Three-dimensional methods for quantification of cancellous bone architecture

Trabecular bone microarchitecture after alendronate treatment of osteoporotic women

OBJECTIVE

To compare the microarchitecture of iliac crest trabecular bone from women treated for two to three years with alendronate versus that of women treated with placebo.

RESEARCH DESIGN AND METHODS

Three-dimensional micro-computed tomography (micro-CT; resolution 20 microm) and two-dimensional histomorphometry (resolution 5-7 microm) were used to examine trabecular bone from single transilial biopsies obtained at the completion of clinical trials.

MAIN OUTCOME MEASURES

Microarchitectural variables, including bone volume, trabecular number, trabecular thickness, and trabecular spacing in specimens from alendronate- and placebo-treated women were examined. Three-dimensional images of trabecular bone from both groups were constructed from CT images. Correlations among variables and between techniques were also calculated.

RESULTS

Eighty-eight specimens were suitable for evaluation by both techniques. As measured by two-dimensional histomorphometry, bone volume fraction (as a proportion of total volume) and trabecular thickness were significantly greater in alendronate specimens, 17.1 +/- 5.5% vs. 13.4 +/- 5.5% (p = 0.0043) and 127 +/- 29 microm vs. 109 +/- 28 microm (p = 0.0090), respectively, and trabecular spacing was significantly smaller, 729 +/- 227 microm vs. 862 +/- 338 microm (p = 0.005). Micro-CT yielded similar findings: bone volume and trabecular number were significantly greater in alendronate specimens: 19.4 +/- 6.2% vs. 16.2 +/- 6.3% (p = 0.0412) and 1.46(+/-) 0.32 vs. 1.31(+/-) 0.33 per mm (p = 0.0346). Two-dimensional and micro-CT measured characteristics correlated strongly with one another, with Pearson product moment correlation coefficients ranging from 0.60 (for trabecular thickness) to 0.83 (for bone volume).

CONCLUSIONS

Trabecular microarchitecture of the ilium, whether studied by two- or three-dimensional methods, is better (greater bone volume, greater trabecular thickness, decreased trabecular spacing) after alendronate treatment than after two to three years of treatment with placebo. Bone volume in a trabecular region is strongly correlated to its microarchitecture, suggesting that bone quantity predicts values for these microarchitectural endpoints.

Angular orientation of trabecular bone in the femoral head and its relationship to hip joint loads in leaping primates

The elastic properties and mechanical behavior of trabecular bone are largely determined by its three-dimensional (3D) fabric structure. Recent work demonstrating a correlation between the primary mechanical and material axes in trabecular bone specimens suggests that fabric orientation may be used to infer directional components of the material strength and, by extension, the hypothetical loading regime. Here we quantify the principal orientation of trabecular bone in the femoral head and relate these principal fabric directions to loading patterns during various locomotor behaviors. The proximal femora of a diverse sample of prosimians were scanned using a high-resolution X-ray computed tomography scanner with resolution of better than 50 mum. Spherical volumes of interest were defined within the femoral heads and the 3D fabric anisotropy was calculated using the mean intercept length and star volume distribution methods. In addition to differences in bone volume and anisotropy, significant differences were found in the spatial orientation of the principal trabecular axes depending on locomotor behavior. The principal orientations for leapers (Galago, Tarsius, Avahi) are relatively tightly clustered (alpha(95) confidence limit: 8.2; angular variance s: 18.2 degrees ) and oriented in a superoanterior direction, while those of nonleapers are more variable across a range of directions (alpha(95): 16.8; s: 42.0 degrees ). The mean principal directions are significantly different for leaping vs. nonleaping taxa. These results further suggest a relationship between bone microstructure in the hip joint and locomotor behavior and indicate a similarity of loading across leapers despite differences in kinematics and phylogeny.

Analysis of three-dimensional microarchitecture and degree of mineralization in bone metastases from prostate cancer using synchrotron microcomputed tomography

Bone architecture and mineralization are generally considered to be important components of bone quality, and determine bone strength in conjunction with bone mineral density. Although the features of bone quality have recently been studied under conditions in which bone density decreases, such as osteoporosis, little is known in osteosclerotic diseases. In this study, we compared the trabecular bone microarchitecture and degree of mineralization between osteoblastic bone metastasis and degenerative osteosclerosis using synchrotron radiation microcomputed tomography (SR-microCT). Small cubes of lumbar vertebrae were excised postmortem from the sites of osteoblastic metastasis, degenerative osteosclerosis, and comparative sites of normal subjects without skeletal lesions. The samples were imaged at high spatial resolution (voxel size = 6 microm) using the SR-microCT system developed at the synchrotron facility (SPring-8), Hyogo, Japan. The three-dimensional (3D) image data were then analyzed for the morphological parameters and the degree of mineralization of bone (DMB). Trabecular bone in metastatic lesions showed a highly connected and isotropic network pattern compared with the normal samples. Although the trabecular surface was markedly irregular in osteoblastic metastases, no significant difference was found in the mean trabecular thickness (Tb.Th) between osteoblastic metastases and normal tissue. The DMB of trabeculae in metastatic lesions had a broader range and lower mean than that of the normal tissue. In contrast, trabecular bone in degenerative osteosclerotic lesions showed a similar degree of anisotropy (DA) and connectivity to the normal tissue, whereas the trabecular thickness was greater in the degenerative osteosclerotic lesions. No significant difference in DBM between degenerative osteosclerosis and normal tissue was detected. These results characterize the difference in bone quality between osteoblastic bone metastasis and degenerative osteosclerosis. Further study on the relationship between bone quality and bone strength in these osteosclerotic lesions would improve our understanding of the pathogenesis of bone fragility.

Technical considerations for microstructural analysis of human trabecular bone from specimens excised from various skeletal sites

The purpose of this study was to test the effect of repositioning, systematic displacements of the region of interest (ROI), and acquisition parameters (scan mode and integration time) on quantitative analysis of human trabecular bone microstructure at various skeletal sites, using microcomputed tomographic (microCT) technology. We investigated 28 cylindrical specimens of human trabecular bone (length 14 mm, diameter 8 mm) from four skeletal sites (femoral neck, greater trochanter, second lumbar vertebra, and distal radius). These specimens were selected from over 200 microCT measurements, in order to cover a large range of bone volume fraction (BV/TV) observed at each site. Cylindrical ROIs (length 6 mm, diameter 6 mm) were examined twice at an isotropic resolution of 26 microm, 8 weeks apart. In addition, comparative analyses were performed for displacements of the volumes of interest (VOIs) by 1, 2, 3, and 4 mm (83.4%, 66.6%, 50%, and 33.3% overlap), respectively. Eventually, comparative measurements were obtained at different resolution scan modes and integration times. The results show that microCT measurements are highly reproducible (range of the root mean square coefficient variation % (RMS CV%) = 0.64% to 1.29% for BV/TV at different sites). Displacements of the VOI of up to 4 mm generally led to non significant systematic differences in mean values of < 10%. When comparing various combinations of resolution scan modes and integration times, the use of an integration time of 100 ms was found to be preferable for determining microstructural parameters from human samples with this microCT scanner.

Determination of the trabecular bone direction from digitised radiographs

There is increasing evidence for monitoring the bone trabecular structure to explain, in part, the mechanical properties of bone. Despite the emergence of Computed Tomography, a radiograph is the standard format as it is cheap and used for assessing implant performance. Furthermore, various image-processing techniques developed to assess the trabecular structure from radiographs have regained interest owing to improvements in imaging equipment. This study assessed the precision and accuracy of the Co-occurrence and Run-length matrix, Spatial-frequency and Minkowski-fractal techniques to infer the trabecular direction from radiographs. Ten clinical images of femoral neck regions were obtained from digitised pelvic radiographs and subsequently analysed. These data were also used to generate synthetic images where the trabecular thickness, separation and directions were controlled in order to calculate the accuracy of the techniques. Additionally, a Laplacian noise was added in order to infer the precision of the techniques. All methods assessed the trabecular direction with a high degree of accuracy in these synthetic images including a single direction and no noise. However, only the Spatial-frequency and Co-occurrence matrix methods performed well on the clinical and heavily corrupted synthetic images. This demonstrated the possibility of inferring a linear trabecular direction in clinical conditions.

