip joint. By digital image analysis of CT scans, parameters derived from histomorphometry describing the microarchitecture of cancellous bone were measured. The biopsies were also loaded to failure by an uniaxial compression test to determine the biomechanical parameters, Young's modulus, strength, and maximum energy absorption (E(max)). Strong correlations were found for BMD vs. mechanical parameters (r = 0.73 for Young's modulus, r = 0.82 for strength, and r = 0.79 for E(max); p < 0.001, n = 29). The morphological parameters, bone volume per trabecular volume (BV/TV), apparent trabecular thickness (app.Tb.Th), apparent trabecular separation (app.Tb.Sp), and trabecular number (Tb.N), correlated significantly with all mechanical parameters. The combination of morphological parameters with BMD in a multivariate regression model led to an overall, but only moderate, increase in R(2) in all cases. Our data confirm the high predictive value of BMD for the mechanical competence of cancellous bone of the intertrochanteric region. However, quantification of cancellous bone structure by image analysis of CT scans may provide additional qualitative information for the analysis of bone strength.

Aged↗
PubMed2003

[Evaluation of bone architecture and biomechanic properties by peripheral quantitative computed tomography in rats].

OBJECTIVES: To evaluate the value of peripheral quantitative computed tomography (pQCT) in measuring bone architecture and biomechanic properties. METHODS: 50 virgin female Wistar rats six months old were randomly divided into 4 groups: (1) 8 rats were killed as baseline group; (2) 8 rats underwent sham operation and then were killed 14 weeks after (sham operation group); (3) 16 rats underwent bilateral ovariectomy (OVX) without further intervention. Six and 14 weeks after the operation each 8 rats were killed (OVX group); and (4) 18 rats underwent OVX too. After the OVX 9 of the 18 rats were treated with 17beta-estradiol 20 micro g/kg/d IH and 9 rats were treated with estradiol valerate 800 micro g/kg/d po for 8 weeks respectively. Then the 18 rats were killed (OVX plus estrogen group, O + E group). The right tibiae of the rats were taken for histomorphometric analysis, and the right femora were prepared for pQCT scanning and bone biomechanical measurement with indentation test and three-point bending test. RESULTS: Histomorphometric analysis showed that the trabecular volume of proximal tibia (Cn-BV/TV) in the OVX group was 8.1 +/- 1.4%, significantly lower than that in the sham operation group (19.5 +/- 1.5%, P < 0.01). pQCT scanning showed that the femoral trabecular bone mineral content (Trab BMC) in the OVX group was 1.7 +/- 0.3 mg/mm, significantly lower than that in the sham operation group (3.2 +/- 0.5 mg/mm, P < 0.01) and the femoral trabecular bone mineral density (Trab BMD) in the OVX group was 158 +/- 32 mg/mm(3), significantly lower than that in the sham operation group (320 +/- 39 mg/mm(3), P < 0.01). The cancellous maximal load (Can load) of the distal shaft of femur in the OVX group was 12.5 +/- 2.5 N, significantly lower than that in the sham operation group (45.9 +/- 3.2 N, P < 0.01). The cancellous stiffness (Can Stiff) of the distal shaft of femur in the OVX group was 226 +/- 48 N/mm, significantly lower than that in the sham operation group (396 +/- 72 N/mm, P < 0.01). The Can load of O + E group was 21.8 +/- 3.7 N, significantly higher than that in the OVX group (P < 0.05). The Can Stiff of the O + E group was 382 +/- 54 N/mm, significantly higher than that in the OVX group (P < 0.05). There were no significant differences in cortical bone determined by pQCT as well as biomechanic properties in measured by three point test after OVX and estrogen treatment. A significant positive correlation was shown between Trab BMD and Cn-TV/BV and between Trab BMD and Tb N (r = 0.88 and 0.73, both P < 0.01). Similarly, both Trab BMC and Trab BMD of the femur were significantly correlated with the Can load and Can Stiff determined by indentation test (r = 0.47 - 0.68, all P < 0.01). There was also a significant correlation of parameters measured by pQCT in cortical bone with the maximal load and stiffness for the femur midshaft, and the best correlation was found between the maximal load of femur midshaft and Crt BMC and Crt A (both r = 0.76 and P < 0.01). CONCLUSION: The geometric, densitometric and mechanical properties in cortical and trabecular bones of rat can be well described by pQCT.

Animals↗
PubMed1999

[Separate measurement of radial trabecular and cortical bone mineral density by peripheral quantitative computed tomography (pQCT) in degenerative joint disease].

