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Lopes TSB, Shi H, White D, Araújo ICS, Kim WK. Effects of 25-hydroxycholecalciferol on performance, gut health, and bone quality of broilers fed with reduced calcium and phosphorus diet during Eimeria challenge. Poult Sci 2024; 103:103267. [PMID: 38113706 PMCID: PMC10770761 DOI: 10.1016/j.psj.2023.103267] [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: 07/15/2023] [Revised: 10/24/2023] [Accepted: 11/03/2023] [Indexed: 12/21/2023] Open
Abstract
This study evaluated the effects of 25-hydroxycholecalciferol (25-OHD) on performance, gut health, and bone quality of broilers fed with reduced calcium (Ca) and phosphorus (P) diet during Eimeria spp. challenge. A total of 576 fourteen-day-old Cobb 500 male chicks were randomly distributed in a 2 × 2 × 2 factorial arrangement, with 6 replicates of 12 birds each. The main factors were 25-OHD level (0 or 3,000 IU/kg of feed), mineral level (0.84% of Ca/0.42% of P, the levels recommended for the grower phase (NOR) or 0.64% of Ca/0.22% of P (RED), and mid-high mixed Eimeria challenge or nonchallenge. 25-OHD improved phosphorus retention (P = 0.019), bone ash weight (P = 0.04), cortical bone trabecular connectivity (P = 0.043) during coccidiosis. For birds fed with reduced mineral levels, 25-OHD supplementation increased bone ash weight (P = 0.04). However, 25-OHD did not improve bone ash weight when birds were challenged and fed with reduced mineral levels. The dietary 3,000 IU of 25-OHD supplementation did not improve performance or gut morphology but support bone health during coccidiosis. Future investigations are needed for better understand 25-OHD role on bone microarchitecture and oxidative metabolism during coccidiosis.
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Affiliation(s)
- T S B Lopes
- Department of Animal Science, Universidade Federal de Minas Gerais, Belo Horizonte, MG 31270-901, Brazil
| | - H Shi
- Department of Poultry Science, University of Georgia, Athens, GA 30602, USA
| | - D White
- Department of Poultry Science, University of Georgia, Athens, GA 30602, USA
| | - I C S Araújo
- Department of Animal Science, Universidade Federal de Minas Gerais, Belo Horizonte, MG 31270-901, Brazil
| | - W K Kim
- Department of Poultry Science, University of Georgia, Athens, GA 30602, USA.
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2
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Dia AS, Renaud G, Nooghabi AH, Grimal Q. The influence of intra-cortical microstructure on the contrast in ultrasound images of the cortex of long bones: A 2D simulation study. ULTRASONICS 2023; 127:106831. [PMID: 36084514 DOI: 10.1016/j.ultras.2022.106831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 07/14/2022] [Accepted: 08/16/2022] [Indexed: 06/15/2023]
Abstract
Decreased thickness of the bone cortex due to bone loss in the course of ageing and osteoporosis is associated with reduced bone strength. Cortical thickness measurement from ultrasound images was recently demonstrated in young adults. This requires the identification of both the outer (periosteum) and inner (endosteum) surfaces of the bone cortex. However, with bone loss, the cortical porosity and the size of the vascular pores increase resulting in enhanced ultrasound scattering which may prevent the detection of the endosteum. The aim of this work was to study the influence of cortical bone microstructure variables, such as porosity and pore size, on the contrast of the endosteum in ultrasound images. We wanted to estimate the range of these variables for which ultrasound imaging of the endosteum is feasible. We generated synthetic data using a two-dimensional time-domain code to simulate the propagation of elastodynamic waves. A synthetic aperture imaging sequence with an array transducer operating at a center frequency of 2.5 MHz was used. The numerical simulations were conducted for 105 cortical microstructures obtained from high resolution X-ray computed tomography images of ex vivo bone samples with a porosity ranging from 2% to 24 %. Images were reconstructed using a delay-and-sum (DAS) algorithm with optimized f-number, correction of refraction at the periosteum, and sample-specific wave-speed. We observed a range variation of 18 dB of endosteum contrast in our data set depending on the bone microstructure. We found that as porosity increases, speckle intensity inside the bone cortex increases whereas the intensity of the signal from the endosteum decreases. Also, a microstructure with large pores (diameter >250 μm) was associated with poor endosteum visibility, compared with a microstructure with equal porosity but a more narrow distribution of pore sizes. These findings suggest that ultrasound imaging of the bone cortex with a probe operating at a central frequency of 2.5 MHz using refraction-corrected DAS is capable of detecting the endosteum of a cortex with moderate porosity (less than about 10%) if the largest pores remain smaller than about 200 μm.
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Affiliation(s)
- Amadou Sall Dia
- Sorbonne Université, INSERM, CNRS, Laboratoire d'Imagerie Biomédicale, LIB, F-75006, Paris, France.
| | - Guillaume Renaud
- Sorbonne Université, INSERM, CNRS, Laboratoire d'Imagerie Biomédicale, LIB, F-75006, Paris, France; Department of Imaging Physics, Delft University of Technology, The Netherlands
| | - Aida Hejazi Nooghabi
- Sorbonne Université, INSERM, CNRS, Laboratoire d'Imagerie Biomédicale, LIB, F-75006, Paris, France
| | - Quentin Grimal
- Sorbonne Université, INSERM, CNRS, Laboratoire d'Imagerie Biomédicale, LIB, F-75006, Paris, France
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3
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Rothweiler R, Gross C, Bortel E, Früh S, Gerber J, Boller E, Wüster J, Stricker A, Fretwurst T, Iglhaut G, Nahles S, Schmelzeisen R, Hesse B, Nelson K. Comparison of the 3D-Microstructure Between Alveolar and Iliac Bone for Enhanced Bioinspired Bone Graft Substitutes. Front Bioeng Biotechnol 2022; 10:862395. [PMID: 35782504 PMCID: PMC9248932 DOI: 10.3389/fbioe.2022.862395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 05/04/2022] [Indexed: 11/13/2022] Open
Abstract
In oral- and maxillofacial bone augmentation surgery, non-vascularized grafts from the iliac crest demonstrate better clinical performance than alveolar bone grafts. The underlying mechanisms are not fully understood but are essential for the enhancement of bone regeneration scaffolds. Synchrotron Radiation µ-CT at a pixel size of 2.3 μm was used to characterize the gross morphology and the vascular and osteocyte lacuna porosity of patient-matched iliac crest/alveolar bone samples. The results suggest a difference in the spatial distribution of the vascular pore system. Fluid simulations reveal the permeability tensor to be more homogeneous in the iliac crest, indicating a more unidirectional fluid flow in alveolar bone. The average distance between bone mineral and the closest vessel pore boundary was found to be higher in alveolar bone. At the same time, osteocyte lacunae density is higher in alveolar bone, potentially compensating for the longer average distance between the bone mineral and vessel pores. The present study comprehensively quantified and compared the 3D microarchitecture of intraindividual human alveolar and iliac bone. The identified difference in pore network architecture may allow a bone graft from the iliac crest to exhibit higher regeneration potential due to an increased capacity to connect with the surrounding pore network of the residual bone. The results may contribute to understanding the difference in clinical performance when used as bone grafts and are essential for optimization of future scaffold materials.
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Affiliation(s)
- Rene Rothweiler
- Department of Oral- and Craniomaxillofacial Surgery, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany
| | - Christian Gross
- Department of Oral- and Craniomaxillofacial Surgery, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany
| | | | | | | | - Elodie Boller
- European Synchrotron Radiation Facility, Grenoble, France
| | - Jonas Wüster
- Department of Oral and Maxillofacial Surgery, Berlin Institute of Health, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Andres Stricker
- Department of Oral- and Craniomaxillofacial Surgery, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany
| | - Tobias Fretwurst
- Department of Oral- and Craniomaxillofacial Surgery, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany
| | - Gerhard Iglhaut
- Department of Oral- and Craniomaxillofacial Surgery, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany
| | - Susanne Nahles
- Department of Oral and Maxillofacial Surgery, Berlin Institute of Health, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Rainer Schmelzeisen
- Department of Oral- and Craniomaxillofacial Surgery, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany
| | - Bernhard Hesse
- Xploraytion GmbH, Berlin, Germany
- European Synchrotron Radiation Facility, Grenoble, France
- *Correspondence: Bernhard Hesse, ; Katja Nelson,
| | - Katja Nelson
- Department of Oral- and Craniomaxillofacial Surgery, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany
- *Correspondence: Bernhard Hesse, ; Katja Nelson,
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Estimation of Thickness and Speed of Sound for Transverse Cortical Bone Imaging Using Phase Aberration Correction Methods: An In Silico and Ex Vivo Validation Study. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12105283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Delay-and-sum (DAS) beamforming of backscattered echoes is used for conventional ultrasound imaging. Although DAS beamforming is well suited for imaging in soft tissues, refraction, scattering, and absorption, porous mineralized tissues cause phase aberrations of reflected echoes and subsequent image degradation. The recently developed refraction corrected multi-focus technique uses subsequent focusing of waves at variable depths, the tracking of travel times of waves reflected from outer and inner cortical bone interfaces, the estimation of the shift needed to focus from one interface to another to determine cortical thickness (Ct.Th), and the speed of sound propagating in a radial bone direction (Ct.ν11). The method was validated previously in silico and ex vivo on plate shaped samples. The aim of this study was to correct phase aberration caused by bone geometry (i.e., curvature and tilt with respect to the transducer array) and intracortical pores for the multi-focus approach. The phase aberration correction methods are based on time delay estimation via bone geometry differences to flat bone plates and via the autocorrelation and cross correlation of the reflected ultrasound waves from the endosteal bone interface. We evaluate the multi-focus approach by incorporating the phase aberration correction methods by numerical simulation and one experiment on a human tibia bone, and analyze the precision and accuracy of measuring Ct.Th and Ct.ν11. Site-matched reference values of the cortical thickness of the human tibia bone were obtained from high-resolution peripheral computed tomography. The phase aberration correction methods resulted in a more precise (coefficient of variation of 5.7%) and accurate (root mean square error of 6.3%) estimation of Ct.Th, and a more precise (9.8%) and accurate (3.4%) Ct.ν11 estimation, than without any phase aberration correction. The developed multi-focus method including phase aberration corrections provides local estimations of both cortical thickness and sound velocity and is proposed as a biomarker of cortical bone quality with high clinical potential for the prevention of osteoporotic fractures.