The three-dimensional microstructure of the trabecular bone in the mandible

This study investigated the three dimensional (3D) trabecular microstructure of the alveolar and basal bone in the mandible using micro-CT and compared the morphometric values of the different sites. Ten specimens were prepared and scanned using a micro-CT system. Both the alveolar and basal trabecular bone of the premolar region in the mandible were measured for the structural analysis. Cross-sectional 1024x1024 pixel images were created. From the two-dimensional (2D) images produced, 3D structural images were reconstructed. After scanning the specimen, the volumes of interest (VOI) of the alveolar and basal bone regions were selected from the 3D reconstruction images, and the structural parameters such as bone volume fraction, bone surface density, trabecular thickness, trabecular separation, trabecular number and structural model index were analyzed. The trabecular structure showed a marked variation within the sites of the specimen, especially in the basal trabecular bone inferior to the mandibular canal. In both the alveolar and basal bone regions, a mixture of both plate-like and rod-like structures was observed. The alveolar region showed a more compact, plate-type trabecular structure than the basal regions. In parametric comparison with the basal bone, the alveolar bone generally had a higher bone volume fraction, bone trabecular thickness and trabecular number, and lower bone surface density, trabecular separation and structural model index. The alveolar bone consisted of a compact bone structure with a large amount of thick plate-type trabecular bone, which was effectively resistant to the masticatory forces. As the measurements were made closer to the basal bone, a loose structure was observed with lower bone volume and fewer, thin, rod-like trabeculae.

Loss of chaotic trabecular structure in OPG-deficient juvenile Paget's disease patients indicates a chaogenic role for OPG in nonlinear pattern formation of trabecular bone

The RANK-RANKL-OPG system of osteoclast regulation may play a key role in determining chaotic structure in trabecular bone. Iliac trabecular bone from juvenile Paget's disease patients deficient in functional OPG shows parallel, anisotropic structure instead of normal chaotic structure. Evidence from experimental systems suggests that RANK-RANKL-OPG controls key nonlinear "chaogenic" parameters, such as friction, forcing frequency, feedback, and boundary forcing. The RANK-RANKL-osteoprotegerin (OPG) system of osteoclast regulation may play a key role in determining chaotic structure in trabecular bone. Iliac trabecular bone from juvenile Paget's disease (JPD) patients deficient in functional OPG shows parallel, anisotropic structure instead of normal chaotic structure. Evidence from experimental systems suggests that RANK-RANKL-OPG controls key nonlinear "chaogenic" parameters, such as friction, forcing frequency, feedback, and boundary forcing. The Belousov-Zhabotinsky reaction-diffusion system, the catalytic oxidation of CO on platinum surfaces, and thermal diffusion in liquid helium allow visualization of nonlinear emergent patterns such as labyrinthine structures, turbulence, and cellular structures, all of which bear some resemblance to trabecular bone. In JPD, the gene for OPG (TNFRSF11B) is subject to an inactivating mutation, leading to increased resorption and accelerated remodeling. Histomorphometric images of iliac crest trabecular bone from teenagers suffering from JPD show a highly unusual array of parallel, regular trabecular plates, instead of the typical chaotic, fractal patterns of normal trabecular bone. Loss of OPG function is associated with a change from chaotic to regular structure, suggesting that the RANK-RANKL-OPG system is controlling key nonlinear "chaogenic" parameters. Looking at trabecular bone from the perspective of nonlinear pattern formation may help understand other phenomena, such as the marked dependence of trabecular bone's architectural and mechanical quality on remodeling rate independent of the trabecular bone mass.

Risedronate preserves bone architecture in postmenopausal women with osteoporosis as measured by three-dimensional microcomputed tomography

The deterioration of trabecular microarchitecture induced by elevated bone turnover is increasingly recognized as a factor in the pathogenesis of osteoporotic fractures. We investigated the effect of the reduction of turnover with risedronate on trabecular architecture in postmenopausal women with osteoporosis. Iliac crest bone biopsy specimens taken before and after 3 years of treatment from patients receiving risedronate 5 mg daily (n = 21) or placebo (n = 17) were analyzed using 3-D microcomputed tomography. We found a significant correlation between baseline bone turnover and bone loss in the placebo group, providing evidence that higher turnover induced higher bone loss leading to a greater degree of architectural degradation. When patients were classified into two groups based on baseline bone turnover (MS/BS less than or greater than the median value for the entire cohort), significant decreases in trabecular bone volume (BV/TV, P = 0.009) and trabecular thickness (Tb.Th*, P = 0.008) and an increase in marrow star volume (Ma.St.V, P = 0.008), a measure of trabecular porosity, were observed in the higher turnover (MS/BS> median) placebo-treated patients. The trabecular structure shifted from plates to rods as shown by an increase in structure model index (SMI, P = 0.028) and bone surface to bone volume ratio (BS/BV, P = 0.006). The changes from baseline in the lower turnover (MS/BS<median) placebo patients were variable and not statistically significant. In the risedronate group, the bone volume and the architectural parameters did not change significantly from baseline values in either the higher or the lower turnover groups. Comparing the pair-wise changes from baseline in the higher turnover group, the placebo group experienced decreases in BV/TV (P = 0.071) and Tb.Th* (P = 0.012), and increase in Ma.St.V (P = 0.043), compared to the risedronate-treated women. Also, in comparison to the risedronate group, the trabecular structures in the placebo group were more rod-like, indicated by higher SMI (P = 0.009) and BS/BV (P = 0.02). The results demonstrated that trabecular architecture deteriorated significantly in the placebo-treated women who had higher bone turnover at baseline, and this deterioration was prevented by 3 years of risedronate treatment, presumably because of the reduction in bone turnover. The preservation of architecture may be a contributory mechanism by which risedronate reduces the risk of vertebral fractures in osteoporotic women.

Genetically based influences on the site-specific regulation of trabecular and cortical bone morphology

The degree of site-specificity by which genes influence bone quantity and architecture was investigated in the femur of three strains of mice. Morphological indices were highly dependent on both genetic makeup as well as anatomical location showing that the assessment of bone structure from a single site cannot be extrapolated to other sites even within a single bone.

INTRODUCTION

The identification of genes responsible for establishing peak BMD will yield critical information on the regulation of bone quantity and quality. Whereas such knowledge may eventually uncover novel molecular drug targets or enable the identification of individuals at risk of osteoporosis, the site-specificity by which putative genotypes cause low or high bone mass (and effective bone morphology) is essentially unknown.

MATERIALS AND METHODS

microCT was used to determine morphological and microarchitectural features of the femora harvested from three genetically distinct strains of 4-month-old female mice, each with distinct skeletal mass (low: C57BL/6J [B6], medium: BALB/cByJ [BALB], high: C3H/HeJ [C3H]). Two trabecular regions (distal epiphysis and metaphysis) were considered in addition to four cortical regions within the metaphysis and diaphysis.

RESULTS AND CONCLUSIONS

Comparing morphological properties of the different trabecular and cortical femoral regions between the three strains of mice, it was apparent that high or low values of specific parameters of bone morphology could not be consistently attributed to the same genetic strain. Trabecular metaphyseal bone volume, for instance, was 385% larger in C3H mice than in B6 mice, yet the two strains displayed similar bone volume fractions in the epiphysis. Similarly, BALB mice had 48% more trabecular bone than C3H mice in the epiphysis, but there were no strain-specific differences in cortical bone area at the diaphysis. These data suggest that the genetic control of bone mass and morphology, even within a given bone, is highly site-specific and that a comprehensive search for genes that are indicative of bone quantity and quality may also have to occur on a very site-specific basis.

Mapping quantitative trait loci for vertebral trabecular bone volume fraction and microarchitecture in mice

BMD, which reflects both cortical and cancellous bone, has been shown to be highly heritable; however, little is known about the specific genetic factors regulating trabecular bone. Genome-wide linkage analysis of vertebral trabecular bone traits in 914 adult female mice from the F2 intercross of C57BL/6J and C3H/HeJ inbred strains revealed a pattern of genetic regulation derived from 13 autosomes, with 5-13 QTLs associated with each of the traits. Ultimately, identification of genes that regulate trabecular bone traits may yield important information regarding mechanisms that regulate mechanical integrity of the skeleton.

INTRODUCTION

Both cortical and cancellous bone influence the mechanical integrity of the skeleton, with the relative contribution of each varying with skeletal site. Whereas areal BMD, which reflects both cortical and cancellous bone, has been shown to be highly heritable, little is known about the genetic determinants of trabecular bone density and architecture.

