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Haverfield ZA, Agnew AM, Loftis K, Zhang J, Hayden LE, Hunter RL. Multi-site phantomless bone mineral density from clinical quantitative computed tomography in males. JBMR Plus 2024; 8:ziae106. [PMID: 39224571 PMCID: PMC11366047 DOI: 10.1093/jbmrpl/ziae106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 07/09/2024] [Accepted: 08/01/2024] [Indexed: 09/04/2024] Open
Abstract
Volumetric bone mineral density (vBMD) is commonly assessed using QCT. Although standard vBMD calculation methods require phantom rods that may not be available, internal-reference phantomless (IPL) and direct measurements of Hounsfield units (HU) can be used to calculate vBMD in their absence. Yet, neither approach has been systemically assessed across skeletal sites, and HU need further validation as a vBMD proxy. This study evaluated the accuracy of phantomless methods, including IPL and regression-based phantomless (RPL) calibration using HU to calculate vBMD, compared to phantom-based (PB) methods. vBMD from QCT scans of 100 male post-mortem human subjects (PMHS) was calculated using site-specific PB calibration at multiple skeletal sites throughout the body. A development sample of 50/100 PMHS was used to determine site-specific reference material density for IPL calibration and RPL equations. Reference densities and equations from the development sample were used to calculate IPL and RPL vBMD on the remaining 50/100 PMHS for method validation. PB and IPL/RPL vBMD were not significantly different (p > .05). Univariate regressions between PB and IPL/RPL vBMD were universally significant (p < 0.05), except for IPL Rad-30 (p = 0.078), with a percent difference across all sites of 6.97% ± 5.95% and 5.22% ± 4.59% between PB and IPL/RPL vBMD, respectively. As vBMD increased, there were weaker relationships and larger differences between PB vBMD and IPL/RPL vBMD. IPL and RPL vBMD had strong relationships with PB vBMD across sites (R2 = 97.99, R2 = 99.17%, respectively), but larger residual differences were found for IPL vBMD. As the accuracy of IPL/RPL vBMD varied between sites, phantomless methods should be site-specific to provide values more comparable to PB vBMD. Overall, this study suggests that RPL calibration may better represent PB vBMD compared to IPL calibration, increases the utility of opportunistic QCT, and provides insight into bone quality and fracture risk.
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Affiliation(s)
- Zachary A Haverfield
- Injury Biomechanics Research Center, The Ohio State University, Columbus, Ohio 43210, United States
| | - Amanda M Agnew
- Injury Biomechanics Research Center, The Ohio State University, Columbus, Ohio 43210, United States
| | - Kathryn Loftis
- United States Army Futures Command DEVCOM Analysis Center, Aberdeen Proving Ground, Maryland, 21005, United States
| | - Jun Zhang
- Medical Physics, The Ohio State University Wexner Medical Center, Columbus, Ohio 43210, United States
| | - Lauren E Hayden
- Injury Biomechanics Research Center, The Ohio State University, Columbus, Ohio 43210, United States
| | - Randee L Hunter
- Injury Biomechanics Research Center, The Ohio State University, Columbus, Ohio 43210, United States
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2
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Rahn S, Skornitzke S, Melzig C, Reiner T, Stiller W, Heussel CP, Kauczor HU, Weber TF, Do TD. The influence of contrast media on calcium-based imaging of the spine in dual-layer CT. Sci Rep 2024; 14:18898. [PMID: 39143146 PMCID: PMC11324893 DOI: 10.1038/s41598-024-69743-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Accepted: 08/08/2024] [Indexed: 08/16/2024] Open
Abstract
This study aimed to evaluate the impact of contrast media application on CT attenuation of the bone using a novel calcium-only imaging technique (VCa) from dual-layer spectral detector CT (DLCT), which enables CT-based bone mineral density measurement unimpeded by soft tissue components. For this, true non-contrast (TNC) and venous phase images (VP) of n = 97 patients were acquired. CT attenuation of the first lumbar vertebra (L1) was measured in TNC-VCa, VP-VCa, and in virtual non-contrast images (VNC). CT attenuation was significantly higher in VP-VCa than in TNC-VCa (p < 0.001), although regression analyses revealed a strong linear association between these measures (R2 = 0.84). A statistical model for the prediction of TNC-VCa CT attenuation was established (TNC-VCa[HU] = - 6.81 + 0.87 × VP-VCa[HU]-0.55 × body weight[kg]) and yielded good agreement between observed and predicted values. Furthermore, a L1 CT attenuation threshold of 293 HU in VP-VCa showed a sensitivity of 90% and a specificity of 96% for detecting osteoporosis. The application of contrast media leads to an overestimation of L1 CT attenuation in VCa. However, CT attenuation values from VP-VCa can be used within CT-based opportunistic osteoporosis screening eighter by applying a separate threshold of 293 HU or by converting measured data to TNC-VCa CT attenuation with the given regression equation.