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Forager and farmer evolutionary adaptations to malaria evidenced by 7000 years of thalassemia in Southeast Asia. Sci Rep 2021; 11:5677. [PMID: 33707498 PMCID: PMC7952380 DOI: 10.1038/s41598-021-83978-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 02/08/2021] [Indexed: 11/21/2022] Open
Abstract
Thalassemias are inherited blood disorders that are found in high prevalences in the Mediterranean, Southeast Asia and the Pacific. These diseases provide varying levels of resistance to malaria and are proposed to have emerged as an adaptive response to malaria in these regions. The transition to agriculture in the Holocene has been suggested to have influenced the selection for thalassemia in the Mediterranean as land clearance for farming encouraged interaction between Anopheles mosquitos, the vectors for malaria, and human groups. Here we document macroscopic and microscopic skeletal evidence for the presence of thalassemia in both hunter-gatherer (Con Co Ngua) and early agricultural (Man Bac) populations in northern Vietnam. Firstly, our findings demonstrate that thalassemia emerged prior to the transition to agriculture in Mainland Southeast Asia, from at least the early seventh millennium BP, contradicting a long-held assumption that agriculture was the main driver for an increase in malaria in Southeast Asia. Secondly, we describe evidence for significant malarial burden in the region during early agriculture. We argue that the introduction of farming into the region was not the initial driver of the selection for thalassemia, as it may have been in other regions of the world.
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6
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Vahidi G, Rux C, Sherk VD, Heveran CM. Lacunar-canalicular bone remodeling: Impacts on bone quality and tools for assessment. Bone 2021; 143:115663. [PMID: 32987198 PMCID: PMC7769905 DOI: 10.1016/j.bone.2020.115663] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 09/23/2020] [Accepted: 09/23/2020] [Indexed: 01/06/2023]
Abstract
Osteocytes can resorb as well as replace bone adjacent to the expansive lacunar-canalicular system (LCS). Suppressed LCS remodeling decreases bone fracture toughness, but it is unclear how altered LCS remodeling impacts bone quality. The first goal of this review is to assess how LCS remodeling impacts LCS morphology as well as the composition and mechanical properties of surrounding bone tissue. The second goal is to compare tools available for the assessment of bone quality at length-scales that are physiologically-relevant to LCS remodeling. We find that changes to LCS morphology occur in response to a variety of physiological conditions and diseases and can be classified in two general phenotypes. In the 'aging phenotype', seen in aging and in some disuse models, the LCS is truncated and osteocytes apoptosis is increased. In the 'osteocytic osteolysis' phenotype, which is adaptive in some physiological settings and possibly maladaptive in others, the LCS enlarges and osteocytes generally maintain viability. Bone composition and mechanical properties vary near the osteocyte and change with at least some conditions that alter LCS morphology. However, few studies have evaluated bone composition and mechanical properties close to the LCS and so the impacts of LCS remodeling phenotypes on bone tissue quality are still undetermined. We summarize the current understanding of how LCS remodeling impacts LCS morphology, tissue-scale bone composition and mechanical properties, and whole-bone material properties. Tools are compared for assessing tissue-scale bone properties, as well as the resolution, advantages, and limitations of these techniques.
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Affiliation(s)
- G Vahidi
- Department of Mechanical & Industrial Engineering, Montana State University, United States of America
| | - C Rux
- Department of Mechanical & Industrial Engineering, Montana State University, United States of America
| | - V D Sherk
- Department of Orthopedics, University of Colorado Anschutz School of Medicine, United States of America
| | - C M Heveran
- Department of Mechanical & Industrial Engineering, Montana State University, United States of America.
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7
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Sh Sufiiarov V, V Borisov E, V Sokolova V, O Chukovenkova M, V Soklakov A, S Mikhaluk D, A Popovich A. Structural analysis of an endoprosthesis designed with graded density lattice structures. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2021; 37:e3420. [PMID: 33249737 DOI: 10.1002/cnm.3420] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 10/30/2020] [Accepted: 11/25/2020] [Indexed: 06/12/2023]
Abstract
The most common causes of conducting a hip revision surgery after total hip replacement are aseptic loosening (aseptic instability) of the endoprosthesis, bone destruction as a result of contact with the endoprosthesis, and a periprosthetic fracture. These are the effects of load transfer to the bone tissue in arthroplasty resulting due to the difference in stiffness of the endoprosthesis and the bone. Titanium alloy is widely used in endoprostheses manufacturing because of its high biocompatibility, good wear properties, and corrosion resistance, but such endoprostheses are stiffer than the femur. These problems have raised interest in searching for the best materials and topology for a femoral implant. Nowadays additive technology is of great interest as it enables to create materials with graded density. These materials consist of multiple lattice structures with variable parameters and topology. By varying the parameters of lattice structures one can adjust the mechanical properties of the material as required. These materials find their application in hip endoprostheses manufacturing, allowing to adjust the parameters of the lattice structures, and deliver a product with femur-like mechanical properties. The porous structure also ensures bone tissue ingrowth into the prosthesis. The authors designed and simulated an endoprosthesis made of graded density lattice structures with femur-like mechanical properties. Using a numerical simulation software Ansys Mechanical authors determined the effect of the topology on the structural behavior of the femur and defined the endoprosthesis-femur combined performance under various load cases.
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Affiliation(s)
- Vadim Sh Sufiiarov
- Peter the Great Saint Petersburg Polytechnic University, Saint Petersburg, Russia
| | - Evgeniy V Borisov
- Peter the Great Saint Petersburg Polytechnic University, Saint Petersburg, Russia
| | - Viktoriya V Sokolova
- Peter the Great Saint Petersburg Polytechnic University, Saint Petersburg, Russia
| | | | | | - Dmitry S Mikhaluk
- Center of Engineering Physics Simulation and Analysis, Saint Petersburg, Russia
| | - Anatoliy A Popovich
- Peter the Great Saint Petersburg Polytechnic University, Saint Petersburg, Russia
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Akhter MP, Recker RR. High resolution imaging in bone tissue research-review. Bone 2021; 143:115620. [PMID: 32866682 DOI: 10.1016/j.bone.2020.115620] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 08/21/2020] [Accepted: 08/24/2020] [Indexed: 12/14/2022]
Abstract
This review article focuses on imaging of bone tissue to understand skeletal health with regards to bone quality. Skeletal fragility fractures are due to bone diseases such as osteoporosis which result in low bone mass and bone mineral density (BMD) leading to high risk of fragility fractures. Recent advances in imaging and analysis technologies have highly benefitted the field of biological sciences. In particular, their application in skeletal health has been of significant importance in understanding bone mechanical behavior (structure and properties) at the tissue level. While synchrotron based microCT technique has remained the gold standard for non-destructive evaluation of structure in material and biological sciences, several lab based microCT systems have been developed to provide high resolution imaging of specimens with greater access, and ease of use in laboratory settings. Lab based microCT scanners are widely used in the bone field as a standard tool to evaluate three-dimensional (3D) morphologies of bone structure at image resolutions appropriate for bone samples from small animals to bone biopsy specimens from humans. Both synchrotron and standard lab based microCT systems provide high resolution imaging ex vivo for a small sized specimen. A few X-ray based systems are also commercially available for in vivo scanning at relatively low image resolutions. Synchrotron-based CT microscopy is being used for various ultra-high-resolution image analyses using complex 3D software. However, the synchrotron-based CT technology is in high demand, allows only limited numbers of specimens, expensive, requires complex additional instrumentation, and is not easily available to researchers as it requires access to a synchrotron source which is always limited. Therefore, desktop laboratory scanners (microXCT, Zeiss/Xradia, Scanco, SkyScan. etc.), mimicking the synchrotron based CT technology or image resolution, have been developed to solve the accessibility issues. These lab based scanners have helped both material science, and the bone field to investigate bone tissue morphologies at submicron mage resolutions. Considerable progress has been made in both in vivo and ex vivo imaging towards providing high resolution images of bone tissue. Both clinical and research imaging technologies will continue to improve and help understand osteoporosis and other related skeletal issues in order to develop targeted treatments for bone fragility. This review summarizes the high resolution imaging work in bone research.
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Affiliation(s)
- M P Akhter
- Creighton University Osteoporosis Research Center, Omaha, NE, United States of America.
| | - R R Recker
- Creighton University Osteoporosis Research Center, Omaha, NE, United States of America
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9
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Jones BC, Jia S, Lee H, Feng A, Shetye SS, Batzdorf A, Shapira N, Noël PB, Pleshko N, Rajapakse CS. MRI-derived porosity index is associated with whole-bone stiffness and mineral density in human cadaveric femora. Bone 2021; 143:115774. [PMID: 33271401 PMCID: PMC7769997 DOI: 10.1016/j.bone.2020.115774] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 11/23/2020] [Accepted: 11/24/2020] [Indexed: 01/13/2023]
Abstract
Ultrashort echo time (UTE) magnetic resonance imaging (MRI) measures proton signals in cortical bone from two distinct water pools, bound water, or water that is tightly bound to bone matrix, and pore water, or water that is freely moving in the pore spaces in bone. By isolating the signal contribution from the pore water pool, UTE biomarkers can directly quantify cortical bone porosity in vivo. The Porosity Index (PI) is one non-invasive, clinically viable UTE-derived technique that has shown strong associations in the tibia with μCT porosity and other UTE measures of bone water. However, the efficacy of the PI biomarker has never been examined in the proximal femur, which is the site of the most catastrophic osteoporotic fractures. Additionally, the loads experienced during a sideways fall are complex and the femoral neck is difficult to image with UTE, so the usefulness of the PI in the femur was unknown. Therefore, the aim of this study was to examine the relationships between the PI measure in the proximal cortical shaft of human cadaveric femora specimens compared to (1) QCT-derived bone mineral density (BMD) and (2) whole bone stiffness obtained from mechanical testing mimicking a sideways fall. Fifteen fresh, frozen whole cadaveric femora specimens (age 72.1 ± 15.0 years old, 10 male, 5 female) were scanned on a clinical 3-T MRI using a dual-echo UTE sequence. Specimens were then scanned on a clinical CT scanner to measure volumetric BMD (vBMD) and then non-destructively mechanically tested in a sideways fall configuration. The PI in the cortical shaft demonstrated strong correlations with bone stiffness (r = -0.82, P = 0.0014), CT-derived vBMD (r = -0.64, P = 0.0149), and with average cortical thickness (r = -0.60, P = 0.0180). Furthermore, a hierarchical regression showed that PI was a strong predictor of bone stiffness which was independent of the other parameters. The findings from this study validate the MRI-derived porosity index as a useful measure of whole-bone mechanical integrity and stiffness.