MATERIALS AND METHODS

To identify heritable determinants of vertebral trabecular bone traits, we evaluated the fifth lumbar vertebra from 914 adult female mice from the F2 intercross of C57BL/6J (B6) and C3H/HeJ (C3H) progenitor strains. High-resolution microCT was used to assess total volume (TV), bone volume (BV), bone volume fraction (BV/TV), trabecular thickness (Tb.Th), separation (Tb.Sp), and number (Tb.N) of the trabecular bone in the vertebral body in the progenitors (n = 8/strain) and female B6C3H-F2 progeny (n = 914). Genomic DNA from F2 progeny was screened for 118 PCR-based markers discriminating B6 and C3H alleles on all 19 autosomes.

RESULTS AND CONCLUSIONS

Despite having a slightly larger trabecular bone compartment, C3H progenitors had dramatically lower vertebral trabecular BV/TV (-53%) and Tb.N (-40%) and higher Tb.Sp (71%) compared with B6 progenitors (p < 0.001 for all). Genome-wide quantitative trait analysis revealed a pattern of genetic regulation derived from 13 autosomes, with 5-13 quantitative trait loci (QTLs) associated with each of the vertebral trabecular bone traits, exhibiting adjusted LOD scores ranging from 3.1 to 14.4. The variance explained in the F2 population by each of the individual QTL after adjusting for contributions from other QTLs ranged from 0.8% to 5.9%. Taken together, the QTLs explained 22-33% of the variance of the vertebral traits in the F2 population. In conclusion, we observed a complex pattern of genetic regulation for vertebral trabecular bone volume fraction and microarchitecture using the F2 intercross of the C57BL/6J and C3H/HeJ inbred mouse strains and identified a number of QTLs, some of which are distinct from those that were previously identified for total femoral and vertebral BMD. Identification of genes that regulate trabecular bone traits may ultimately yield important information regarding the mechanisms that regulate the acquisition and maintenance of mechanical integrity of the skeleton.

Genetically linked site-specificity of disuse osteoporosis

The genetic influence on bone loss in response to mechanical unloading was investigated within diaphyseal and distal femoral regions in three genetically distinct strains of mice. One mouse strain failed to lose bone after removal of function, whereas osteopenia was evident in multiple regions of the remaining two strains but in different areas of the bone.

INTRODUCTION

It is well recognized that susceptibility to osteoporosis is, in large measure, determined by the genome, but whether this influence is systemic or site-specific is not yet known. Here, the extent to which genetic variations influence regional bone loss caused by disuse was studied in the femora of adult female mice from three inbred strains.

MATERIALS AND METHODS

Adult C57BL/6J (B6), C3H/HeJ (C3H), and BALB/cByJ (BALB) mice were subjected to 15-21 days of disuse, achieved by hindlimb suspension, and six distinct anatomical regions of the femur were analyzed by high-resolution microCT.

RESULTS AND CONCLUSIONS

In B6 mice, the amount of disuse stimulated bone loss was relatively uniform across all regions, with 20% loss of trabecular bone and 10% loss of cortical bone. The degree of bone loss in BALB mice varied greatly, ranging from 59% in the metaphysis to 3% in the proximal diaphysis. In this strain, the nonuniformity of bone loss was directly related to the nonuniform distribution of baseline bone morphology (r2 = 0.94). In direct contrast with BALB and B6, disuse failed to produce significant losses of bone in any of the analyzed regions of the C3H mice. Instead, these animals displayed a unique compensatory mechanism to disuse, where the large loss of calcified tissue from the endocortical surface (-24%) was compensated for by an expansion of the periosteal envelope (10%). These data indicate a strong, yet complex, genetic dependence of the site-specific regulation of bone remodeling in response to a powerful catabolic signal. Consequently, the skeletal region of interest and the genetic make-up of the individual may have to be considered interdependently when considering the pathogenesis of osteoporosis or the efficacy of an intervention to prevent or recover bone loss.

Quantification and visualization of anisotropy in trabecular bone

A number of methods for measuring anisotropy in trabecular bone using high-resolution X-ray computed tomography exist, which give different answers but have not been compared in detail. In this study, we examine the mean-intercept length (MIL), star volume distribution (SVD) and star length distribution (SLD) methods, their algorithmic implementation for three-dimensional (3D) data, and how their results relate to each other. A uniform ordered sampling scheme for determining which orientations to sample during analysis enhances the reproducibility of anisotropy and principal component direction determinations, with no evident introduction of biasing. This scheme also facilitates the creation of a 3D rose diagram that can be used to gain additional insights from the data. The directed secant algorithm that is frequently used for traversing pixel and voxel grids for these calculations is prone to bias unless a previously unreported normalization is used. This normalization ameliorates the bias present when using cubic voxels, and also permits calculations on data sets in which the slice spacing is not equal to the pixel spacing. Overall, the three methods for quantification of anisotropy give broadly similar results, but there are systematic divergences that can be traced to their differences in data and processing, and which may impact on their relative utility in estimating mechanical properties. Although discussed in the context of computed tomography of trabecular bone, the methods described here may be applied to any 3D data set from which fabric information is desired.

A method for the automatic characterization of bone architecture in 3D mice microtomographic images

We developed an automatic method to characterize mice bone architecture from three-dimensional (3D) microtomographic images. The distal metaphyses of the femur of mice were imaged using 3D synchrotron radiation microtomography at the European Synchrotron Radiation Facility (ID19) with a voxel size of 6.65 mum. Within each reconstructed volume, a region of interest was defined and trabecular and cortical bones were automatically separated. Then, 3D morphologic and topologic model-independent parameters quantifying the 3D bone architecture were computed in both regions. The technique was applied to study the response of the C57BL/6J@Ico strain of mice submitted to a model of bone loss by hind limb unloading produced by tail-suspension.

Development of the trabecular structure within the ulnar medial coronoid process of young dogs

This study describes the timing of development of the trabecular structure of the ulnar medial coronoid process (MCP) in the dog. The right MCPs of nine healthy golden retrievers, aged 4 to 24 weeks, without signs of secondary joint disease were dissected and scanned with microcomputed tomography (micro-CT) at a voxel size of 34 microm to determine histomorphometric parameters. Bone volume fraction and mean trabecular separation show a reciprocal pattern in time, reflecting an initial high bone density (and low trabecular separation), and then a sharp drop in density at 8-10 weeks, followed by a gradual increase to high values at 24 weeks. With a similar bone volume fraction as in young bone, the older bone shows thicker trabeculae and a more plate-like structure. This is reflected in the much smaller number of trabeculae and the lower surface/volume ratio at higher age. An anisotropic structure of the trabeculae with an orientation in the direction of the proximodistal axis of the ulna is already present at 6 weeks after birth. This primary alignment was perpendicular to the humeroulnar articular surface, matching the direction of the compressive forces applied to the MCP by the humeral trochlea. The secondary alignment appeared at 13 weeks after birth and was directed along the craniocaudal axis of the MCP, toward the attachment of the anular ligament. In comparison with data from long bones and vertebrae, the findings of a high bone volume fraction and a well-defined trabecular alignment at a very early age are remarkable. The high bone volume fraction is possibly a remnant of the fetal trabecular structure, as dogs are relatively immature at birth compared to other animals. Soon after the start of steady locomotion, the trabecular structure changes into a more mature-like structure. The early trabecular alignment is possibly a reflection of the early load-bearing function of the MCP in the elbow joint.

Detecting and tracking local changes in the tibiae of individual rats: a novel method to analyse longitudinal in vivo micro-CT data

In this study we present the analysis of in vivo micro-CT scans using a new method based on image registration that accurately evaluates longitudinal micro-CT studies. We tested if detailed changes in the bone architecture could be detected and tracked in individual animals. A prototype in vivo micro-CT scanner (Skyscan 1076) was developed in which tibiae of rats that are lying on a bed under gas anaesthesia were scanned. For this study, three female Wistar rats were used: a sham-operated rat, an ovariectomised (OVX) rat and one rat that served as a reproducibility control. The reproducibility control rat was scanned twice in 1 day. The other animals were scanned at week 0, just before surgery, at week 4 and at week 14 after surgery. Architectural changes over time were detected by overlaying two data sets made at different time points using an algorithm that uses mutual information for optimal registration. The scans were segmented into binary data sets using a local thresholding algorithm. The reproducibility test showed small errors of less than 3% in bone volume measurements and errors less than 0.5% in measurements of trabecular thickness. The sham-operated rat showed no changes in total bone volume, though thinning and eventual loss of some small trabeculae could be detected, which could be related to the age of the animal. The OVX rat lost much trabecular bone volume, especially in the metaphysis (60% at week 4, 75% at week 14). The remaining trabeculae slowly increased in thickness. Following the different scans in time showed the forming of new trabecular structures. Additionally, small longitudinal growth at the growth plate could be detected after the first 4 weeks. Further, the OVX rat showed extensive modelling at the proximal endosteal lateral cortex. We have shown a new method that can detect and track changes in the local bone architecture and individual trabeculae in time, in an individual living animal. This method enables longitudinal in vivo micro-CT studies and has the potential to greatly contribute to experimental rat or mouse studies on pharmacological intervention and transgenic models.