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Affiliation(s)
- S Rahn
- Clinic of Diagnostic and Interventional Radiology (DIR), Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany
| | - S Skornitzke
- Clinic of Diagnostic and Interventional Radiology (DIR), Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany
| | - C Melzig
- Clinic of Diagnostic and Interventional Radiology (DIR), Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany
| | - T Reiner
- Clinic of Orthopedics and Trauma Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - W Stiller
- Clinic of Diagnostic and Interventional Radiology (DIR), Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany
| | - C P Heussel
- Department of Radiology, Thoraxklinik Heidelberg, Heidelberg University Hospital, Heidelberg, Germany
| | - H U Kauczor
- Clinic of Diagnostic and Interventional Radiology (DIR), Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany
| | - T F Weber
- Clinic of Diagnostic and Interventional Radiology (DIR), Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany
| | - T D Do
- Clinic of Diagnostic and Interventional Radiology (DIR), Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany.
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Wang Y, Chen G, Zheng F, Dong C, Chen T. Effects of stepped rehabilitation on postoperative rehabilitation process and pain in patients with lumbar spine fracture. Minerva Pediatr (Torino) 2023; 75:932-934. [PMID: 37255398 DOI: 10.23736/s2724-5276.23.07303-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Affiliation(s)
- Yawei Wang
- Department of Orthopedics, Gansu Provincial Hospital of TCM, Lanzhou, China
| | - Guodong Chen
- Department of Orthopedics, Gansu Provincial Hospital of TCM, Lanzhou, China
| | - Fangjiang Zheng
- Propaganda United Front Department, Gansu Provincial Hospital of TCM, Lanzhou, China
| | - Chunxuan Dong
- Department of Rehabilitation Medicine, Gansu Provincial Hospital of TCM, Lanzhou, China
| | - Tao Chen
- Department of Acupuncture, Gansu Provincial Hospital of TCM, Lanzhou, China -
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4
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Eghbali P, Becce F, Goetti P, Vauclair F, Farron A, Büchler P, Pioletti D, Terrier A. Age- and sex-specific normative values of bone mineral density in the adult glenoid. J Orthop Res 2023; 41:263-270. [PMID: 35578979 PMCID: PMC10083916 DOI: 10.1002/jor.25379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 04/19/2022] [Accepted: 05/14/2022] [Indexed: 02/04/2023]
Abstract
The objective of this study was to determine the normative bone mineral density (BMD) of cortical and trabecular bone regions in the adult glenoid and its dependence on the subject's age and sex. We analyzed computed tomography (CT) scans of 441 shoulders (310 males, 18-69 years) without any signs of glenohumeral joint pathology. Glenoid BMD was automatically quantified in six volumes of interest (VOIs): cortical bone (CO), subchondral cortical plate (SC), subchondral trabecular bone (ST), and three adjacent layers of trabecular bone (T1, T2, and T3). BMD was measured in Hounsfield unit (HU). We evaluated the association between glenoid BMD and sex and age with the Student's t test and Pearson's correlation coefficient (r), respectively. The lambda-mu-sigma method was used to determine age- and sex-specific normative values of glenoid BMD in cortical (CO and SC) and trabecular (ST, T1, T2, and T3) bone. Glenoid BMD was higher in males than females, in most age groups and most VOIs. Before 40 years old, the effect of age on BMD was very weak in both males and females. After 40 years old, BMD declined over time in all VOIs. This BMD decline with age was greater in females (cortical: r = -0.45, trabecular: r = -0.41) than in males (cortical: r = -0.30; trabecular: r = -0.32). These normative glenoid BMD values could prove clinically relevant in the diagnosis and management of patients with various shoulder disorders, in particular glenohumeral osteoarthritis and shoulder arthroplasty or shoulder instability, as well as in related research.