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Affiliation(s)
- Brandon C Jones
- Department of Radiology, University of Pennsylvania, United States of America; Department of Bioengineering, University of Pennsylvania, United States of America.
| | - Shaowei Jia
- Department of Radiology, University of Pennsylvania, United States of America; School of Biomedical Science and Medical Engineering, Beihang University, China
| | - Hyunyeol Lee
- Department of Radiology, University of Pennsylvania, United States of America
| | - Anna Feng
- Department of Bioengineering, University of Pennsylvania, United States of America
| | - Snehal S Shetye
- Department of Orthopaedic Surgery, University of Pennsylvania, United States of America
| | - Alexandra Batzdorf
- Department of Radiology, University of Pennsylvania, United States of America
| | - Nadav Shapira
- Department of Radiology, University of Pennsylvania, United States of America
| | - Peter B Noël
- Department of Radiology, University of Pennsylvania, United States of America
| | - Nancy Pleshko
- Department of Bioengineering, Temple University, United States of America
| | - Chamith S Rajapakse
- Department of Radiology, University of Pennsylvania, United States of America; Department of Orthopaedic Surgery, University of Pennsylvania, United States of America
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Nguyen Minh H, Du J, Raum K. Estimation of Thickness and Speed of Sound in Cortical Bone Using Multifocus Pulse-Echo Ultrasound. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2020; 67:568-579. [PMID: 31647428 DOI: 10.1109/tuffc.2019.2948896] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Most bone loss during the development of osteoporosis occurs in cortical bone at the peripheral skeleton. Decreased cortical thickness (Ct.Th) and the prevalence of large pores at the tibia are associated with reduced bone strength at the hip. Ct.Th and cortical sound velocity, i.e., a surrogate marker for changes of cortical porosity (Ct.Po), are key biomarkers for the identification of patients at high fracture risk. In this study, we have developed a method using a conventional ultrasound array transducer to determine thickness (Ct.Th) and the compressional sound velocity propagating in the radial bone direction (Ct. ν11 ) using a refraction-corrected multifocus imaging approach. The method was validated in-silico on porous bone plate models using a 2-D finite-difference time-domain method and ex vivo on plate-shaped plastic reference materials and on plate-shaped cortical bovine tibia samples. Plane-wave pulse-echo measurements provided reference values to assess precision and accuracy of our method. In-silico results revealed the necessity to account for inclination-dependent transmission losses at the bone surface. Moreover, the dependence of Ct. ν11 on both porosity and pore density was observed. Ct.Th and Ct. ν11 obtained ex vivo showed a high correlation ) with reference values. The ex-vivo accuracy and precision for Ct. ν11 were 29.9 m/s and 0.94%, respectively, and those for Ct.Th were 0.04 mm and 1.09%, respectively. In conclusion, this numerical and experimental study demonstrates an accurate and precise estimation of Ct.Th and Ct. ν11 . The developed multifocus technique may have high clinical potential to improve fracture risk prediction using noninvasive and nonionizing conventional ultrasound technology with image guidance.
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11
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Andreasen CM, Bakalova LP, Brüel A, Hauge EM, Kiil BJ, Delaisse JM, Kersh ME, Thomsen JS, Andersen TL. The generation of enlarged eroded pores upon existing intracortical canals is a major contributor to endocortical trabecularization. Bone 2020; 130:115127. [PMID: 31689525 DOI: 10.1016/j.bone.2019.115127] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 10/28/2019] [Accepted: 10/29/2019] [Indexed: 02/04/2023]
Abstract
The gradual conversion of cortical bone into trabecular bone on the endocortical surface contributes substantially to thinning of the cortical bone. The purpose of the present study was to characterize the intracortical canals (3D) and pores (2D) in human fibular bone, to identify the intracortical remodeling events leading to this endocortical trabecularization. The analysis was conducted in fibular diaphyseal bone specimens obtained from 20 patients (6 women and 14 men, age range 41-75 years). μCT revealed that endosteal bone had a higher cortical porosity (p< 0.05) and canals with a larger diameter (p< 0.05) than periosteal bone, while the canal spacing and number were similar in the endosteal and periosteal half. Histological analysis showed that the endosteal half versus the periosteal half: (i) had a higher likelihood of being non-quiescent type 2 pores (i.e. remodeling of existing pores) than other pore types (OR = 1.6, p< 0.01); (ii) that the non-quiescent type 2 pores contributed to a higher porosity (p< 0.001); and that (iii) amongst these pores especially eroded type 2 pores contributed to the elevated cortical porosity (p< 0.001). In conclusion, we propose that endocortical trabecularization results from the accumulation of eroded cavities upon existing intracortical canals, favored by delayed initiation of bone formation.
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Affiliation(s)
- Christina Møller Andreasen
- Department of Orthopedic Surgery & Traumatology, Odense University Hospital, Odense, Denmark; Clinical Cell Biology, Research Unit of Pathology, Department of Clinical Research, University of Southern Denmark and Department of Pathology, Odense University Hospital, Odense, Denmark; Department of Molecular Medicine, University of Southern Denmark, Odense, Denmark.
| | - Lydia Peteva Bakalova
- Department of Mechanical Science and Engineering, University of Illinois at Urbana-Champaign, IL, USA.
| | - Annemarie Brüel
- Department of Biomedicine, Aarhus University, Aarhus, Denmark.
| | - Ellen Margrethe Hauge
- Department of Rheumatology, Aarhus University Hospital and Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
| | - Birgitte Jul Kiil
- Department of Plastic Surgery, Aarhus University Hospital, Aarhus, Denmark.
| | - Jean-Marie Delaisse
- Clinical Cell Biology, Research Unit of Pathology, Department of Clinical Research, University of Southern Denmark and Department of Pathology, Odense University Hospital, Odense, Denmark; Department of Molecular Medicine, University of Southern Denmark, Odense, Denmark; Clinical Cell Biology, Vejle Hospital - Lillebælt Hospital, University of Southern Denmark, Vejle, Denmark.
| | - Mariana Elizabeth Kersh
- Department of Mechanical Science and Engineering, University of Illinois at Urbana-Champaign, IL, USA.
| | | | - Thomas Levin Andersen
- Clinical Cell Biology, Research Unit of Pathology, Department of Clinical Research, University of Southern Denmark and Department of Pathology, Odense University Hospital, Odense, Denmark; Department of Molecular Medicine, University of Southern Denmark, Odense, Denmark; Clinical Cell Biology, Vejle Hospital - Lillebælt Hospital, University of Southern Denmark, Vejle, Denmark; Department of Forensic Medicine, Aarhus University, Aarhus, Denmark.
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12
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Blais A, Rochefort GY, Moreau M, Calvez J, Wu X, Matsumoto H, Blachier F. Monosodium Glutamate Supplementation Improves Bone Status in Mice Under Moderate Protein Restriction. JBMR Plus 2019; 3:e10224. [PMID: 31687652 PMCID: PMC6820464 DOI: 10.1002/jbm4.10224] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 07/10/2019] [Accepted: 07/15/2019] [Indexed: 12/14/2022] Open
Abstract
Adequate protein intake during development is critical to ensure optimal bone gain and to attain a higher peak bone mass later. Using a mild protein restriction model in Balb/C mice consuming 6% of their total energy intake as soy protein (LP-SOY)-for which we observed a significantly lower femoral cortical thickness, bone volume, trabecular number, and thickness reduction-we evaluated the effects of monosodium glutamate (MSG) supplementation at different concentrations (0.5, 1, 5, 10, and 20 g/kg of diet) on bone characteristics in LP-SOY-fed mice. After 6 and 12 weeks, LP-SOY-fed mice had lower BMD and reduced body weight related to lower lean mass, which was associated with a reduced IGF-1 level. The negative effect of the LP-SOY diet on BMD correlated with impaired bone formation. MSG supplementation, at 5, 10, and 20 g/kg of diet, and PTH injection, used as a positive control, were able to improve BMD and to increase osteoblast activity markers (P1NP and osteocalcin), as well as glutamine plasma concentration. An analysis of bone microarchitecture found that cortical bone was less sensitive to protein restriction than trabecular bone, and that MSG ingestion was able to preserve bone quality through an increase of collagen synthesis, although it did not allow normal bone growth. Our study reinforces the view that glutamate can act as a functional amino acid for bone physiology and support clinical investigation of glutamate supplementation in adults characterized by poor bone status, notably as a result of insufficient protein intake. © 2019 The Authors. JBMR Plus published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Anne Blais
- UMR PNCA, AgroParisTech, INRA Université Paris-Saclay Paris France
| | - Gael Y Rochefort
- EA 2496, Dental School Faculty Université Paris Descartes Montrouge France
| | - Manon Moreau
- UMR PNCA, AgroParisTech, INRA Université Paris-Saclay Paris France
| | - Juliane Calvez
- UMR PNCA, AgroParisTech, INRA Université Paris-Saclay Paris France
| | - Xin Wu
- Key Laboratory of Agro-ecological Process in Subtropical Region, Institute of Subtropical Agriculture Chinese Academy of Sciences Changsha China
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13
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Boughton OR, Ma S, Cai X, Yan L, Peralta L, Laugier P, Marrow J, Giuliani F, Hansen U, Abel RL, Grimal Q, Cobb JP. Computed tomography porosity and spherical indentation for determining cortical bone millimetre-scale mechanical properties. Sci Rep 2019; 9:7416. [PMID: 31092837 PMCID: PMC6520408 DOI: 10.1038/s41598-019-43686-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 04/23/2019] [Indexed: 12/11/2022] Open
Abstract
The cortex of the femoral neck is a key structural element of the human body, yet there is not a reliable metric for predicting the mechanical properties of the bone in this critical region. This study explored the use of a range of non-destructive metrics to measure femoral neck cortical bone stiffness at the millimetre length scale. A range of testing methods and imaging techniques were assessed for their ability to measure or predict the mechanical properties of cortical bone samples obtained from the femoral neck of hip replacement patients. Techniques that can potentially be applied in vivo to measure bone stiffness, including computed tomography (CT), bulk wave ultrasound (BWUS) and indentation, were compared against in vitro techniques, including compression testing, density measurements and resonant ultrasound spectroscopy. Porosity, as measured by micro-CT, correlated with femoral neck cortical bone's elastic modulus and ultimate compressive strength at the millimetre length scale. Large-tip spherical indentation also correlated with bone mechanical properties at this length scale but to a lesser extent. As the elastic mechanical properties of cortical bone correlated with porosity, we would recommend further development of technologies that can safely measure cortical porosity in vivo.
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Affiliation(s)
- Oliver R Boughton
- The MSk Lab, Department of Surgery and Cancer, Imperial College London, London, United Kingdom.