Degenerative joint disease and osteoporosis, both of which tend to increase with advance in age, were thought to be essentially different mainly because of the artifactually high lumbar spine bone mineral density (BMD) in the former unlike osteoporosis characterized by persistent decrease of BMD. To clarify the relationship between these two diseases, three-dimensional BMD of the trabecular and cortical bone was measured separately in an area of the radius relatively free of degenerative changes by peripheral computed tomography (pQCT). In addition to radiological assessment of spondylosis deformans, quantification of vertebral deformity was attempted by calculation of standard deviation, coefficient of variation, difference between maximum and minimum density divided by the mean of L1-L4. With advance in age and progress of spondylosis deformans, the standard deviation, coefficient of variation difference between the maximum and minimum density and this difference divided by the mean of L1-L4 increased, but radial trabecular bone density, cortcal density and relative cortical volume decreased, suggesting parallel advance of degenerative joint disease and osteoporosis. Sodium etidronate, an antiresorber commonly used in the treatment of osteoporosis, increased mean lumbar spine BMD and markedly decreased the standard deviation, coefficient of variation, difference between the maximum and minimum density and this difference divided by the mean of L1 and L2 but maintained maximum BMD constant, decreasing vertebral deformity due to spondylosis deformans. It is conceivable that calcium release from bone on increased resorption leads to osteoporosis, and calcium entrance into cartilage, causing its hardening, disappearance and degeneration, direct contact between bones, osteoarthritis and subsequent deformity in a single sequence of events.

Absorptiometry, Photon↗
PubMed2005

Bone measurements by peripheral quantitative computed tomography (pQCT) in children with cerebral palsy.

OBJECTIVE: To use peripheral quantitative computed tomography (pQCT) to determine bone measurements in patients with cerebral palsy (CP) age 3 to 20 years and compare them with control subjects. STUDY DESIGN: A total of 13 (5 male) patients with CP, along with 2 sex- and age-matched controls for each, were included in a mixed-model analysis with matched pairs as random effects for pQCT bone measurements of the 20% distal tibia. RESULTS: Tibia length was similar in the CP and control groups (P = .57). Weight was marginally higher in the control group (P = .06). Cortical bone mineral content (BMC), area, thickness, polar strength-strain index (pSSI), and periosteal and endosteal circumferences were greater in the control group (P < .05 for all). Relationships between bone measurements and weight showed that cortical BMC, area, periosteal circumference, and pSSI were greater at higher weights in the control group (group-by-weight interaction, P < .05 for all). Cortical thickness was greater in the control group and was correlated with weight. Cortical volumetric bone mineral density (vBMD) was greater with higher weights in the CP group (group-by-weight interaction, P = .03). CONCLUSIONS: Bone strength, as indicated by pSSI, is compromised in children with CP due to smaller and thinner bones, not due to lower cortical bone density.

Adolescent↗
PubMed1998

Diagnostic sensitivity of peripheral quantitative computed tomography measurements at ultradistal and proximal radius in postmenopausal women.

Peripheral quantitative computed tomography (pQCT) is a bone densitometry technique that is able to provide real volumetric bone density values not only of the total but also of trabecular and cortical bone separately. Normal reference curves were constructed with cross-sectional data obtained in 275 postmenopausal women (50-85 years), measured at 4% of the ulnar length (ultradistal region), and data for total, trabecular, and cortical bone density were obtained. In these postmenopausal subjects, continuously significant (p < 0.0001) age-dependent declines in bone density of 1.14%, 1.1%, and 0.57% for total, trabecular, and cortical bone, respectively, were observed while similar declines of 0.9%, 0.9%, and 0.4% per year since menopause, respectively, were found. The estimated mechanical stability index also showed linear dependencies with decreases of 0.84%/year and 0.6%/year since menopause (p < 0.0001). A more proximal acquisition at 15% of the ulnar length, an almost pure cortical region, resulted in linear declines of 0.41%/year and 0.27%/year (p < 0.0001) for the cortical bone and the mechanical stability index with significant changes of -0.27% and -0.23% per year, respectively, since menopause. Covariance analysis showed similar age dependencies of the different bone indices obtained in both regions of interest except for the stability index. A significant size adaptation of the bone with age was also observed, which was seen in the relationships of the trabecular and cortical bone areas to age and to bone density. Diagnostic sensitivity of all parameters for established osteoporosis was assessed by receiver operating characteristic (ROC) curves, comparing 99 patients with at least one fracture to the reference population. The area under these curves was highest in the ultradistal pure trabecular density of the radius (75%), followed by stability index (72%) and the area of cortical bone (65%) of the proximal site. No distinguishing power was seen for the cortical bone density values obtained in either the ultradistal (51%) or proximal radius (52%).

Age Factors↗
PubMed2004

Accuracy and precision of peripheral quantitative computed tomography measurements at the tibial metaphysis.