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Affiliation(s)
- Pezhman Eghbali
- Laboratory of Biomechanical Orthopedics, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Fabio Becce
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Patrick Goetti
- Service of Orthopedics and Traumatology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Frederic Vauclair
- Service of Orthopedics and Traumatology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Alain Farron
- Service of Orthopedics and Traumatology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Philippe Büchler
- ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Dominique Pioletti
- Laboratory of Biomechanical Orthopedics, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Alexandre Terrier
- Laboratory of Biomechanical Orthopedics, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland.,Service of Orthopedics and Traumatology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
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Liu Z, Huang D, Zhang Y, Chang R, Zhang X, Jiang Y, Ma X. Accuracy and applicability of dual-energy computed tomography in quantifying vertebral bone marrow adipose tissue compared with magnetic resonance imaging. Insights Imaging 2022; 13:181. [DOI: 10.1186/s13244-022-01326-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 11/03/2022] [Indexed: 11/28/2022] Open
Abstract
Abstract
Objectives
To evaluate the accuracy of dual-energy computed tomography (DECT) in quantifying bone marrow adipose tissue (BMAT) and its applicability in the study of osteoporosis (OP).
Methods
A total of 83 patients with low back pain (59.77 ± 7.46 years, 30 males) were enrolled. All patients underwent lumbar DECT and magnetic resonance imaging (MRI) scanning within 48 h, and the vertebral fat fraction (FF) was quantitatively measured, recorded as DECT-FF and MRI-FF. A standard quantitative computed tomography (QCT) phantom was positioned under the waist during DECT procedure to realize the quantization of bone mineral density (BMD). The intraclass correlation coefficient (ICC) and Bland–Altman method was used to evaluate the agreement between DECT-FF and MRI-FF. The Pearson test was used to study the correlation between DECT-FF, MRI-FF, and BMD. With BMD as a gold standard, the diagnostic efficacy of DECT-FF and MRI-FF in different OP degrees was compared by receiver operating characteristic (ROC) curve and DeLong test.
Results
The values of DECT-FF and MRI-FF agreed well (ICC = 0.918). DECT-FF and MRI-FF correlated with BMD, with r values of −0.660 and −0.669, respectively (p < 0.05). In the diagnosis of OP and osteopenia, the areas under curve (AUC) of DECT-FF was, respectively, 0.791 and 0.710, and that of MRI-FF was 0.807 and 0.708, and there was no significant difference between AUCs of two FF values (with Z values of 0.503 and 0.066, all p > 0.05).
Conclusion
DECT can accurately quantify the BMAT of vertebrae and has the same applicability as MRI in the study of OP.