- The Biomechanics Group, Department of Mechanical Engineering, Imperial College London, London, United Kingdom.
| | - Shaocheng Ma
- The MSk Lab, Department of Surgery and Cancer, Imperial College London, London, United Kingdom
- The Biomechanics Group, Department of Mechanical Engineering, Imperial College London, London, United Kingdom
| | - Xiran Cai
- Sorbonne Université, INSERM, CNRS, Laboratoire d'Imagerie Biomédicale, F-75006, Paris, France
| | - Liye Yan
- Department of Materials, University of Oxford, Oxford, United Kingdom
| | - Laura Peralta
- Sorbonne Université, INSERM, CNRS, Laboratoire d'Imagerie Biomédicale, F-75006, Paris, France
| | - Pascal Laugier
- Sorbonne Université, INSERM, CNRS, Laboratoire d'Imagerie Biomédicale, F-75006, Paris, France
| | - James Marrow
- Department of Materials, University of Oxford, Oxford, United Kingdom
| | - Finn Giuliani
- Centre for Advanced Structural Ceramics, Department of Materials, Imperial College London, London, United Kingdom
| | - Ulrich Hansen
- The Biomechanics Group, Department of Mechanical Engineering, Imperial College London, London, United Kingdom
| | - Richard L Abel
- The MSk Lab, Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Quentin Grimal
- Sorbonne Université, INSERM, CNRS, Laboratoire d'Imagerie Biomédicale, F-75006, Paris, France
| | - Justin P Cobb
- The MSk Lab, Department of Surgery and Cancer, Imperial College London, London, United Kingdom
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14
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Schneider J, Ramiandrisoa D, Armbrecht G, Ritter Z, Felsenberg D, Raum K, Minonzio JG. In Vivo Measurements of Cortical Thickness and Porosity at the Proximal Third of the Tibia Using Guided Waves: Comparison with Site-Matched Peripheral Quantitative Computed Tomography and Distal High-Resolution Peripheral Quantitative Computed Tomography. ULTRASOUND IN MEDICINE & BIOLOGY 2019; 45:1234-1242. [PMID: 30777311 DOI: 10.1016/j.ultrasmedbio.2019.01.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 12/20/2018] [Accepted: 01/08/2019] [Indexed: 05/09/2023]
Abstract
The aim of this study was to estimate cortical porosity (Ct.Po) and cortical thickness (Ct.Th) using 500-kHz bi-directional axial transmission (AT). Ct.ThAT and Ct.PoAT were obtained at the tibia in 15 patients from a 2-D transverse isotropic free plate model fitted to measured guided wave dispersion curves. The velocities of the first arriving signal (υFAS) and A0 mode (υA0) were also determined. Site-matched peripheral quantitative computed tomography (pQCT) provided volumetric cortical bone mineral density (Ct.vBMDpQCT) and Ct.ThpQCT. Good agreement was found between Ct.ThAT and Ct.ThpQCT (R2 = 0.62, root mean square error [RMSE] = 0.39 mm). Ct.vBMDpQCT correlated with Ct.PoAT (R2 = 0.57), υFAS (R2 = 0.43) and υA0 (R2 = 0.28). Furthermore, a significant correlation was found between AT and distal high-resolution pQCT. The measurement ofcortical parameters at the tibia using guided waves might improve the prediction of bone fractures in a cost-effective and radiation-free manner.
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Affiliation(s)
- Johannes Schneider
- Berlin-Brandenburg School for Regenerative Therapies (BSRT), Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Donatien Ramiandrisoa
- Laboratoire d'Imagerie Biomédicale (LIB), Sorbonne University, CNRS, INSERM, Paris, France; BleuSolid, Pomponne, France
| | - Gabriele Armbrecht
- Center for Muscle and Bone Research (ZMK), Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Zully Ritter
- Center for Muscle and Bone Research (ZMK), Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Dieter Felsenberg
- Center for Muscle and Bone Research (ZMK), Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Kay Raum
- Berlin-Brandenburg School for Regenerative Therapies (BSRT), Charité-Universitätsmedizin Berlin, Berlin, Germany.
| | - Jean-Gabriel Minonzio
- Laboratoire d'Imagerie Biomédicale (LIB), Sorbonne University, CNRS, INSERM, Paris, France; Escuela de Ingeniería Civil en Informática, Universidad de Valparaíso, Valparaíso, Chile
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15
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Iori G, Schneider J, Reisinger A, Heyer F, Peralta L, Wyers C, Gräsel M, Barkmann R, Glüer CC, van den Bergh JP, Pahr D, Raum K. Large cortical bone pores in the tibia are associated with proximal femur strength. PLoS One 2019; 14:e0215405. [PMID: 30995279 PMCID: PMC6469812 DOI: 10.1371/journal.pone.0215405] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 04/01/2019] [Indexed: 11/23/2022] Open
Abstract
Alterations of structure and density of cortical bone are associated with fragility fractures and can be assessed in vivo in humans at the tibia. Bone remodeling deficits in aging women have been recently linked to an increase in size of cortical pores. In this ex vivo study, we characterized the cortical microarchitecture of 19 tibiae from human donors (aged 69 to 94 years) to address, whether this can reflect impairments of the mechanical competence of the proximal femur, i.e., a major fracture site in osteoporosis. Scanning acoustic microscopy (12 μm pixel size) provided reference microstructural measurements at the left tibia, while the bone vBMD at this site was obtained using microcomputed tomography (microCT). The areal bone mineral density of both left and right femoral necks (aBMDneck) was measured by dual‐energy X‐ray absorptiometry (DXA), while homogenized nonlinear finite element models based on high-resolution peripheral quantitative computed tomography provided hip stiffness and strength for one-legged standing and sideways falling loads. Hip strength was associated with aBMDneck (r = 0.74 to 0.78), with tibial cortical thickness (r = 0.81) and with measurements of the tibial cross-sectional geometry (r = 0.48 to 0.73) of the same leg. Tibial vBMD was associated with hip strength only for standing loads (r = 0.59 to 0.65). Cortical porosity (Ct.Po) of the tibia was not associated with any of the femoral parameters. However, the proportion of Ct.Po attributable to large pores (diameter > 100 μm) was associated with hip strength in both standing (r = -0.61) and falling (r = 0.48) conditions. When added to aBMDneck, the prevalence of large pores could explain up to 17% of the femur ultimate force. In conclusion, microstructural characteristics of the tibia reflect hip strength as well as femoral DXA, but it remains to be tested whether such properties can be measured in vivo.
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Affiliation(s)
- Gianluca Iori
- Berlin-Brandenburg Center for Regenerative Therapies, Charité –Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Johannes Schneider
- Berlin-Brandenburg Center for Regenerative Therapies, Charité –Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Andreas Reisinger
- Division Biomechanics, Karl Landsteiner University of Health Sciences, Krems, Austria
| | - Frans Heyer
- Department of Internal Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Internal Medicine, VieCuri Medical Center, Venlo, The Netherlands
| | - Laura Peralta
- Laboratoire d’Imagerie Biomédicale, Sorbonne Universités, INSERM UMR S 1146, CNRS UMR 7371, Paris, France
- Department of Biomedical Engineering, School of Biomedical Engineering & Imaging Sciences, King’s College London, London, United Kingdom
| | - Caroline Wyers
- Department of Internal Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Internal Medicine, VieCuri Medical Center, Venlo, The Netherlands
| | - Melanie Gräsel
- Sektion Biomedizinische Bildgebung, Klinik für Radiologie und Neuroradiologie, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - Reinhard Barkmann
- Sektion Biomedizinische Bildgebung, Klinik für Radiologie und Neuroradiologie, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - Claus C. Glüer
- Sektion Biomedizinische Bildgebung, Klinik für Radiologie und Neuroradiologie, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - J. P. van den Bergh
- Department of Internal Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Internal Medicine, VieCuri Medical Center, Venlo, The Netherlands
| | - Dieter Pahr
- Division Biomechanics, Karl Landsteiner University of Health Sciences, Krems, Austria
- Institute for Lightweight Design and Structural Biomechanics, TU Wien, Vienna, Austria
| | - Kay Raum
- Berlin-Brandenburg Center for Regenerative Therapies, Charité –Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- * E-mail:
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16
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Wang Y, Li J, Yang J, Dong J. Regional characteristics of cortical bone quality in the proximal humerus of postmenopausal women: a preliminary study. J Shoulder Elbow Surg 2019; 28:685-691. [PMID: 30527884 DOI: 10.1016/j.jse.2018.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Revised: 09/04/2018] [Accepted: 09/05/2018] [Indexed: 02/01/2023]
Abstract
BACKGROUND Proximal humeral fractures represent the third most common fragility fracture treated in osteoporotic populations, after hip and distal radial fractures. The purpose of this study was to characterize the spatial variability in cortical geometry in the proximal humerus in postmenopausal women. METHODS The proximal humeri in 43 healthy postmenopausal women were imaged by computed tomography. Cortical bone mapping was applied to create color 3-dimensional thickness maps for each proximal humerus. Cortical parameters, including the cortical thickness (CTh), cortical mass surface density (CM), and endocortical trabecular density, were measured over the humeral head and metaphyseal region after 15 regions of interest (ROIs) were defined. RESULTS In the humeral head region, significant differences in CTh and CM values were detected between the anterior, lateral, and posterior walls (P < .05). The highest CTh and CM were found in the anterior wall in each plane (P < .05). Regarding the endocortical trabecular density, no significant findings were noted in the 3 planes (P > .05). In the metaphyseal region, the cortical structure in the medial column had higher CTh and CM values in ROI 10 compared with the lateral column (P < .05). The highest CTh and CM values of compact bone were seen in ROI 10 of the medial column (ROIs 10-12) (P < .05). CONCLUSION Our results showed significant regional variation of cortical bone in the humeral head region in postmenopausal women. Similar conditions were seen in the medial column in the metaphyseal region. This finding provides discriminatory information for stronger fixation of implants.