Assessment of trabecular bone structure in postmenopausal and senile osteoporosis in women by image analysis

OBJECTIVE

The aim of the study was to assess bone trabecular structure in postmenopausal and senile osteoporosis.

METHODS

The study was performed on transiliac specimens obtained from women with postmenopausal (n=10) and senile osteoporosis (n=10) and on normal autopsy bone (n=7). Digitalized microradiographs were analysed using dedicated software allowing for selection of longitudinal and transversal elements.

RESULTS

Significant differences between transversal and control, as well as between longitudinal and control trabecular areas were observed in senile osteoporosis (p<0.005). In postmenopausal osteoporosis, such differences were found for longitudinal trabeculae only (p<0.005). Mean longitudinal trabecular area loss in senile and postmenopausal osteoporosis as compared to control group was 57.2% and 25.7%, respectively. Respective values for transversal trabecular area were 35.0% and 59.4%.

CONCLUSION

Structural anisotropy of trabecular bone is greater in postmenopausal than in senile osteoporosis and control group. The method developed allows the evaluation of bone structures in radiographs with uneven exposure.

The importance of the endplate for interbody cages in the lumbar spine

Intervertebral cages in the lumbar spine represent an advancement in spinal fusion to relieve low back pain. Different implant designs require different endplate preparations, but the question of to what extent preservation of the bony endplate might be necessary remains unanswered. In this study the effects of endplate properties and their distribution on stresses in a lumbar functional spinal unit were investigated using finite-element analyses. Three-dimensional finite-element models of L2-L3 with and without a cage were used. An anterior approach for a monobloc, box-shaped cage was modelled. The results showed that inserting a cage increased the maximum von Mises stress and changed the load distribution in the adjacent structures. A harder endplate led to increased concentration of the stress peaks and high stresses were propagated further into the vertebral body, into areas that would usually not experience such stresses. This may cause structural changes and provide an explanation for the damage occurring to the underlying bone, as well as for the subsequent subsidence of the cage. Stress distributions were similar for the two endplate preparation techniques of complete endplate preservation and partial endplate removal from the centre. It can be concluded that cages should be designed such that they rely on the strong peripheral part of the endplate for support and offer a large volume for the graft. Furthermore, the adjacent vertebrae should be assessed to ensure that they show sufficient density in the peripheral regions to tolerate the altered load transfer following cage insertion until an adequate adaptation to the new loading situation is produced by the remodelling process.

Excised Bone Structures in Mice: Imaging at Three-dimensional Synchrotron Radiation Micro CT

Bone microarchitecture and mineralization were determined at three-dimensional synchrotron radiation micro computed tomography in two inbred mice strains. Distal metaphysis of the left femur was imaged in three dimensions at 6.65 microm, whereas the right femur was analyzed with histomorphometry. Three-dimensional quantitative parameters of trabecular and cortical bone architecture were computed. C3H/HeJ@Ico mice had greater bone density and thicker trabeculae; greater cortical bone density, cortical thickness, and porosity; and greater mineralization than did C57BL/6J@Ico mice. The technique is well suited for assessment of trabecular and cortical bone in small animals and at the same time provides mineralization status in three dimensions.

The dependence of the elastic properties of osteoporotic cancellous bone on volume fraction and fabric

Osteoporosis is a progressive systemic skeletal condition characterized by low bone mass and microarchitectural deterioration, with a consequent increase in susceptibility to fracture. Hence, osteoporosis would be best diagnosed by in vivo measurements of bone strength. As this is not clinically feasible, our goal is to estimate bone strength through the assessment of elastic properties, which are highly correlated to strength. Previously established relations between morphological parameters (volume fraction and fabric) and elastic constants could be applied to estimate cancellous bone stiffness in vivo. However, these relations were determined for normal cancellous bone. Cancellous bone from osteoporotic patients may require different relations. In this study we set out to answer two questions. First, can the elastic properties of osteoporotic cancellous bone be estimated from morphological parameters? Second, do the relations between morphological parameters and elastic constants, determined for normal bone, apply to osteoporotic bone as well? To answer these questions we used cancellous bone cubes from femoral heads of patients with (n=26) and without (n=32) hip fractures. The elastic properties of the cubes were determined using micro-finite element analysis, assuming equal tissue moduli for all specimens. The morphological parameters were determined using microcomputed tomography. Our results showed that, for equal tissue properties, the elastic properties of cancellous bone from fracture patients could indeed be estimated from morphological parameters. The morphology-based relations used to estimate the elastic properties of cancellous bone are not different for women with or without fractures.

Quantifying trabecular orientation in the pelvic cancellous bone of modern humans, chimpanzees, and the Kebara 2 Neanderthal

The adaptive nature of bone lies in its ability to respond to the environment by conforming and reshaping itself constantly to accommodate life-time stresses experienced throughout daily activities. In order to keep strains within the bone as uniform and isotropic as possible, the trabecular orientation is determined by forces acting on the bone through adaptive remodeling. Hence, the preserved structure of bones may contain direct information about the forces they may have undergone. Some authors (Correnti [1952], Atti Acc Naz Lincei 12:518-523, [1955] Riv Antrop 42:289-336; Macchiarelli et al. [1999] J Hum Evol 36:211-232, [2001] Cambridge, UK: Cambridge University Press) have described in detail the trabecular systems of the hip bone in different primate species and have identified a gait-related system above the acetabulum with substantial differences across species (Macchiarelli et al. [1999]; Rook et al. [1999] Proc Natl Acad Sci USA 96:8875-8879). The aim of this study was to quantify trabecular orientation above the acetabulum to test the hypothesis that hominoid biomechanical behavior is recorded in the cancellous bone. The pelvic bones of 23 archaeological adult modern humans (12 females, 11 males), 20 adult Pan troglodytes (10 females, 10 males), and one adult male Neanderthal were radiographed and digitized. Fast Fourier transforms (FFTs) of the regions of interest in the corpus of the ilium were performed, with the angular distribution of the trabeculae quantified. All species displayed a constant and periodic orthogonal arrangement in the trabeculae with differences in the pattern of dominance between the arcades oriented along the 0 degrees or the 90 degrees axes. The variation in the FFT spectrum between species is discussed in the light of distinctive biomechanical features.

Simulated aging--a novel method for estimating the risk of fracture of trabecular bone

In the study we show how the methods of percolation theory could be used in the description of age-related changes of mechanical competence of trabecular bone. A previously introduced stochastic model of remodeling of trabecular bone is applied to the simulated aging of pairs of 2D sections of trabecular bone matched for apparent density, structural anisotropy, and the age of the donors. The critical density of the structures--defined here as the density below which percolating bone cluster disappears, i.e., the structure is fractured--is estimated for each structure. It is shown that structures belonging to pairs matched for density (clinically used as the principal determinant of fracture risk) lose mechanical competence at a different rate, depending on the value of critical density. Thus it is hypothesized that the risk of fracture must depend not only on the density of the structure but also on its critical density.

Trabecular bone modulus-density relationships depend on anatomic site

One outstanding issue regarding the relationship between elastic modulus and density for trabecular bone is whether the relationship depends on anatomic site. To address this, on-axis elastic moduli and apparent densities were measured for 142 specimens of human trabecular bone from the vertebra (n=61), proximal tibia (n=31), femoral greater trochanter (n=23), and femoral neck (n=27). Specimens were obtained from 61 cadavers (mean+/-SD age=67+/-15 years). Experimental protocols were used that minimized end-artifact errors and controlled for specimen orientation. Tissue moduli were computed for a subset of 18 specimens using high-resolution linear finite element analyses and also using two previously developed theoretical relationships (Bone 25 (1999) 481; J. Elasticity 53 (1999) 125). Resultant power law regressions between modulus and density did depend on anatomic site, as determined via an analysis of covariance. The inter-site differences were among the leading coefficients (p<0.02), but not the exponents (p>0.08), which ranged 1.49-2.18. At a given density, specimens from the tibia had higher moduli than those from the vertebra (p=0.01) and femoral neck (p=0.002); those from the trochanter had higher moduli than the vertebra (p=0.02). These differences could be as large as almost 50%, and errors in predicted values of modulus increased by up to 65% when site-dependence was ignored. These results indicate that there is no universal modulus-density relationship for on-axis loading. Tissue moduli computed using methods that account for inter-site architectural variations did not differ across site (p>0.15), suggesting that the site-specificity in apparent modulus-density relationships may be attributed to differences in architecture.