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Yang K, Qiu X, Cao L, Qiu S. The role of melatonin in the development of postmenopausal osteoporosis. Front Pharmacol 2022; 13:975181. [PMID: 36278157 PMCID: PMC9585202 DOI: 10.3389/fphar.2022.975181] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 09/26/2022] [Indexed: 11/28/2022] Open
Abstract
Melatonin is an important endogenous hormone that modulates homeostasis in the microenvironment. Recent studies have indicated that serum melatonin levels are closely associated with the occurrence and development of osteoporosis in postmenopausal women. Exogenous melatonin could also improve bone mass and increase skeletal strength. To determine the underlying mechanisms of melatonin in the prevention and treatment of postmenopausal osteoporosis, we performed this review to analyze the role of melatonin in bone metabolism according to its physiological functions. Serum melatonin is related to bone mass, the measurement of which is a potential method for the diagnosis of osteoporosis. Melatonin has a direct effect on bone remodeling by promoting osteogenesis and suppressing osteoclastogenesis. Melatonin also regulates the biological rhythm of bone tissue, which benefits its osteogenic effect. Additionally, melatonin participates in the modulation of the bone microenvironment. Melatonin attenuates the damage induced by oxidative stress and inflammation on osteoblasts and prevents osteolysis from reactive oxygen species and inflammatory factors. As an alternative drug for osteoporosis, melatonin can improve the gut ecology, remodel microbiota composition, regulate substance absorption and maintain metabolic balance, all of which are beneficial to the health of bone structure. In conclusion, our review systematically demonstrates the effects of melatonin on bone metabolism. Based on the evidence in this review, melatonin will play a more important role in the diagnosis, prevention and treatment of postmenopausal osteoporosis.
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Affiliation(s)
- Keda Yang
- Department of Orthopedics, First Hospital of China Medical University, Shenyang, China
| | - Xueshan Qiu
- Department of Pathology, The First Affiliated Hospital of China Medical University and College of Basic Medical Sciences Shenyang, Shenyang, Liaoning, China
| | - Lili Cao
- Department of Medical Oncology, First Hospital of China Medical University, Shenyang, China
- *Correspondence: Lili Cao, ; Shui Qiu,
| | - Shui Qiu
- Department of Orthopedics, First Hospital of China Medical University, Shenyang, China
- *Correspondence: Lili Cao, ; Shui Qiu,
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Foti G, Lombardo F, Guerriero M, Rodella T, Cicciò C, Faccioli N, Serra G, Manenti G. Management of vertebral compression fractures: the role of dual-energy CT in clinical practice. Radiol Med 2022; 127:627-636. [PMID: 35553350 DOI: 10.1007/s11547-022-01498-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 04/20/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE To evaluate the role of dual-energy computed tomography (DECT) in the management of vertebral compression fractures in clinical practice. MATERIALS AND METHODS This retrospective IRB-approved study included 497 consecutive patients with suspected acute vertebral fractures, imaged either by DECT (group 1) or MRI (group 2) before vertebroplasty. The site, number and type of fractures at imaging findings, and clinical outcome based on any change in pain (DELTA-VAS), before (VAS-pre) and after treatment (VAS-post), were determined and compared. Two radiologists evaluated DECT and MRI images (15 and 5 years of experience, respectively), and inter-observer and intra-observer agreement were calculated using k statistics. RESULTS Both in the control group (n = 124) and in the group of patients treated by vertebroplasty (n = 373), the clinical outcome was not influenced by the imaging approach adopted, with a DELTA-VAS of 5.45 and 6.42 in the DECT group and 5.12 and 6.65 in the MRI group (p = 0.326; p = 0.44). In the group of treated patients, sex, age, lumbar fractures, multiple fractures, previous fractures, Genant grade, involvement of anterior apex or superior endplates, and increased spinal curvatures were similar (p = ns); however, dorsal fractures were more prevalent in group 1 (p = 0.0197). Before treatment, the mean VAS-pre was 8.74 in group 1 (DECT) and 8.65 in group 2 (MRI) (p = 0.301), whereas after treatment, the mean VAS-post value was 2.32 in group 1 (p = 0.0001), and 2.00 in group 2 (p = 0.0001). The DELTA-VAS was 6.42 in the group of patients imaged using DECT and 6.65 in the group imaged using MRI (p = 0.326). Inter-observer and intra-observer agreement were 0.85 and 0.89 for DECT, and 0.88 and 0.91 for MRI, respectively. CONCLUSION The outcome of vertebral compression fracture management was no different between the two groups of patients studied.