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Affiliation(s)
- Yeming Wang
- Department of Orthopedics, Tianjin Hospital, Tianjin University, Tianjin, China.
| | - Jian Li
- Department of Radiology, Tianjin Hospital, Tianjin University, Tianjin, China
| | - Jianhua Yang
- Department of Orthopedics, Tianjin Hospital, Tianjin University, Tianjin, China
| | - Jingming Dong
- Department of Orthopedics, Tianjin Hospital, Tianjin University, Tianjin, China
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17
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Cai X, Brenner R, Peralta L, Olivier C, Gouttenoire PJ, Chappard C, Peyrin F, Cassereau D, Laugier P, Grimal Q. Homogenization of cortical bone reveals that the organization and shape of pores marginally affect elasticity. J R Soc Interface 2019; 16:20180911. [PMID: 30958180 PMCID: PMC6408344 DOI: 10.1098/rsif.2018.0911] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 01/21/2019] [Indexed: 12/12/2022] Open
Abstract
With ageing and various diseases, the vascular pore volume fraction (porosity) in cortical bone increases, and the morphology of the pore network is altered. Cortical bone elasticity is known to decrease with increasing porosity, but the effect of the microstructure is largely unknown, while it has been thoroughly studied for trabecular bone. Also, popular micromechanical models have disregarded several micro-architectural features, idealizing pores as cylinders aligned with the axis of the diaphysis. The aim of this paper is to quantify the relative effects on cortical bone anisotropic elasticity of porosity and other descriptors of the pore network micro-architecture associated with pore number, size and shape. The five stiffness constants of bone assumed to be a transversely isotropic material were measured with resonant ultrasound spectroscopy in 55 specimens from the femoral diaphysis of 29 donors. The pore network, imaged with synchrotron radiation X-ray micro-computed tomography, was used to derive the pore descriptors and to build a homogenization model using the fast Fourier transform (FFT) method. The model was calibrated using experimental elasticity. A detailed analysis of the computed effective elasticity revealed in particular that porosity explains most of the variations of the five stiffness constants and that the effects of other micro-architectural features are small compared to usual experimental errors. We also have evidence that modelling the pore network as an ensemble of cylinders yields biased elasticity values compared to predictions based on the real micro-architecture. The FFT homogenization method is shown to be particularly efficient to model cortical bone.
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Affiliation(s)
- Xiran Cai
- Laboratoire d’Imagerie Biomédicale, Sorbonne Université, INSERM UMR S 1146, CNRS UMR 7371, 75006 Paris, France
| | - Renald Brenner
- Institut Jean le Rond ∂’Alembert, Sorbonne Université, CNRS UMR 7190, 75005 Paris, France
| | - Laura Peralta
- Laboratoire d’Imagerie Biomédicale, Sorbonne Université, INSERM UMR S 1146, CNRS UMR 7371, 75006 Paris, France
| | - Cécile Olivier
- CREATIS, Université de Lyon, INSERM U1206, CNRS UMR 5220 , INSA-Lyon, UCBL, 69621 Villeurbanne, France
- ESRF, 38043 Grenoble, France
| | | | | | - Françoise Peyrin
- CREATIS, Université de Lyon, INSERM U1206, CNRS UMR 5220 , INSA-Lyon, UCBL, 69621 Villeurbanne, France
- ESRF, 38043 Grenoble, France
| | - Didier Cassereau
- Laboratoire d’Imagerie Biomédicale, Sorbonne Université, INSERM UMR S 1146, CNRS UMR 7371, 75006 Paris, France
| | - Pascal Laugier
- Laboratoire d’Imagerie Biomédicale, Sorbonne Université, INSERM UMR S 1146, CNRS UMR 7371, 75006 Paris, France
| | - Quentin Grimal
- Laboratoire d’Imagerie Biomédicale, Sorbonne Université, INSERM UMR S 1146, CNRS UMR 7371, 75006 Paris, France
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18
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Ex vivo cortical porosity and thickness predictions at the tibia using full-spectrum ultrasonic guided-wave analysis. Arch Osteoporos 2019; 14:21. [PMID: 30783777 PMCID: PMC6394459 DOI: 10.1007/s11657-019-0578-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 01/31/2019] [Indexed: 02/03/2023]
Abstract
UNLABELLED The estimation of cortical thickness (Ct.Th) and porosity (Ct.Po) at the tibia using axial transmission ultrasound was successfully validated ex vivo against site-matched micro-computed tomography. The assessment of cortical parameters based on full-spectrum guided-wave analysis might improve the prediction of bone fractures in a cost-effective and radiation-free manner. PURPOSE Cortical thickness (Ct.Th) and porosity (Ct.Po) are key parameters for the identification of patients with fragile bones. The main objective of this ex vivo study was to validate the measurement of Ct.Po and Ct.Th at the tibia using a non-ionizing, low-cost, and portable 500-kHz ultrasound axial transmission system. Additional ultrasonic velocities and site-matched reference parameters were included in the study to broaden the analysis. METHODS Guided waves were successfully measured ex vivo in 17 human tibiae using a novel 500-kHz bi-directional axial transmission probe. Theoretical dispersion curves of a transverse isotropic free plate model with invariant matrix stiffness were fitted to the experimental dispersion curves in order to estimate Ct.Th and Ct.Po. In addition, the velocities of the first arriving signal (υFAS) and A0 mode (υA0) were measured. Reference Ct.Po, Ct.Th, and vBMD were obtained from site-matched micro-computed tomography. Scanning acoustic microscopy (SAM) provided the acoustic impedance of the axial cortical bone matrix. RESULTS The best predictions of Ct.Po (R2 = 0.83, RMSE = 2.2%) and Ct.Th (R2 = 0.92, RMSE = 0.2 mm, one outlier excluded) were obtained from the plate model. The second best predictors of Ct.Po and Ct.Th were vBMD (R2 = 0.77, RMSE = 2.6%) and υA0 (R2 = 0.28, RMSE = 0.67 mm), respectively. CONCLUSIONS Ct.Th and Ct.Po were accurately predicted at the human tibia ex vivo using a transverse isotropic free plate model with invariant matrix stiffness. The model-based predictions were not further enhanced when we accounted for variations in axial tissue stiffness as reflected by the acoustic impedance from SAM.
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19
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Ciani A, Toumi H, Pallu S, Tsai EHR, Diaz A, Guizar-Sicairos M, Holler M, Lespessailles E, Kewish CM. Ptychographic X-ray CT characterization of the osteocyte lacuno-canalicular network in a male rat's glucocorticoid induced osteoporosis model. Bone Rep 2018; 9:122-131. [PMID: 30246062 PMCID: PMC6146379 DOI: 10.1016/j.bonr.2018.07.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 07/27/2018] [Indexed: 01/15/2023] Open
Abstract
Ptychographic X-ray computed tomography (PXCT) is a quantitative imaging modality that non-destructively maps the 3D electron density inside an object with tens of nanometers spatial resolution. This method provides unique access to the morphology and structure of the osteocyte lacuno-canalicular network (LCN) and nanoscale density of the tissue in the vicinity of an osteocyte lacuna. Herein, we applied PXCT to characterize the lacunae and LCN in a male Wistar rat model of glucocorticoid-induced osteoporosis (GIO). The ptychographic images revealed significant (p < 0.05) differences in the number of canaliculi originating from the lacuna per ellipsoidal surface unit, Ca.Nb (p = 0.0106), and the 3D morphology of the lacuna (p = 0.0064), between GIO and SHAM groups. Moreover, the mean canalicular diameter, Ca.Dm, was slightly statistically un-significantly smaller in GIO (152 ± 6.5) nm than in SHAM group (165 ± 8) nm (p = 0.053). Our findings indicate that PXCT can non-destructively provide detailed, nanoscale information on the 3D organization of the LCN in correlative studies of pathologies, such as osteoporosis, leading to improved diagnosis and therapy.
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Affiliation(s)
- Antonia Ciani
- Synchrotron Soleil, L'Orme des Merisiers, 91192 Gif-sur-Yvette, France.,EA4708, Imagerie Multimodale, Multiéchelles et Modélisation du Tissu Osseux et Articulaire (I3MTO), Université d'Orléans, 45000 Orléans, France
| | - Hechmi Toumi
- EA4708, Imagerie Multimodale, Multiéchelles et Modélisation du Tissu Osseux et Articulaire (I3MTO), Université d'Orléans, 45000 Orléans, France.,Département Rhumatologie, Centre Hospitalier Régional d'Orléans, 45067 Orléans, France
| | - Stéphane Pallu
- EA4708, Imagerie Multimodale, Multiéchelles et Modélisation du Tissu Osseux et Articulaire (I3MTO), Université d'Orléans, 45000 Orléans, France
| | | | - Ana Diaz
- Paul Scherrer Institut, 5232 Villigen, Switzerland
| | | | - Mirko Holler
- Paul Scherrer Institut, 5232 Villigen, Switzerland
| | - Eric Lespessailles
- EA4708, Imagerie Multimodale, Multiéchelles et Modélisation du Tissu Osseux et Articulaire (I3MTO), Université d'Orléans, 45000 Orléans, France.,Département Rhumatologie, Centre Hospitalier Régional d'Orléans, 45067 Orléans, France
| | - Cameron M Kewish
- Synchrotron Soleil, L'Orme des Merisiers, 91192 Gif-sur-Yvette, France
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20
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Kawai T, Shanjani Y, Fazeli S, Behn AW, Okuzu Y, Goodman SB, Yang YP. Customized, degradable, functionally graded scaffold for potential treatment of early stage osteonecrosis of the femoral head. J Orthop Res 2018; 36:1002-1011. [PMID: 28782831 PMCID: PMC5924591 DOI: 10.1002/jor.23673] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 07/24/2017] [Indexed: 02/04/2023]
Abstract
Osteonecrosis of the femoral head (ONFH) is a debilitating disease that results in progressive collapse of the femoral head and subsequent degenerative arthritis. Few treatments provide both sufficient mechanical support and biological cues for regeneration of bone and vascularity when the femoral head is still round and therefore salvageable. We designed and 3D printed a functionally graded scaffold (FGS) made of polycaprolactone (PCL) and β-tricalcium phosphate (β-TCP) with spatially controlled porosity, degradation, and mechanical strength properties to reconstruct necrotic bone tissue in the femoral head. The FGS was designed to have low porosity segments (15% in proximal and distal segments) and a high porosity segment (60% in middle segment) according to the desired mechanical and osteoconductive properties at each specific site after implantation into the femoral head. The FGS was inserted into a bone tunnel drilled in rabbit femoral neck and head, and at 8 weeks after implantation, the tissue formation as well as scaffold degradation was analyzed. Micro-CT analysis demonstrated that the FGS-filled group had a significantly higher bone ingrowth ratio compared to the empty-tunnel group, and the difference was higher at the distal low porosity segments. The in vivo degradation rate of the scaffold was higher in the proximal and distal segments than in the middle segment. Histological analysis of both non-decalcified and calcified samples clearly indicated new bone ingrowth and bone marrow-containing bone formation across the FGS. A 3D printed PCL-β-TCP FGS appears to be a promising customized resorbable load-bearing implant for treatment of early stage ONFH. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:1002-1011, 2018.