Combining high-resolution micro-computed tomography with material composition to define the quality of bone tissue

Atraumatic fractures of the skeleton in osteoporotic patients are directly related to a deterioration of bone strength. However, the failure of the bone tissue to withstand functional load bearing cannot be explained as a simple decrease in bone mineral density (quantity); strength is also significantly dependent upon bone quality. While a formal definition of bone quality is somewhat elusive, at the very least, it incorporates architectural, physical, and biologic factors that are critical to bone strength. Such factors include bone morphology (ie, trabecular connectivity, cross-sectional geometry, longitudinal curvature); the tissue's material properties (eg, stiffness, strength); its chemical composition and architecture (eg, ratio of calcium to other components of the organic and/or inorganic phase, collagen orientation, porosity, permeability); and the viability of the tissue (eg, responsivity of the bone cell population). Combining high-resolution structural indices of bone, as determined by micro-computed tomography; material properties determined by nanoindentation; and the chemical make-up of bone, as determined by infrared spectroscopy, helps to provide critical information toward a more comprehensive assessment of the interdependence of bone quality, quantity, and fracture risk.

High bone mass in mice expressing a mutant LRP5 gene

A unique mutation in LRP5 is associated with high bone mass in man. Transgenic mice expressing this LRP5 mutation have a similar phenotype with high bone mass and enhanced strength. These results underscore the importance of LRP5 in skeletal regulation and suggest targets for therapies for bone disease. A mutation (G171V) in the low-density lipoprotein receptor related protein 5 (LRP5) has been associated with high bone mass (HBM) in two independent human kindreds. To validate the role of the mutation, several lines of transgenic mice were created expressing either the human LRP5 G171V substitution or the wildtype LRP5 gene in bone. Volumetric bone mineral density (vBMD) analysis by pQCT showed dramatic increases in both total vBMD (30-55%) and trabecular vBMD (103-250%) of the distal femoral metaphysis and increased cortical size of the femoral diaphysis in mutant G171V transgenics at 5, 9, 17, 26, and 52 weeks of age (p < 0.01 for all). In addition, high-resolution microcomputed tomography (microCT) analysis of the distal femorae and lumbar vertebrae revealed an increase (110-232%) in trabecular bone volume fraction caused by both increased trabecular number (41-74%) and increased trabecular thickness (34-46%; p < 0.01 for all) in the mutant G171V mice. The increased bone mass was associated with significant increases in vertebral compressive strength (80-140%) and the increased cortical size with significant increases in femoral bending strength (50-130%). There were no differences in osteoclast number at 17 weeks of age. However, compared with littermate controls, the mutant G171V transgenic mice showed an increase in actively mineralizing bone surface, enhanced alkaline phosphatase staining in osteoblasts, and a significant reduction in the number of TUNEL-positive osteoblasts and osteocytes. These results suggest that the increased bone mineral density in mutant G171V mice was caused by increased numbers of active osteoblasts, which could in part be because of their increased functional lifespan. While slight bone anabolic activity was observed from overexpression of the wildtype LRP5 gene, it is clear that the G171V mutation, rather than overexpression of the receptor itself, is primarily responsible for the dramatic HBM bone effects. Together, these findings establish the importance of this novel and unexpected role of a lipoprotein receptor in regulating bone mass and afford a new model to explore LRP5 and its recent association with Wnt signaling in bone biology.

Time course of epiphyseal growth plate fusion in rat tibiae

Although the rat is the most common animal model used in studying osteoporosis, it is often used inappropriately. Osteoporosis is a disease that most commonly occurs in humans long after growth plate fusion with the associated cessation of longitudinal bone growth, but there has been a question as to when or to what extent the rat growth plate fuses. To investigate this question, we used microcomputed X-ray tomography, at voxel resolutions ranging from (5.7 micro m)(3) to (11 micro m)(3), to image the proximal epiphyseal growth plates of both male (n = 19) and female (n = 15) rat tibiae, ranging in age from 2 to 25 months. The three-dimensional images were used to evaluate fusion of the epiphyseal growth plate by quantitating the amount of cancellous bone that has bridged across the growth plate. The results suggest that the time course of fusion of the epiphyseal growth plate follows a sigmoidal pattern, with 10% of the maximum number of bridges having formed by 3.9 months in the male tibiae and 5.8 months in the female tibiae, 50% of the maximum number of bridges having formed by 5.6 months in the male tibiae and 5.9 months in the female tibiae, and 90% of the total maximum of bridges have formed by 7.4 months for the males and 6.5 months for the females. The total volume of bridges per tibia at the age at which the maximum number of bridges per tibia has first formed is 0.99 mm(3)/tibia for the males and 0.40 mm(3)/tibia for the females. After the maximum number of bridges (-290 for females, -360 for males) have formed the total volume of bridges per tibia continues to increase for an additional 7.0 months in the males and 17.0 months for the females until they reach maximum values (-1.5 mm(3)/tibia for the males and -2.2 mm(3)/tibia for the females).

Quantitative analysis of bone mineral content by x-ray microtomography

A new non-destructive method based on x-ray microtomography (micro-CT) was developed to measure calcium density in bone. X-ray micro-CT was used as a quantitative approach to acquire and reconstruct virtual cross-sections through the sample. Accurate beam-hardening correction was implemented. Grey values in the virtual cross-sections were calibrated as calcium mineral density in bone. From these cross-sections, three-dimensional models were created. Calcium content was calculated directly from images and expressed as percentage per volume and per weight. Calcium mineral density was studied by this method in a unique set of bones isolated from newts (Pleurodeles waltlii Michah) that had travelled into space. A demineralization of 10% was shown as a consequence of sustained micro-gravity.

Topology-based orientation analysis of trabecular bone networks

After bone mineral density, orientation is the major determinant of trabecular bone strength and is thus of significant interest in understanding the clinical implications of osteoporotic bone loss. The methods used to measure orientation and anisotropy of the trabecular bone have largely relied on deriving global measures along test lines, computing the best-fit ellipsoid, and decomposing to eigenvalue-eigenvector pairs that yield the mean orientation and anisotropy of the region. These techniques ignore the differences between measuring the orientation of trabecular plates versus rods, and do not provide insight into the relationship between local orientation and biomechanical stresses. Digital topological analysis allows a unique determination of each voxel's topological class as belonging to a plate, rod, or junction. The digital topology-based orientation analysis (DTA-O) method extracts the voxels belonging to plates and determines the local surface normal by fitting a plane through the local neighborhood BVF map. Modeling regional distributions of these vectors allows assessment of anisotropy measures, such as mean and variance of the orientation distribution. High-resolution microcomputed tomography, synthetic, and in vivo images were used for a validation of the new method and compare the results with the mean intercept length (MIL) technique. The results indicate that DTA-O is a better measure of trabecular orientation and anisotropy than MIL. Applying DTA-O to a recently completed study on the distal radius of 82 subjects [F.W. Wehrli et al., J. Bone Min. Res. 16, 1520 (2001)] shows that the mean orientation and anisotropy at the medial and lateral sides in the distal radius mataphyseal trabecular network are consistent with the mechanical stresses acting on the radius during common tasks.

MicroCT evaluation of normal and osteoarthritic bone structure in human knee specimens

Although trabecular bone structure has been evaluated, variation with knee compartment and depth from joint surface is not completely understood. Cadaver knees were evaluated with microcomputed tomography analysis for these variations. Objective differences were compared between: medial vs. lateral compartments; femoral vs. tibial bone; and normal vs. arthritic knees. Depth dependent changes in the parameters were observed for the first 6 mm of the cores in normal knees: BV/TV, Tb.N and Conn.D gradually decrease, while Tb.Sp and SMI increase. In the first 6 mm of the normal tibia BV/TV, Tb.N, and Tb.Th are greater than in the femur on both the medial and lateral compartments while Tb.Sp, SMI, and Conn.D are lower. The medial compartment values for BV/TV, Tb.N, Tb.Th and Conn.D are generally greater than for the lateral in both the femur and tibia while Tb.Sp and SMI are lower. In comparison of normal vs. arthritic knees significant differences are observed in the first 6 mm of the medial tibia. With arthritis BV/TV and Tb.Th are lower, while SMI and Tb.Sp are higher. Tb.N and Conn.D show no statistically significant difference. The bone structure variations are, thus, most prominent in the first 6 mm of depth and medial compartment bone is generally more structurally sound than lateral. Severely arthritic bone changes are most prominent in the medial compartment of the tibia and bone structure is less sound in severe arthritis.