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Affiliation(s)
- Giovanni Foti
- Department of Radiology, IRCCS Sacro Cuore Don Calabria Hospital, Via Don A. Sempreboni 10, 37024, Negrar, VR, Italy
| | - Fabio Lombardo
- Department of Radiology, IRCCS Sacro Cuore Don Calabria Hospital, Via Don A. Sempreboni 10, 37024, Negrar, VR, Italy.
| | - Massimo Guerriero
- Clinical Research Unit, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Italy
| | - Tommaso Rodella
- Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiation Therapy "Tor Vergata", Rome, Italy
| | - Carmelo Cicciò
- Department of Radiology, IRCCS Sacro Cuore Don Calabria Hospital, Via Don A. Sempreboni 10, 37024, Negrar, VR, Italy
| | - Niccolò Faccioli
- Department of Radiology, Verona University Hospital, Verona, Italy
| | - Gerardo Serra
- Department of Anesthesia and Analgesic Therapy, IRCCS Sacro Cuore Don Calabria Hospital, Via Don A. Sempreboni 5, Negrar, Italy
| | - Guglielmo Manenti
- Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiation Therapy "Tor Vergata", Rome, Italy
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de Bakker CM, Knowles NK, Walker RE, Manske SL, Boyd SK. Independent changes in bone mineralized and marrow soft tissues following acute knee injury require dual-energy or high-resolution computed tomography for accurate assessment of bone mineral density and stiffness. J Mech Behav Biomed Mater 2022; 127:105091. [DOI: 10.1016/j.jmbbm.2022.105091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 12/12/2021] [Accepted: 01/12/2022] [Indexed: 11/16/2022]
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The Effect of Abdominal Anatomy on the Measurement of Bone Mineral Density With Dual-Energy X-Ray Absorptiometry. J Comput Assist Tomogr 2021; 45:458-462. [PMID: 34297515 DOI: 10.1097/rct.0000000000001158] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE This study aimed to assess the effects of abdominal fat content and anatomical changes on the measurement of bone mineral density using dual-energy X-ray absorptiometry (DXA). MATERIALS AND METHODS The bone mineral density measurements were performed with quantitative computed tomography for patients who underwent DXA and abdominal CT on the same day. The effects of abdominal fat content and anatomic changes on the results of DXA were assessed. RESULTS Of the 43 patients, 88.3% were women, 11.7% were men, and the mean age was 55.6 years (range, 32-72). There was a significant relationship between the error in the measurement of T-scores with DXA and osteophytic new bone formation (P = 0.011). There were significant relationships between the error in detecting osteoporosis with DXA and osteophytic new bone formation, facet joint degeneration, and aortic calcification (P < 0.05). CONCLUSIONS Abdominal fat content does not significantly affect T-scores. However, DXA can give false-negative results in detecting osteoporosis, especially in patients with osteophyte new bone formation, facet joint degeneration, and aortic calcifications, all conditions primarily in elderly patients. In these cases, it is more appropriate to use quantitative computed tomography instead of DXA.