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Affiliation(s)
- Toshiyuki Kawai
- Department of Orthopaedic Surgery, Stanford University, 300 Pasteur Drive, Stanford, 94305, California
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku Kyoto, 606-8507, Japan
| | - Yaser Shanjani
- Department of Orthopaedic Surgery, Stanford University, 300 Pasteur Drive, Stanford, 94305, California
| | - Saba Fazeli
- Department of Orthopaedic Surgery, Stanford University, 300 Pasteur Drive, Stanford, 94305, California
- Department of Mechanical Engineering, Stanford University, 440 Escondido Mall, Stanford, 94305, California
| | - Anthony W Behn
- Department of Orthopaedic Surgery, Stanford University, 300 Pasteur Drive, Stanford, 94305, California
| | - Yaichiro Okuzu
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku Kyoto, 606-8507, Japan
| | - Stuart B Goodman
- Department of Orthopaedic Surgery, Stanford University, 300 Pasteur Drive, Stanford, 94305, California
- Department of Bioengineering, Stanford University, 318 Campus Drive, Stanford, 94305, California
| | - Yunzhi P Yang
- Department of Orthopaedic Surgery, Stanford University, 300 Pasteur Drive, Stanford, 94305, California
- Department of Bioengineering, Stanford University, 318 Campus Drive, Stanford, 94305, California
- Department of Materials Science and Engineering, Stanford University, 496 Lomita Mall, Stanford, 94305, California
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21
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Lampi T, Dekker H, Ten Bruggenkate CM, Schulten EAJM, Mikkonen JJW, Koistinen A, Kullaa AM. Acid-etching technique of non-decalcified bone samples for visualizing osteocyte-lacuno-canalicular network using scanning electron microscope. Ultrastruct Pathol 2017; 42:74-79. [PMID: 29192847 DOI: 10.1080/01913123.2017.1384418] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The aim of this study was to define the acid-etching technique for bone samples embedded in polymethyl metacrylate (PMMA) in order to visualize the osteocyte lacuno-canalicular network (LCN) for scanning electron microscopy (SEM). Human jaw bone tissue samples (N = 18) were collected from the study population consisting of patients having received dental implant surgery. After collection, the bone samples were fixed in 70% ethanol and non-decalcified samples embedded routinely into polymethyl metacrylate (PMMA). The PMMA embedded specimens were acid-etched in either 9 or 37% phosphoric acid (PA) and prepared for SEM for further analysis. PMMA embedded bone specimens acid-etched by 9% PA concentration accomplishes the most informative and favorable visualization of the LCN to be observed by SEM. Etching of PMMA embedded specimens is recommendable to start with 30 s or 40 s etching duration in order to find the proper etching duration for the samples examined. Visualizing osteocytes and LCN provides a tool to study bone structure that reflects changes in bone metabolism and diseases related to bone tissue. By proper etching protocol of non-decalcified and using scanning electron microscope it is possible to visualize the morphology of osteocytes and the network supporting vitality of bone tissue.
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Affiliation(s)
- Tiina Lampi
- a Institute of Dentistry, School of Medicine, Faculty of Health Sciences , University of Eastern Finland , Kuopio, Finland
| | - Hannah Dekker
- b Department of Oral and Maxillofacial Surgery/Oral Pathology , VU University Medical Center/Academic Centre for Dentistry Amsterdam (ACTA) , Amsterdam , The Netherlands
| | - Chris M Ten Bruggenkate
- b Department of Oral and Maxillofacial Surgery/Oral Pathology , VU University Medical Center/Academic Centre for Dentistry Amsterdam (ACTA) , Amsterdam , The Netherlands
| | - Engelbert A J M Schulten
- b Department of Oral and Maxillofacial Surgery/Oral Pathology , VU University Medical Center/Academic Centre for Dentistry Amsterdam (ACTA) , Amsterdam , The Netherlands
| | - Jopi J W Mikkonen
- a Institute of Dentistry, School of Medicine, Faculty of Health Sciences , University of Eastern Finland , Kuopio, Finland.,c SIB Labs, Faculty of Science and Forestry , University of Eastern Finland , Kuopio , Finland
| | - Arto Koistinen
- c SIB Labs, Faculty of Science and Forestry , University of Eastern Finland , Kuopio , Finland
| | - Arja M Kullaa
- a Institute of Dentistry, School of Medicine, Faculty of Health Sciences , University of Eastern Finland , Kuopio, Finland.,d Research Group of Oral Health Sciences, Faculty of Medicine , University of Oulu, and Oulu University Hospital , Oulu , Finland.,e Educational Dental Clinic, Kuopio University Hospital , Kuopio , Finland
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22
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Tong X, Malo MKH, Burton IS, Jurvelin JS, Isaksson H, Kröger H. Histomorphometric and osteocytic characteristics of cortical bone in male subtrochanteric femoral shaft. J Anat 2017; 231:708-717. [PMID: 28786101 DOI: 10.1111/joa.12670] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2017] [Indexed: 12/12/2022] Open
Abstract
The histomorphometric properties of the subtrochanteric femoral region have rarely been investigated. The aim of this study was to investigate the age-associated variations and regional differences of histomorphometric and osteocytic properties in the cortical bone of the subtrochanteric femoral shaft, and the association between osteocytic and histological cortical bone parameters. Undecalcified histological sections of the subtrochanteric femoral shaft were obtained from cadavers (n = 20, aged 18-82 years, males). They were cut and stained using modified Masson-Goldner stain. Histomorphometric parameters of cortical bone were analysed with ×50 and ×100 magnification after identifying cortical bone boundaries using our previously validated method. Within cortical bone areas, only complete osteons with typical concentric lamellae and cement line were selected and measured. Osteocytic parameters of cortical bone were analyzed under phase contrast microscopy and epifluorescence within microscopic fields (0.55 mm2 for each). The cortical widths of the medial and lateral quadrants were significantly higher than other quadrants (P < 0.01). Osteonal area per cortical bone area was lower and cortical porosities were higher in the posterior quadrant than in the other quadrants (P < 0.05). Osteocyte lacunar number per cortical bone area was found higher in the young subjects (≤ 50 years) than in the older ones (> 50 years) both before and after adjustments for body height and weight (P < 0.05). Moreover, significant but low correlations were found between the cortical bone and osteocytic parameters (0.20 ≤ R2 ≤ 0.35, P < 0.05). It can be concluded that in healthy males, the cortical histomorphometric parameters differ between the anatomical regions of the subtrochanteric femoral shaft, and are correlated with the osteocytic parameters from the same site. These findings may be of use when discussing mechanisms that predispose patients to decreasing bone strength.
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Affiliation(s)
- Xiaoyu Tong
- Kuopio Musculoskeletal Research Unit (KMRU), Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.,Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Markus K H Malo
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Inari S Burton
- Kuopio Musculoskeletal Research Unit (KMRU), Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.,Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Jukka S Jurvelin
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.,Diagnostic Imaging Centre, Kuopio University Hospital, Kuopio, Finland
| | - Hanna Isaksson
- Department of Biomedical Engineering, Department of Orthopaedics, Lund University, Lund, Sweden
| | - Heikki Kröger
- Kuopio Musculoskeletal Research Unit (KMRU), Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.,Department of Orthopaedics, Traumatology, and Hand Surgery, Kuopio University Hospital, Kuopio, Finland
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23
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Gräsel M, Glüer CC, Barkmann R. Characterization of a new ultrasound device designed for measuring cortical porosity at the human tibia: A phantom study. ULTRASONICS 2017; 76:183-191. [PMID: 28107676 DOI: 10.1016/j.ultras.2017.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 12/30/2016] [Accepted: 01/02/2017] [Indexed: 06/06/2023]
Abstract
Quantitative ultrasound (QUS) measurements of trabecular bone are a useful tool for the assessment of osteoporotic fracture risk. However, cortical bone properties (e.g. porosity) have an impact on bone strength as well and thus current research is focused on QUS assessment of cortical bone properties. Simulation studies of ultrasound propagation through cortical bone indicate that anisotropy, calculated from the ratio of the velocities in axial and tangential directions, is correlated with porosity. However, this relationship is affected by error sources, specifically bone surface curvature and variability of probe positioning. With the aim of in vivo estimation of cortical porosity a new ultrasound device was developed, which sequentially measures velocities in 3 different directions (axial=0° and ±37.5°) using the axial transmission method. Measurements on planar porosity phantoms (0-25%) were performed to confirm the results of the afore mentioned simulation studies. Additionally, measurements on cylindrical phantoms without pores (min. radius=34mm for strongest curvature) were performed to estimate the influence of surface curvature on velocity measurements (the tibia bone surface is fairly flat but may show surface curvature in some patients). The velocities in the axial and ±37.5° directions were used to calculate an anisotropy index. The velocities measured on the porosity phantoms showed a decrease by -6.3±0.2m/s and -10.1±0.2m/s per percent increase in porosity in axial and ±37.5° directions, respectively. Surface curvature had an effect on the velocities measured in ±37.5° directions which could be minimized by a correction algorithm resulting in an error of 5m/s. The anisotropy index could be used to estimate porosity with an accuracy error of 1.5%. These results indicate that an estimation of porosity using velocity measurements in different directions might be feasible, even in bones with curved surface. These results obtained on phantom material indicate that the approach tested may be suited for porosity measurements on human tibia bone.
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Affiliation(s)
- M Gräsel
- Sektion Biomedizinische Bildgebung, Klinik für Radiologie und Neuroradiologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Am Botanischen Garten 14, 24118 Kiel, Germany.
| | - C-C Glüer
- Sektion Biomedizinische Bildgebung, Klinik für Radiologie und Neuroradiologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Am Botanischen Garten 14, 24118 Kiel, Germany.
| | - R Barkmann
- Sektion Biomedizinische Bildgebung, Klinik für Radiologie und Neuroradiologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Am Botanischen Garten 14, 24118 Kiel, Germany.
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24
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Eneh CTM, Malo MKH, Karjalainen JP, Liukkonen J, Töyräs J, Jurvelin JS. Effect of porosity, tissue density, and mechanical properties on radial sound speed in human cortical bone. Med Phys 2017; 43:2030. [PMID: 27147315 DOI: 10.1118/1.4942808] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE The purpose of this study was to investigate the effect of simultaneous changes in cortical porosity, tissue mineral density, and elastic properties on radial speed of sound (SOS) in cortical bone. The authors applied quantitative pulse-echo (PE) ultrasound techniques that hold much potential especially for screening of osteoporosis at primary healthcare facilities. Currently, most PE measurements of cortical thickness, a well-known indicator of fracture risk, use a predefined estimate for SOS in bone to calculate thickness. Due to variation of cortical bone porosity, the use of a constant SOS value propagates to an unknown error in cortical thickness assessment by PE ultrasound. METHODS The authors conducted 2.25 and 5.00 MHz focused PE ultrasound time of flight measurements on femoral diaphyses of 18 cadavers in vitro. Cortical porosities of the samples were determined using microcomputed tomography and related to SOS in the samples. Additionally, the effect of cortical bone porosity and mechanical properties of the calcified matrix on SOS was investigated using numerical finite difference time domain simulations. RESULTS Both experimental measurements and simulations demonstrated significant negative correlation between radial SOS and cortical porosity (R(2) ≥ 0.493, p < 0.01 and R(2) ≥ 0.989, p < 0.01, respectively). When a constant SOS was assumed for cortical bone, the error due to variation of cortical bone porosity (4.9%-16.4%) was about 6% in the cortical thickness assessment in vitro. CONCLUSIONS Use of a predefined, constant value for radial SOS in cortical bone, i.e., neglecting the effect of measured variation in cortical porosity, propagated to an error of 6% in cortical thickness. This error can be critical as characteristic cortical thinning of 1.10% ± 1.06% per yr decreases bending strength of the distal radius and results in increased fragility in postmenopausal women. Provided that the cortical porosity can be estimated in vivo, the relationship between radial SOS and cortical porosity can be utilized and a porosity based radial SOS estimate could be implemented to determine cortical thickness. This would constitute a step toward individualized quantitative ultrasound diagnostics of osteoporosis.