X-ray microCT study of pyramids of the sea urchin Lytechinus variegatus

This paper reports results of a novel approach, X-ray microCT, for quantifying stereom structures applied to ossicles of the sea urchin Lytechinus variegatus. MicroCT, a high resolution variant of medical CT (computed tomography), allows noninvasive mapping of microstructure in 3-D with spatial resolution approaching that of optical microscopy. An intact pyramid (two demipyramids, tooth epiphyses, and one tooth) was reconstructed with 17 microm isotropic voxels (volume elements); two individual demipyramids and a pair of epiphyses were studied with 9-13 microm isotropic voxels. The cross-sectional maps of a linear attenuation coefficient produced by the reconstruction algorithm showed that the structure of the ossicles was quite heterogeneous on the scale of tens to hundreds of micrometers. Variations in magnesium content and in minor elemental constitutents could not account for the observed heterogeneities. Spatial resolution was insufficient to resolve the individual elements of the stereom, but the observed values of the linear attenuation coefficient (for the 26 keV effective X-ray energy, a maximum of 7.4 cm(-1) and a minimum of approximately 2 cm(-1) away from obvious voids) could be interpreted in terms of fractions of voxels occupied by mineral (high magnesium calcite). The average volume fraction of mineral determined for a transverse slice of the demipyramid near where it joins an epiphysis was 0.46; for a slice 3.3 mm adoral it was 0.70. Local volume fractions of mineral approached 1, and, away from resolvable voids, considerable portions of the demipyramids had volume fractions of calcite at or below approximately 0.33. MicroCT imaging of a demipyramid before and after infiltration with a high absorptivity fluid (sodium polytungstate) confirmed the determination of the volume fractions of minerals.

Characterization of the integrity of three-dimensional trabecular bone microstructure by connectivity and shape analysis using high-resolution magnetic resonance imaging in vivo

Bone mineral density and bone structure are the main determinants of bone strength in osteoporosis. In this study we used high-resolution magnetic resonance imaging to visualize the bone microstructure in the finger phalanges in vivo and to assess the topological three-dimensional connectivity of the trabecular network and the shape of the trabeculae as measures of bone quality. We visualized the phalanges of young and elderly healthy volunteers in vivo with a spatial resolution of 152 microm x 152 microm x 280 microm. Image processing software to quantify three measures of connectedness was developed and tested: connectivity, global connectivity density, and local connectivity density. Global three-dimensional connectivity ranged from 904 to 1,607 connections. Global connectivity density ranged from 2.9 to 4.7 connections per mm with large intersubject differences. We found a decrease of local connectivity density with growing distance from the joint ranging from 5.1 to 0.2 connections per mm. These preliminary results represent a quantitative description of the well-known rarefication of the trabecular network when moving from epiphysis to the diaphysis. Three-dimensional visualization showed a dense network consisting mostly of rod-like trabeculae at the epiphysis changing to a less dense network of a few plate-like structures near the medullary canal. An algorithm for the quantitative classification of trabecular architecture with regard to plate or rod-like shape was tested for feasibility. We conclude that in vivo assessment of three-dimensional properties of the trabecular network is possible in human phalanges. Determination of connectivity and shape will allow quantification of structural aspects of osteoporotic changes and may improve assessment of fracture risk.

How morphology predicts mechanical properties of trabecular structures depends on intra-specimen trabecular thickness variations

Two observations underlie this work. First, that the architecture of trabecular bone can accurately predict the mechanical stiffness characteristics of bone specimens when considering the combination of volume fraction and fabric, which is a measure of architectural anisotropy. Second, that the same morphological measures could not accurately predict the mechanical properties of porous structures in general. We hypothesize that this discrepancy can be explained by the special nature of trabecular bone as a structure in remodeling equilibrium relative to the external loads. We tested this hypothesis using a generic model of trabecular bone. Five series of 153 different architectures were created with this model. Each architecture was subjected to morphological analysis, and four different fabric measures were calculated to evaluate their effectiveness in characterizing the architecture. Relationships were determined relating morphology to the elastic constants. The quality of these relationships was tested by correlating the predicted elastic constants with those determined from finite element analysis. We found that the four fabric measures used could estimate the mechanical properties almost equally well. So the suggestion that fabric measures based on trabecular bone volume better represent the architecture than mean intercept length could not be affirmed. We conclude that for structures with equally sized elliptical voids the mechanical properties can be predicted well only if trabecular thickness variations within each structure are limited. These structures closely resemble previously developed models of trabecular bone. Furthermore, they are stiff in the principal fabric direction, hence, according to Cowin (J. Biomech. Eng. (108) (1986) 83), they are in remodeling equilibrium. These structures are also stiff over a large range of loading orientations, hence, are relatively insensitive to deviations in direction of loading.

Synchrotron radiation microtomography allows the analysis of three-dimensional microarchitecture and degree of mineralization of human iliac crest biopsy specimens: effects of etidronate treatment

Quantitative microcomputed tomography using synchrotron radiation (SR microCT) was used to assess the effects of a sequential etidronate therapy on both three-dimensional (3D) microarchitecture and degree of mineralization of bone (DMB) in postmenopausal osteoporosis. Thirty-two iliac crest biopsy specimens were taken from 14 patients with osteoporosis (aged 64 +/- 1.8 years) before (baseline) and after 1 year of etidronate treatment, and after 2 years of treatment for four of the patients. The samples were imaged at high spatial resolution (voxel size = 10 microm) using the microtomography system developed at the European Synchrotron Radiation Facility (ESRF), Grenoble, France. Three-dimensional microarchitecture parameters were calculated and compared with those obtained from conventional histomorphometry. In addition, the DMB was evaluated also in 3D. No significant statistical changes regarding bone mass and structural parameters were observed in histomorphometry or 3D analyses. The distribution of the DMB in cortical and trabecular bone showed a trend to a shift toward highest mineralization values after 1 year of etidronate treatment (3.88% and 1.24% in cortical and trabecular bone, respectively). This trend was more evident after 2 years. The study also showed that SR microCT is an accurate technique and the only one for quantifying both the mineralization and the microarchitecture of bone samples at the same time in 3D.

Femoral head trabecular bone structure in two omomyid primates

The study of the three-dimensional structure of trabecular bone and its relationship to locomotor behavioral differences across different primate taxa provides a potentially useful analytic tool for reconstructing the behavior of extinct taxa. The purpose of the current study is to quantify the three-dimensional architecture of trabecular bone in the femoral head of Omomys carteri and Shoshonius cooperi and to compare this structure to that of several extant strepsirrhine taxa. Bone volume fraction (BV/TV) and fabric anisotropy were quantified in three dimensions using serial high-resolution X-ray computed tomography scan data collected from one femoral head from each fossil taxon. Three cubic volumes of interest (VOI) were identified within the femoral head. The BV/TV was quantified by assessing the percentage of bone voxels within each VOI and the structural anisotropy was quantified using the star volume distribution method. The Omomys femur used here has a high BV/TV with the galagine-like pattern of decreasing BV/TV from the superior to the inferior half of the femoral head. The fabric structure, however, is more lorisine-like in being relatively isotropic throughout the femoral head. The trabecular structure in Omomys is unique in its mix of features and appears to be most similar overall to the lorisines, suggesting that Omomys engaged in a quadrupedal mode of locomotion. By contrast the Shoshonius specimen possesses a relatively uniform BV/TV across the head but displays the distinctly galagine-like pattern of increasing anisotropy moving inferiorly in the femoral head. Taken as a whole, the trabecular structure in Shoshonius appears to be most like that of the galagines and is consistent with that of either an occasional leaper-quadruped or a specialized leaper. Despite the overall similarities in the external postcranial anatomy of Omomys and Shoshonius, the results of this study indicate potentially important differences in the magnitude and orientation of the external loads at the hip joint, suggesting that these animals engaged in divergent locomotor behaviors.