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Prado M, Khosla S, Chaput C, Giambini H. Opportunistic application of phantom-less calibration methods for fracture risk prediction using QCT/FEA. Eur Radiol 2021; 31:9428-9435. [PMID: 34047849 DOI: 10.1007/s00330-021-08071-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 04/30/2021] [Accepted: 05/11/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Quantitative computed tomography (QCT)-based finite element analysis (FEA) implements a calibration phantom to estimate bone mineral density (BMD) and assign material properties to the models. The objectives of this study were to (1) propose robust phantom-less calibration methods, using subject-specific tissues, to obtain vertebral fracture properties estimations using QCT/FEA; and (2) correlate QCT/FEA predictions to DXA values of areal BMD. METHODS Eighty of a cohort of 111 clinical QCT scans were used to obtain subject-specific parameters using a phantom calibration approach and for the development of the phantom-less calibration equations. Equations were developed based on the HU measured from various soft tissues and regions, and using multiple linear regression analyses. Thirty-one additional QCT scans were used for cross-validation of QCT/FEA estimated fracture loads from the L3 vertebrae based on the phantom and phantom-less equations. Finally, QCT/FEA-predicted fracture loads were correlated with aBMD obtained from DXA. RESULTS Overall, 217 QCT/FEA models from 31 subjects (20 females, 11 men) with mean ages of 69.6 (13.1) and 67.3 (14) were used to cross-validate the phantom-less equations and assess bone strength. The proposed phantom-less equations showed high correlations with phantom-based estimates of BMD (99%). Cross-validation of QCT/FEA-predicted fracture loads from phantom-less equations and phantom-specific outcomes resulted in high correlations for all proposed methods (0.94-0.99). QCT/FEA correlation outcomes from the phantom-less equations and DXA-aBMD were moderately high (0.64-0.68). CONCLUSIONS The proposed QCT/FEA subject-specific phantom-less calibration methods demonstrated the potential to be applied to both prospective and retrospective applications in the clinical setting. KEY POINTS • QCT/FEA overcomes the disadvantages of DXA and improves fracture properties predictions of vertebrae. • QCT/FEA fracture estimates using the phantom-less approach highly correlated to values obtained using a calibration phantom. • QCT/FEA prediction using a phantom-less approach is an accurate alternative over phantom-based methods.
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Affiliation(s)
- Maria Prado
- Department of Biomedical Engineering and Chemical Engineering, University of Texas at San Antonio, One UTSA Circle, San Antonio, TX, 78249, USA
| | - Sundeep Khosla
- Kogod Center on Aging and Division of Endocrinology, Mayo Clinic College of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Christopher Chaput
- Department of Orthopedics, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Hugo Giambini
- Department of Biomedical Engineering and Chemical Engineering, University of Texas at San Antonio, One UTSA Circle, San Antonio, TX, 78249, USA.
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11
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Woisetschläger M, Hägg M, Spångeus A. Computed tomography-based opportunistic osteoporosis assessment: a comparison of two software applications for lumbar vertebral volumetric bone mineral density measurements. Quant Imaging Med Surg 2021; 11:1333-1342. [PMID: 33816172 DOI: 10.21037/qims-20-1013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background We aimed to compare two volumetric bone mineral density (vBMD) analysis programs, regarding (I) agreement of vBMD values based on mono- and dual-energy computed tomography (MECT and DECT) scans and (II) suitability for analyzing DECT data obtained at different energies. Methods We retrospectively analyzed two abdominal CT datasets: one performed in a MECT scan (vertebrae L1-L3) and one in a DECT scan (vertebrae L1-L4). Each dataset included different individuals [MECT 15 patients (45 vertebrae) and DECT 12 patients (48 vertebrae), respectively]. vBMD analysis was conducted using Philips IntelliSpace (IP) and Mindways qCT Pro (MW). Regarding the DECT scans, vBMD analysis was done at three different energies: 80, 150 and synthetic 120 kVp and for MECT scan at 120 kVp. For comparison of vBMD results between different software (aim 1) MECT 120 kVp and DECT synthetic 120 kVp data was used. For analyzing suitability of using different DECT energies for vBMD assessment (aim 2) all three DECT energies were used and results from each software was analyzed separately. Results vBMD assessed with MW and IP, respectively correlated significantly for both the MECT (r=0.876; P<0.001) and DECT (r=0.837; P<0.001) scans, but the vBMD values were lower in using IP for vBMD assessment (8% and 14% lower for MECT and DECT, respectively; P=0.001). Regarding the different DECT energies, using MW for vBMD assessment showed significant correlations in vBMD results between 120 kVp and the two other energies (r=0.988 and r=0.939) and no significant differences in absolute vBMD values (P>0.05). The IP analysis as well showed significant correlation between 120 kVp and the other energies (r=0.769 and r=0.713, respectively), but differences in absolute vBMD values between the energies (P≤0.001). Conclusions We show that the correlations between the vBMD derived from the two investigated software solutions were generally good but that absolute vBMD value did differ and might impact the clinical diagnosis of osteoporosis. Though small, our study data indicate that vBMD might be assessed in energies other than 120 kVp when using MW but not when using IP.