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Affiliation(s)
- C T M Eneh
- Department of Applied Physics, University of Eastern Finland, P.O. Box 1627, Kuopio FI-70211, Finland and Diagnostic Imaging Center, Kuopio University Hospital, P.O. Box 100, Kuopio FI-70029, Finland
| | - M K H Malo
- Department of Applied Physics, University of Eastern Finland, P.O. Box 1627, Kuopio FI-70211, Finland
| | - J P Karjalainen
- Bone Index Finland Ltd., P.O. Box 1188, Kuopio FI-70211, Finland
| | - J Liukkonen
- Department of Applied Physics, University of Eastern Finland, P.O. Box 1627, Kuopio FI-70211, Finland
| | - J Töyräs
- Department of Applied Physics, University of Eastern Finland, P.O. Box 1627, Kuopio FI-70211, Finland and Diagnostic Imaging Center, Kuopio University Hospital, P.O. Box 100, Kuopio FI-70029, Finland
| | - J S Jurvelin
- Department of Applied Physics, University of Eastern Finland, P.O. Box 1627, Kuopio FI-70211, Finland and Diagnostic Imaging Center, Kuopio University Hospital, P.O. Box 100, Kuopio FI-70029, Finland
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25
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Tong X, Burton IS, Jurvelin JS, Isaksson H, Kröger H. Iliac crest histomorphometry and skeletal heterogeneity in men. Bone Rep 2016; 6:9-16. [PMID: 28377976 PMCID: PMC5365273 DOI: 10.1016/j.bonr.2016.11.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 11/10/2016] [Accepted: 11/26/2016] [Indexed: 12/17/2022] Open
Abstract
Purpose The cortical characteristics of the iliac crest in male have rarely been investigated with quantitative histomorphometry. Also it is still unknown how cortical microarchitecture may vary between the iliac crest and fractures related sites at the proximal femur. We studied the microarchitecture of both external and internal cortices within the iliac crest, and compared the results with femoral neck and subtrochanteric femoral shaft sites. Methods Undecalcified histological sections of the iliac crest were obtained bicortically from cadavers (n = 20, aged 18–82 years, males). They were cut (7 μm) and stained using modified Masson-Goldner stain. Histomorphometric parameters of cortical bone were analysed with low (× 50) and high (× 100) magnification, after identifying cortical bone boundaries using our previously validated method. Within cortical bone area, only complete osteons with typical concentric lamellae and cement line were selected and measured. Results At the iliac crest, the mean cortical width of external cortex was higher than at the internal cortex (p < 0.001). Also, osteon structural parameters, e.g. mean osteonal perimeter, were higher in the external cortex (p < 0.05). In both external and internal cortices, pore number per cortical bone area was higher in young subjects (≤ 50 years) (p < 0.05) while mean pore perimeter was higher in the old subjects (> 50 years) (p < 0.05). Several cortical parameters (e.g. osteon area per cortical bone area, pore number per cortical area) were the lowest in the femoral neck (p < 0.05). The maximal osteonal diameter and mean wall width were the highest in the external cortex of the iliac crest (p < 0.05), and the mean cortical width, osteon number per cortical area were the highest in the subtrochanteric femoral shaft (p < 0.05). Some osteonal structural parameters (e.g. min osteonal diameter) were significantly positively correlated (0.29 ≤ R2 ≤ 0.45, p < 0.05) between the external iliac crest and the femoral neck. Conclusions This study reveals heterogeneity in cortical microarchitecture between the external and internal iliac crest cortices, as well as between the iliac crest, the femoral neck and the subtrochanteric femoral shaft. Standard iliac crest biopsy does not reflect accurately cortical microarchitecture of other skeletal sites. The structural asymmetry between cortices of the ilium remains after childhood. In both cortices of the ilium, cortical pore perimeter was higher in the old subjects. The cortical microarchitecture is highly variable between different skeletal sites. Positive correlation is revealed between the external iliac crest and the femoral neck in osteonal characteristics.
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Affiliation(s)
- Xiaoyu Tong
- Kuopio Musculoskeletal Research Unit (KMRU), Institute of Clinical Medicine, University of Eastern Finland, POB 1627, FIN-70211 Kuopio, Finland; Department of Applied Physics, University of Eastern Finland, POB 1627, FIN-70211 Kuopio, Finland
| | - Inari S Burton
- Kuopio Musculoskeletal Research Unit (KMRU), Institute of Clinical Medicine, University of Eastern Finland, POB 1627, FIN-70211 Kuopio, Finland; Department of Applied Physics, University of Eastern Finland, POB 1627, FIN-70211 Kuopio, Finland
| | - Jukka S Jurvelin
- Department of Applied Physics, University of Eastern Finland, POB 1627, FIN-70211 Kuopio, Finland; Diagnostic Imaging Centre, Kuopio University Hospital, POB 100, FIN-70029 KYS, Kuopio, Finland
| | - Hanna Isaksson
- Department of Biomedical Engineering, Department of Orthopaedics, Lund University, POB 118, SE-221 00 Lund, Sweden
| | - Heikki Kröger
- Kuopio Musculoskeletal Research Unit (KMRU), Institute of Clinical Medicine, University of Eastern Finland, POB 1627, FIN-70211 Kuopio, Finland; Department of Orthopaedics, Traumatology, and Hand Surgery, Kuopio University Hospital, POB 100, FIN-70029 KYS, Kuopio, Finland
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26
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Ostertag A, Peyrin F, Gouttenoire PJ, Laredo JD, DeVernejoul MC, Cohen Solal M, Chappard C. Multiscale and multimodality computed tomography for cortical bone analysis. Phys Med Biol 2016; 61:8553-8576. [PMID: 27845939 DOI: 10.1088/0031-9155/61/24/8553] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
In clinical studies, high resolution peripheral quantitative computed tomography (HR-pQCT) is used to separately evaluate cortical bone and trabecular bone with an isotropic voxel of 82 µm3, and typical cortical parameters are cortical density (D.comp), thickness (Ct.Th), and porosity (Ct.Po). In vitro, micro-computed tomography (micro-CT) is used to explore the internal cortical bone micro-structure with isotropic voxels and high resolution synchrotron radiation (SR); micro-CT is considered the 'gold standard'. In 16 tibias and 8 femurs, HR-pQCT measurements were compared to conventional micro-CT measurements. To test modality effects, conventional micro-CT measurements were compared to SR micro-CT measurements at 7.5 µm3; SR micro-CT measurements were also tested at different voxel sizes for the femurs, specifically, 7.5 µm3 versus 2.8 µm3. D.comp (r = -0.88, p < 10-3) was the parameter best correlated with porosity (Po.V/TV). The correlation was not affected by the removal of pores under 130 µm. Ct.Th was also significantly highly correlated (r = -0.89 p < 10-3), while Ct.Po was correlated with its counterpart Po.V/TV (r = 0.74, p < 10-3). From SR micro-CT and conventional micro-CT at 7.5 µm3 in matching areas, Po.V/TV and pore diameter were underestimated in conventional micro-CT with mean ± standard deviation (SD) biases of -2.5 ± 1.9% and -0.08 ± 0.08 mm, respectively. In contrast, pore number (Po.N) and pore separation (Po.Sp) were overestimated with mean ± SD biases of +0.03 ± 0.04 mm-1 and +0.02 ± 0.04 mm, respectively. The results from the tibia and femur were similar when the results of SR micro-CT at 7.5 µm3 and 2.8 µm3 were compared. Po.V/TV, specific surface of pores (Po.S/Po.V), and Po.N were underestimated with mean biases of -1.7 ± 0.9%, -4.6 ± 4.4 mm-1, and -0.26 ± 0.15 mm-1, respectively. In contrast, pore spacing was overestimated at 7.5 µm3 compared to 2.8 µm3 with mean biases of 0.05 ± 0.03 mm. Cortical bone measurements from HR-pQCT images provided consistent results compared to those obtained using conventional micro-CT at the distal tibia. D.comp was highly correlated to Po.V/TV because it considers both the micro-porosity (Haversian systems) and macro-porosity (resorption lacunae) of cortical bone. The complexity of canal organization, (including shape, connectivity, and surface) are not fully considered in conventional micro-CT in relation to beam hardening and cone beam reconstruction artifacts. With the exception of Po.V/TV measurements, morphological and topological measurements depend on the characteristics of the x-ray beam, and to a lesser extent, on image resolution.
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Affiliation(s)
- A Ostertag
- Bioscar U1132 Inserm-Paris Diderot University, Paris, France
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27
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Bjørnerem Å. The clinical contribution of cortical porosity to fragility fractures. BONEKEY REPORTS 2016; 5:846. [PMID: 27818743 PMCID: PMC5081000 DOI: 10.1038/bonekey.2016.77] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Accepted: 09/20/2016] [Indexed: 01/13/2023]
Abstract
Cortical bone is not compact; rather it is penetrated by many Haversian and Volkmann canals for blood supply. The lining of these canals are the intracortical bone surfaces available for bone remodeling. Increasing intracortical bone remodeling increases cortical porosity. However, cortical bone loss occurs more slowly than trabecular loss due to the fact that less surface per unit of bone matrix volume is available for bone remodeling. Nevertheless, most of the bone loss over time is cortical because cortical bone constitutes 80% of the skeleton, and the relative proportion of trabecular bone diminishes with advancing age. Higher serum levels of bone turnover markers are associated with higher cortical porosity of the distal tibia and the proximal femur. Greater porosity of the distal radius is associated with higher odds for forearm fracture, and greater porosity of the proximal femur is associated with higher odds for non-vertebral fracture in postmenopausal women. Measurement of cortical porosity contributes to fracture risk independent of areal bone mineral density and Fracture Risk Assessment Tool. On the other hand, antiresorptive treatment reduces porosity at the distal radius and at the proximal femoral shaft. Thus, porosity is a substantial determinant of the bone fragility that underlies the risk of fractures and may be a target for fracture prevention.