Age-related differences between thinning of horizontal and vertical trabeculae in human lumbar bone as assessed by a new computerized method

To investigate whether vertical trabeculae undergo compensatory thickening with age in the human vertebral body, a new computerized method was developed that is able to distinguish between horizontal and vertical trabeculae on normal histological sections. Study subjects included 48 individuals (24 women aged 19-97 years, and 24 men aged 23-95 years). From each L-2, thick frontal sections of half of the vertebra were embedded undecalcified in methylmetacrylate and cut into 10-microm-thick sections. A simple method able to classify image pixels as belonging to either vertical or horizontal trabeculae was developed and implemented in a computer program. The parallel-plate model was modified so that it was able to determine trabecular thickness, number, and separation (Tb.Th, Tb.N, and Tb.Sp) for horizontal and vertical trabeculae separately. The histomorphometric parameters were measured in three different regions: whole section, mid-third, and sub-endplate, for both horizontal and vertical trabeculae. It was found that the trabecular thickness of vertical trabeculae was independent of age in all investigated regions. The thickness of the horizontal trabeculae, in contrast, decreased significantly with age in all these regions. Tb.N decreased significantly with age for both horizontal and vertical trabeculae in all regions. However, the relative loss of trabeculae per unit length was largest for the horizontal trabeculae, whereas the absolute loss of trabeculae per unit length was largest for the vertical trabeculae. Tb.Sp was found to increase significantly with age for both vertical and horizontal trabeculae in all regions. No significant gender-related differences were found. In conclusion, in this study we describe a new, simple method for separation of horizontal and vertical bone tissue. This method has been applied on frontal vertebral sections. Trabecular bone thickness measured with the parallel-plate model showed that the thickness of horizontal trabeculae decreases significantly with age, whereas the thickness of vertical trabeculae did not decrease significantly with age. Furthermore, although the relative loss of trabeculae was larger for horizontal trabeculae than for vertical trabeculae, the absolute loss of vertical trabeculae was higher than that of horizontal trabeculae.

The three-dimensional structure of trabecular bone in the femoral head of strepsirrhine primates

It has been hypothesized for over a hundred years that trabecular bone plays an important structural role in the musculoskeletal system of animals and that it responds dynamically to applied loads through growth. The objectives of this study are to quantify the three-dimensional structure of femoral head trabecular bone in a sample of extant strepsirrhines and to relate patterns of interspecific variation to locomotor behavioral differences. The bone volume fraction (BV/TV) and fabric anisotropy of trabecular bone in the femoral heads of Cheirogaleus major, Avahi laniger, Galago senegalensis, Galago alleni, Loris tardigradus, Otolemur crassicaudatus, and Perodicticus potto were quantified in three dimensions using serial high-resolution X-ray computed tomography scan data. A volume based method was used to quantify the structural anisotropy in three cubic samples located inside the central portion of the femoral head. Significant structural differences were found between the predominantly leaping galagines and indriids and the nonleaping lorisines and cheirogaleids. The leapers in general have relatively anisotropic trabecular bone. The galagines display a unique pattern of decreasing bone volume and increasing anisotropy moving from the superior to the inferior half of the femoral head. By contrast, the nonleaping taxa possess relatively uniform and isotropic bone throughout the femoral head. The differences in femoral head trabecular structure among these taxa seem to be related to locomotor behavioral differences, reflecting variation in the use and loading of the hip joint during normal locomotion.

A comparison of the femoral head and neck trabecular architecture of Galago and Perodicticus using micro-computed tomography (microCT)

Innovations in micro-computed tomography (microCT) in the medical field have resulted in the development of techniques that allow the precise quantification of bone density and fabric related parameters of trabecular bone. For the purpose of this study, the technique was applied to a small sample of Perodicticus potto and Galago senegalensis femora to see if differences in loading environment elicit the predicted effects on trabecular structure. While the overall bone volume was approximately three times larger in the potto, there was no significant difference in the apparent volume density in the two taxa. When regional differences in the proximal femur were examined, the cancellous bone of the femoral head of Perodicticus potto and Galago senegalensis, while not differing in volume density, showed differences in trabecular orientation, with the potto having more randomly oriented trabeculae than the bushbaby. This was as hypothesized, given that the bushbaby submits its femora to more stereotypical loading environments than the potto. In the femoral neck, the cancellous bone was not only more randomly oriented, it was also denser in the potto compared with the bushbaby. This suggests that trabecular morphology may be extremely sensitive to certain differences in the loading environment and that this information, combined with information on cortical bone structure and external geometry, will result in a more complete understanding of how bone shape and composition correspond to loading and locomotor patterns. Ultimately, a synthesis of these different lines of evidence may have considerable applications in paleontological studies that attempt to reconstruct bone use from morphology.

Dietary essential amino acid supplements increase bone strength by influencing bone mass and bone microarchitecture in ovariectomized adult rats fed an isocaloric low-protein diet

This study was designed to investigate whether the administration of dietary essential amino acid supplements in adult rats made osteoporotic by estrogen deficiency and reduced protein intake could reverse the deleterious effects caused by these maneuvers. This animal model was selected to mimic the situation observed in elderly women in whom estrogen deficiency and/or low-protein intake (but also calcium and vitamin D deficiency) are known to contribute to the pathogenesis of osteoporosis. Six-month-old rats were ovariectomized (OVX) and fed an isocaloric 2.5% casein diet for 10 weeks or sham-operated (SHAM) and fed an isocaloric 15% casein diet. The animals fed the 2.5% casein diet were given isocaloric supplements of essential amino acids in similar relative proportion to that of casein at doses of 2.5% or 5% of total diet for an additional 16 weeks. Vertebrae, femur, and tibia bone mineral density (BMD); ultimate strength; and microtomographic histomorphometry were evaluated before and after dietary essential amino acid supplements. Essential amino acid supplements increased vertebrae, femur, and tibia bone strength in OVX rats fed a low-protein diet. The mechanical changes induced by this dietary isocaloric supplement were associated with the prevention of a further BMD decrease or even with some increases and changes in microarchitecture such as from a rod to a plate trabecular spacial configuration and increased cortical thickness. Higher insulin-like growth factor (IGF) I levels, as well as greater bone formation and reduced bone resorption as assessed by biochemical markers of bone remodeling, were found in rats receiving essential amino acid supplements. In conclusion, dietary essential amino acid supplements increased bone strength through modifications of BMD, trabecular architecture, and cortical thickness possibly by an IGF-I-mediated process.

Hierarchical structure of bone and micro-computed tomography

Bone is highly complex, with multiple hierarchical levels of structure. Micro-CT has been able to provide much information about the properties of bone at several of these levels at the mid-range of bone's hierarchical structure, and it will continue to provide a valuable tool for further characterizing bone in various conditions and explaining mechanisms of bone failure.

Changes in bone structure and mass with advancing age in the male C57BL/6J mouse

To determine whether the mouse loses bone with aging and whether the changes mimic those observed in human aging, we examined the changes in the tibial metaphysis and diaphysis in the male C57BL/6J mouse over its life span using microcomputed tomography (microCT). Cancellous bone volume fraction (BV/TV) decreased 60% between 6 weeks and 24 months of age. Loss was characterized by decreased trabecular number (Tb.N), increased trabecular spacing (Tb.Sp), and decreased connectivity. Anisotropy decreased while the structure model index increased with age. Cortical bone thickness increased between 6 weeks and 6 months of age and then decreased continuously to 24 months (-12%). Cortical bone area (Ct.Ar) remained constant between 6 and 24 months. Fat-free weight reached a peak at 12 months and gradually declined to 24 months. Total mass lost between 12 and 24 months reached 10%. Overall, the age-related changes in skeletal mass and architecture in the mouse were remarkably similar to those seen in human aging. Furthermore, the rapid early loss of cancellous bone suggests that bone loss is not just associated with old age in the mouse but rather occurs as a continuum from early growth. We conclude that the C57BL/6J male mouse maybe a useful model to study at least some aspects of age-related bone loss in humans.

Age-related variations in the microstructure of human tibial cancellous bone

A thorough understanding of the microstructure of cancellous bone is crucial for diagnosis, prophylaxis, and treatment of age-related skeletal diseases. Until now, little has been known about age-related variations in the microstructure of peripheral cancellous bone. This study quantified age-related changes in the three-dimensional (3D) microstructure of human tibial cancellous bone. One hundred and sixty cylindrical cancellous bone specimens were produced from 40 normal proximal tibiae from 40 donors, aged 16-85 years. These specimens were micro-computed tomography (micro-CT) scanned, and microstructural properties were determined. The specimens were then tested in compression to obtain Young's modulus. The degree of anisotropy, mean marrow space volume, and bone surface-to-volume ratio increased significantly with age. Bone volume fraction, mean trabecular volume, and bone surface density decreased significantly with age. Connectivity did not have a general relationship with age. Bone volume fraction together with anisotropy best predicted Young's modulus. Age-related changes in the microstructural properties had the same trends for both medial and lateral condyles of the tibia. The observed increase of anisotropy and constant connectivity suggest a bone remodeling mechanism that may reorient trabecular volume orientation in aging tibial cancellous bone. The aging trabeculae align more strongly to the primary direction--parallel to the tibial longitudinal loading axis.