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Affiliation(s)
- Mischa Woisetschläger
- Department of Radiology and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.,Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
| | - Martin Hägg
- Department of Radiology and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.,Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
| | - Anna Spångeus
- Department of Acute Internal Medicine and Geriatrics and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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Chen X, Zhang C, Li J, Liu W, Zhang J, Zhou Z. Effects of Laparoscopic Sleeve Gastrectomy on Bone Mineral Density and Bone Metabolism in Chinese Patients with Obesity. Diabetes Metab Syndr Obes 2020; 13:4095-4103. [PMID: 33149649 PMCID: PMC7605606 DOI: 10.2147/dmso.s274614] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 09/30/2020] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE Laparoscopic sleeve gastrectomy (LSG) is one of the most effective therapies to treat obesity. Due to a lack of longitudinal research, we explored the changes in BMD and bone metabolism in Chinese patients with obesity before and after LSG. MATERIALS AND METHODS A total of 49 obese Chinese patients with obesity were recruited from the Second Xiangya Hospital of Central South University. All patients underwent LSG, and the metabolic indicators were evaluated, including the serum osteocalcin (OC), total-terminal propeptide of type I procollagen (TPINP) and carboxy terminal telopeptide of collagen type I (CTX) levels at baseline and 2, 6 and 12 months postoperatively. Dual energy X-ray absorptiometry (DEXA) was used to measure body composition and BMD before and 12 months after LSG. RESULTS The body mass index (BMI) significantly decreased at 12 months postoperatively, and no patients developed osteoporosis. The BMD of femoral neck and total hip significantly decreased from the baseline to 12 months postoperatively, while the BMD of lumbar spine did not change significantly. The OC, TPINP and CTX levels significantly increased at 12 months postoperatively. The excess BMI loss (EBMIL) was positively related while the reduction in visceral adipose tissue (VAT) mass was negatively related to the decreases in BMD of the femoral neck and total hip at 12 months postoperatively. The increase in OC was negatively correlated with the decrease in BMD of the femoral neck, while the increase in TPINP was positively correlated with the decrease in BMD of total hip. CONCLUSION Based on the 12-month follow-up results, the BMD of the femoral neck and total hip was decreased in Chinese patients with obesity after LSG, while bone remodelling was active. This finding suggested that weight loss, a decrease in the VAT mass and an increase in bone remodelling may be correlated with a reduction in BMD.
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Affiliation(s)
- Xi Chen
- National Clinical Research Center for Metabolic Diseases, Metabolic Syndrome Research Center, Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education, Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha410011, Hunan, People’s Republic of China
| | - Chunlan Zhang
- National Clinical Research Center for Metabolic Diseases, Metabolic Syndrome Research Center, Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education, Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha410011, Hunan, People’s Republic of China
| | - Jingping Li
- Department of Metabolic Surgery, Department of Biliopancreatic Surgery, The Second Xiangya Hospital, Central South University, Changsha410011, Hunan, People’s Republic of China
| | - Wei Liu
- Department of Metabolic Surgery, Department of Biliopancreatic Surgery, The Second Xiangya Hospital, Central South University, Changsha410011, Hunan, People’s Republic of China
| | - Jingjing Zhang
- National Clinical Research Center for Metabolic Diseases, Metabolic Syndrome Research Center, Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education, Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha410011, Hunan, People’s Republic of China
- Correspondence: Jingjing Zhang National Clinical Research Center for Metabolic Diseases, Metabolic Syndrome Research Center, Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education, Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha410011, Hunan, People’s Republic of China Email
| | - Zhiguang Zhou
- National Clinical Research Center for Metabolic Diseases, Metabolic Syndrome Research Center, Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education, Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha410011, Hunan, People’s Republic of China
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