The ability of 29 peripheral quantitative computed tomography (pQCT) software analysis modes at defining cortical from trabecular bone at three tibial metaphyseal regions was evaluated using five cadaveric tibiae. The accuracy of pQCT was determined by comparing the bone mineral content (BMC) with the ash weight. The precision of the pQCT scanner was calculated using repeated measurements. All the analysis modes had a good accuracy when measuring total bone area and a poor accuracy when measuring cortical bone area at the proximal 5% and distal 4% regions. For trabecular bone measured at all three regions and cortical bone area measured at the proximal 10% region, the Stratec peel mode 5 was the most accurate analysis mode. Highly significant correlations (r = 0.71-0.98) and a moderate accuracy error (coefficient of variation [CV] = 5-22%) was found between ash weight and BMC when using this mode. The precision of bone mineral density (BMD) measurements was good (total, CV = 2-5%; trabecular, CV = 2-5%; cortical, CV = 4-6%). pQCT is a moderately accurate, precise method of measuring trabecular and total BMD at the tibial metaphysis. The authors recommend caution when interpreting results for cortical BMD, as cortical area measurements at the metaphyseal region are less accurate and less precise.

Adult↗
PubMed2006

Early manifestation of type 1 diabetes in children is a risk factor for changed bone geometry: data using peripheral quantitative computed tomography.

OBJECTIVE: Normal to severely decreased bone mineral density has been reported in children with type 1 diabetes. To detect possible abnormalities in bone mineralization, geometry, and muscle bone unit, we measured selective parameters in children with type 1 diabetes using peripheral quantitative computed tomography. METHODS: Measurements of the radius by peripheral quantitative computed tomography were made to assess cortical and trabecular bone characteristics as well as muscle mass in 88 patients (42 girls, 46 boys) at a mean age of 11.7 +/- 3.0 years, a mean disease duration of 5.6 +/- 3.7 years, and a mean manifestation age of type 1 diabetes of 6.1 +/- 3.5 years. Height, weight, Tanner stage, insulin regimen, and glycosylated hemoglobin values were recorded. Bone metabolism was studied by measurement of bone formation and bone resorption parameters. Dynamic muscle force was measured using a grip strength device. RESULTS: Overall, cortical, trabecular, and total bone mineral density were within the reference range. Total and cortical bone cross-sectional area and muscle mass were low in prepubertal patients, and total cross-sectional area was low in early puberty. Adolescent patients showed normal bone and muscle parameters. Grip strength and recreational physical activity were normal in all in relation to a healthy reference population. In a subgroup of 18 patients, early manifestation of type 1 diabetes was detected as a risk factor for altered bone development with significantly reduced cortical bone mineral density and total, cortical, and muscle cross-sectional area (-0.9 +/- 1.3 SD, -2.1 +/- 1.3 SD, -1.6 +/- 0.7 SD, and -1.0 +/- 0.7 SD, respectively). Bone characteristics were not influenced by metabolic control, disease duration, or insulin regimen. CONCLUSIONS: Manifestation of type 1 diabetes at an early age may impair bone development. Longitudinal data are needed to determine whether this impairment persists into adolescence and adulthood.

Adolescent↗
PubMed2003

Accuracy of peripheral quantitative computed tomography (pQCT) for assessing area and density of mouse cortical bone.

Peripheral quantitative computed tomography (pQCT) is increasingly used for measurement of cortical bone geometry and density in mice. We evaluated the accuracy of pQCT for area and density measurements of thin-walled aluminum phantoms and mouse femora. Aluminum tubes with varying wall thicknesses and femora from 1- to 6-month-old C3H/HeJ (C3H) and C57B1/6J (B6) mice (average cortical thickness 0.14-0.29 mm) were scanned at 70- or 90-microm resolution. pQCT values of area were compared to optical values determined after sectioning, while pQCT density (vBMD) was compared to solid aluminum density or correlated to bone ash content. For the aluminum phantoms, the error in pQCT area and density depended strongly on wall thickness, and density was consistently underestimated. For mouse femora, threshold values were found that produced zero error in bone area for each strain and age group, although the optimal threshold differed between groups. pQCT vBMD correlated strongly with ash content (r2=0.7), although the regression equations differed between strains and the magnitude of the inter-strain difference in vBMD was fourfold greater than the difference in ash content. This finding suggests that pQCT can overestimate the differences in volumetric mineral density between inbred mouse strains whose bones are of different thickness (e.g., C3H vs. B6). In conclusion, both area and density values obtained by pQCT depend strongly on specimen thickness, consistent with a partial volume averaging artifact. Investigators using pQCT to assess cortical bones in mice should be aware of the potential for cortical thickness-dependent errors.

Aluminum↗