Resistance to unloading-induced three-dimensional bone loss in osteopontin-deficient mice

Recent development in three-dimensional (3D) imaging of cancellous bone has made possible true 3D quantification of trabecular architecture. This provides a significant improvement in the measures available to study and understand the mechanical functions of cancellous bone. We recently reported that the presence of osteopontin (OPN) was required for the effects of mechanical stress on bone as OPN-null (OPN-/-) mice showed neither enhancement of bone resorption nor suppression of bone formation when they were subjected to unloading by tail suspension. However, in this previous study, morphological analyses were limited to two-dimensional (2D) evaluation. Although bone structure is 3D and thus stress effect should be evaluated based on 3D parameters, no such 3D morphological features underlying the phenomenon have been known. To elucidate the role of OPN in mediating mechanical stress effect based on true quantitative examination of bone, we evaluated 3D trabecular structures of hindlimb bones of OPN-/- mice after tail suspension. Tail suspension significantly reduced 3D parameters of bone volume (BV/TV), trabecular number (Tb.N), trabecular thickness (Tb.Th), and anisotropy and increased 3D parameters on trabecular separation (Tb.Sp) in wild-type mice. In contrast, these 3D parameters were not altered after tail suspension in OPN-/- mice. These data provided evidence that OPN is required for unloading-induced 3D bone loss.

Biomechanics of trabecular bone

Trabecular bone is a complex material with substantial heterogeneity. Its elastic and strength properties vary widely across anatomic sites, and with aging and disease. Although these properties depend very much on density, the role of architecture and tissue material properties remain uncertain. It is interesting that the strains at which the bone fails are almost independent of density. Current work addresses the underlying structure-function relations for such behavior, as well as more complex mechanical behavior, such as multiaxial loading, time-dependent failure, and damage accumulation. A unique tool for studying such behavior is the microstructural class of finite element models, particularly the "high-resolution" models. It is expected that with continued progress in this field, substantial insight will be gained into such important problems as osteoporosis, bone fracture, bone remodeling, and design/analysis of bone-implant systems. This article reviews the state of the art in trabecular bone biomechanics, focusing on the mechanical aspects, and attempts to identify important areas of current and future research.

Quantity and quality of trabecular bone in the femur are enhanced by a strongly anabolic, noninvasive mechanical intervention

The skeleton's sensitivity to mechanical stimuli represents a critical determinant of bone mass and morphology. We have proposed that the extremely low level (< 10 microstrain), high frequency (20-50 Hz) mechanical strains, continually present during even subtle activities such as standing are as important to defining the skeleton as the larger strains typically associated with vigorous activity (>2000 microstrain). If these low-level strains are indeed anabolic, then this sensitivity could serve as the basis for a biomechanically based intervention for osteoporosis. To evaluate this hypothesis, the hindlimbs of adult female sheep were stimulated for 20 minutes/day using a noninvasive 0.3g vertical oscillation sufficient to induce approximately 5 microstrain on the cortex of the tibia. After 1 year of stimulation, the physical properties of 10-mm cubes of trabecular bone from the distal femoral condyle of experimental animals (n = 8) were compared with controls (n = 9), as evaluated using microcomputed tomography (microCT) scanning and materials testing. Bone mineral content (BMC) was 10.6% greater (p < 0.05), and the trabecular number (Tb.N) was 8.3% higher in the experimental animals (p < 0.01), and trabecular spacing decreased by 11.3% (p < 0.01), indicating that bone quantity was increased both by the creation of new trabeculae and the thickening of existing trabeculae. The trabecular bone pattern factor (TBPf) decreased 24.2% (p < 0.03), indicating trabecular morphology adapting from rod shape to plate shape. Significant increases in stiffness and strength were observed in the longitudinal direction (12.1% and 26.7%, respectively; both, p < 0.05), indicating that the adaptation occurred primarily in the plane of weightbearing. These results show that extremely low level mechanical stimuli improve both the quantity and the quality of trabecular bone. That these deformations are several orders of magnitude below those peak strains which arise during vigorous activity indicates that this biomechanically based signal may serve as an effective intervention for osteoporosis.

Morphologic detail of aging bone in human vertebrae

To investigate aging bone structure of humans--here, in the lumbar vertebral bodies-requires methodologies that have sufficiently high resolving power yet still have sufficient width and depth of field. No clinical imaging method can come close to meeting the first requirement, leading to the disadvantage of being limited to postmortem studies. Few microscopic methods meet the second and third requisites. The three-dimensional (3D) images of bone in this article were obtained using deep-field 3D optical imaging, X-ray imaging, and scanning electron microscopy (SEM) of macerated plane parallel slices. The study of bone as a 3D object provides a different perspective from conventional two-dimensional images, and enriches our understanding of how modeling and remodeling processes regulate bone structure and connectivity. The study of ultraflat block surfaces by quantitative back-scattered electron imaging permits acquisition of data on mineral distributions and densities within a very thin layer (a continuous and perfect very thin section) in the block face. With this information, bone can be viewed as a spectrum of tissue types varying in degree of mineralization.

Static histomorphometry of human iliac crest and vertebral trabecular bone: a comparative study

We recently developed a new, rapid method for conducting static histomorphometry on large histologic sections. This method has now been applied on both iliac crest and lumbar vertebral bone to compare the age-related changes at these two skeletal sites and to investigate the correlation between the histomorphometric measures at the iliac crest and the vertebral body. The material comprised matched sets of unilateral transiliac crest bone biopsies and lumbar vertebral bodies (L-2) from 24 women (19-96 years) and 24 men (23-95 years) selected from a larger autopsy material. Three female subjects (80, 88, and 90 years) had a known vertebral fracture of L-2. The iliac crest biopsies and 9-mm-thick mediolateral slices of half the entire vertebral bodies were embedded in methylmetacrylate, stained with aniline blue, and scanned into a computer with a flatbed image scanner at a high resolution. With a custom-made computer program the following static histomorphometric measures were determined: trabecular bone volume; marrow and bone space star volume; node-strut analysis; trabecular bone pattern factor; trabecular thickness; trabecular number; trabecular separation; and anisotropy of bone and marrow phase. In addition, connectivity density was measured (ConnEulor method). The results showed that the age-related changes in the static histomorphometric measures are generally similar in the iliac crest and the vertebral body, and that these age-related changes are independent of gender. An exception, however, is connectivity density, where the age-related changes are similar for women and men in the vertebral body but significantly different in the iliac crest. Furthermore, the results showed that the histomorphometric measures were weakly intercorrelated between the iliac crest and the vertebral body, despite the generally similar pattern in age-related changes at these two skeletal sites. The highest correlation coefficient was found for trabecular separation (Tb.Sp; r = 0.63). Trabecular bone volume showed a correlation coefficient of r = 0.59. It is concluded that static histomorphometry performed on one skeletal site does not automatically predict static histomorphometric measures at another skeletal site. Therefore, it is recommended that static histomorphometry be performed at the skeletal site of interest-if at all possible.

High-resolution three-dimensional micro-computed tomography detects bone loss and changes in trabecular architecture early: comparison with DEXA and bone histomorphometry in a rat model of disuse osteoporosis

RATIONALE AND OBJECTIVES

The ability of three-dimensional micro-computed tomography (3D-microCT) to detect changes in a rat model of disuse osteoporosis was evaluated and compared with two reference techniques: dual x-ray absorptiometry (DEXA) for bone mass, and bone histomorphometry (BHM) for bone mass and trabecular micro-architecture.

METHODS

Forty-two rats were divided into controls or were hindlimb unloaded for 7, 13, and 23 days. DEXA bone mineral density measurements were performed on right tibiae. Then, after plastic embedding, bone volume (BV/TV) and trabecular (Tb)-derived parameters of trabecular bone architecture (Tb Th, thickness; Tb N, number) were measured with BHM. 3D-microCT measurements of BV/TV, Tb Th, and Tb N were carried out on left tibiae.

RESULTS

Unloaded rats lost bone in a time-dependent manner. DEXA and 3D-microCT detected bone loss earlier than BHM. The decreases in Tb Th and Tb N were observed at day 13 only with 3D-microCT (P < 0.05 and P < 0.01, respectively). All bone mass and architectural parameters measured with the three techniques correlated significantly (0.59, 0.89, P < 0.001), except Tb Th.

CONCLUSIONS

3D-microCT is a valid technique for bone mass and micro-architecture measurements in this rat model of disuse osteoporosis.