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Affiliation(s)
- Åshild Bjørnerem
- Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Obstetrics and Gynaecology, University Hospital of North Norway, Tromsø, Norway
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28
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Pore network microarchitecture influences human cortical bone elasticity during growth and aging. J Mech Behav Biomed Mater 2016; 63:164-173. [DOI: 10.1016/j.jmbbm.2016.05.018] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 05/11/2016] [Accepted: 05/12/2016] [Indexed: 12/30/2022]
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29
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Cooper DML, Kawalilak CE, Harrison K, Johnston BD, Johnston JD. Cortical Bone Porosity: What Is It, Why Is It Important, and How Can We Detect It? Curr Osteoporos Rep 2016; 14:187-98. [PMID: 27623679 DOI: 10.1007/s11914-016-0319-y] [Citation(s) in RCA: 80] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
There is growing recognition of the role of micro-architecture in osteoporotic bone loss and fragility. This trend has been driven by advances in imaging technology, which have enabled a transition from measures of mass to micro-architecture. Imaging trabecular bone has been a key research focus, but advances in resolution have also enabled the detection of cortical bone micro-architecture, particularly the network of vascular canals, commonly referred to as 'cortical porosity.' This review aims to provide an overview of what this level of porosity is, why it is important, and how it can be characterized by imaging. Moving beyond a 'trabeculocentric' view of bone loss holds the potential to improve diagnosis and monitoring of interventions. Furthermore, cortical porosity is intimately linked to the remodeling process, which underpins bone loss, and thus a larger potential exists to improve our fundamental understanding of bone health through imaging of both humans and animal models.
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Affiliation(s)
- D M L Cooper
- Department of Anatomy and Cell Biology, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK, Canada.
| | - C E Kawalilak
- Department of Mechanical Engineering, University of Saskatchewan, 57 Campus Drive, Saskatoon, SK, Canada
| | - K Harrison
- Department of Anatomy and Cell Biology, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK, Canada
| | - B D Johnston
- Department of Anatomy and Cell Biology, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK, Canada
| | - J D Johnston
- Department of Mechanical Engineering, University of Saskatchewan, 57 Campus Drive, Saskatoon, SK, Canada
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30
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Manhard MK, Uppuganti S, Granke M, Gochberg DF, Nyman JS, Does MD. MRI-derived bound and pore water concentrations as predictors of fracture resistance. Bone 2016; 87:1-10. [PMID: 26993059 PMCID: PMC4862893 DOI: 10.1016/j.bone.2016.03.007] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Revised: 03/04/2016] [Accepted: 03/14/2016] [Indexed: 10/22/2022]
Abstract
Accurately predicting fracture risk in the clinic is challenging because the determinants are multi-factorial. A common approach to fracture risk assessment is to combine X-ray-based imaging methods such as dual-energy X-ray absorptiometry (DXA) with an online Fracture Risk Assessment Tool (FRAX) that includes additional risk factors such as age, family history, and prior fracture incidents. This approach still does not adequately diagnose many individuals at risk, especially those with certain diseases like type 2 diabetes. As such, this study investigated bound water and pore water concentrations (Cbw and Cpw) from ultra-short echo time (UTE) magnetic resonance imaging (MRI) as new predictors of fracture risk. Ex vivo cadaveric arms were imaged with UTE MRI as well as with DXA and high-resolution micro-computed tomography (μCT), and imaging measures were compared to both whole-bone structural and material properties as determined by three-point bending tests of the distal-third radius. While DXA-derived areal bone mineral density (aBMD) and μCT-derived volumetric BMD correlated well with structural strength, they moderately correlated with the estimate material strength with gender being a significant covariate for aBMD. MRI-derived measures of Cbw and Cpw had a similar predictive ability of material strength as aBMD but did so independently of gender. In addition, Cbw was the only imaging parameter to significantly correlate with toughness, the energy dissipated during fracture. Notably, the strength of the correlations with the material properties of bone tended to be higher when a larger endosteal region was used to determine Cbw and Cpw. These results indicate that MRI measures of Cbw and Cpw have the ability to probe bone material properties independent of bone structure or subject gender. In particular, toughness is a property of fracture resistance that is not explained by X-ray based methods. Thus, these MRI-derived measures of Cbw and Cpw in cortical bone have the potential to be useful in clinical populations for evaluating fracture risk, especially involving diseases that affect material properties of the bone beyond its strength.
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Affiliation(s)
- Mary Kate Manhard
- Biomedical Engineering, Vanderbilt University, Nashville, TN, United States; Vanderbilt University Institute of Imaging Science, Vanderbilt University, Nashville, TN, United States
| | - Sasidhar Uppuganti
- Department of Orthopaedic Surgery & Rehabilitation, Vanderbilt University, Nashville, TN, United States; Tennessee Valley Healthcare System, Department of Veterans Affairs, Nashville, TN, United States; Center for Bone Biology, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Mathilde Granke
- Department of Orthopaedic Surgery & Rehabilitation, Vanderbilt University, Nashville, TN, United States; Tennessee Valley Healthcare System, Department of Veterans Affairs, Nashville, TN, United States; Center for Bone Biology, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Daniel F Gochberg
- Vanderbilt University Institute of Imaging Science, Vanderbilt University, Nashville, TN, United States; Radiology & Radiological Sciences, Vanderbilt University, Nashville, TN, United States; Department of Physics and Astronomy, Vanderbilt University, Nashville, TN, United States
| | - Jeffry S Nyman
- Biomedical Engineering, Vanderbilt University, Nashville, TN, United States; Vanderbilt University Institute of Imaging Science, Vanderbilt University, Nashville, TN, United States; Department of Orthopaedic Surgery & Rehabilitation, Vanderbilt University, Nashville, TN, United States; Tennessee Valley Healthcare System, Department of Veterans Affairs, Nashville, TN, United States; Center for Bone Biology, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Mark D Does
- Biomedical Engineering, Vanderbilt University, Nashville, TN, United States; Vanderbilt University Institute of Imaging Science, Vanderbilt University, Nashville, TN, United States; Radiology & Radiological Sciences, Vanderbilt University, Nashville, TN, United States; Electrical Engineering, Vanderbilt University, Nashville, TN, United States.
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31
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Abstract
PURPOSE OF REVIEW Trabecular bone loss and vertebral fractures are historical hallmarks of osteoporosis. During the past 70 years, this view has dominated research aiming to understand the structural basis of bone fragility. We suggest this notion needs to be revised to recognize and include the role of cortical bone deterioration as an important determinant of bone strength throughout life. RECENT FINDINGS About 80% of the fragility fractures involve the appendicular skeleton, at regions comprising large amounts of cortical bone. Up to 70% of the age-related bone loss at these locations is the result of intracortical remodeling that cavitates cortical bone producing porosity. It is now possible to accurately quantify cortical porosity in vivo and use this information to understand the pathogenesis of bone fragility throughout life, assist in identifying patients at risk for fracture, and use this as a potential marker to monitor the effects of treatment on bone structure and strength. SUMMARY Cortical bone has an important role in determining bone strength. The loss of strength is the result of intracortical and endocortical remodeling imbalance that produces cortical porosity and thinning. Studies are needed to determine whether porosity is an independent predictor of fracture risk and whether a reduction in porosity serves as a surrogate of antifracture efficacy.
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Seeman E. Growth and Age-Related Abnormalities in Cortical Structure and Fracture Risk. Endocrinol Metab (Seoul) 2015; 30:419-28. [PMID: 26394727 PMCID: PMC4722394 DOI: 10.3803/enm.2015.30.4.419] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Revised: 09/03/2015] [Accepted: 09/10/2015] [Indexed: 01/06/2023] Open
Abstract
Vertebral fractures and trabecular bone loss have dominated thinking and research into the pathogenesis and the structural basis of bone fragility during the last 70 years. However, 80% of all fractures are non-vertebral and occur at regions assembled using large amounts of cortical bone; only 20% of fractures are vertebral. Moreover, ~80% of the skeleton is cortical and ~70% of all bone loss is cortical even though trabecular bone is lost more rapidly than cortical bone. Bone is lost because remodelling becomes unbalanced after midlife. Most cortical bone loss occurs by intracortical, not endocortical remodelling. Each remodelling event removes more bone than deposited enlarging existing canals which eventually coalesce eroding and thinning the cortex from 'within.' Thus, there is a need to study the decay of cortical as well as trabecular bone, and to develop drugs that restore the strength of both types of bone. It is now possible to accurately quantify cortical porosity and trabecular decay in vivo. The challenges still to be met are to determine whether measurement of porosity identifies persons at risk for fracture, whether this approach is compliments information obtained using bone densitometry, and whether changes in cortical porosity and other microstructural traits have the sensitivity to serve as surrogates of treatment success or failure.
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Affiliation(s)
- Ego Seeman
- Division of Endocrinology, Department of Medicine, Austin Health, University of Melbourne, Melbourne, Australia.
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Perilli E, Bala Y, Zebaze R, Reynolds KJ, Seeman E. Regional Heterogeneity in the Configuration of the Intracortical Canals of the Femoral Shaft. Calcif Tissue Int 2015; 97:327-35. [PMID: 26050153 DOI: 10.1007/s00223-015-0014-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Accepted: 05/12/2015] [Indexed: 11/28/2022]
Abstract
Three-dimensional (3D) characterization of cortical porosity, most of which is under 100 µm in diameter, is usually confined to measurements made in 3-4 mm diameter cylinders of bone. We used micro-computed tomography (micro-CT) scanning of entire transaxial cross sections of human proximal femoral shafts (30-35 mm diameter) to quantify regional variation in porosity within the same scan. Complete, up to 10-mm-thick, transaxial slices of femoral upper shafts from 8 female cadavers were studied (n = 3 aged 29-37 years, n = 5 aged 72-90 years). Scanning was performed using high-resolution micro-CT (8.65 µm/voxel). Micro-CT volumes (10 × 10 × 5 mm) were selected via software in the anterior, medial and lateral regions. Images were segmented with voids appearing as 3D-interconnected canals. The percent void-to-tissue volume (Vo.V/TV) and the corresponding void surface area/TV were 86-309% higher in older than younger subjects in anterior (p = 0.034), medial (p = 0.077), and lateral aspects (p = 0.034). Although not significant, void separation was reciprocally lower by 19-39%, and void diameter was 65% larger in older than younger subjects; void number tended to be 24-25% higher medially and laterally but not anteriorly. For all specimens combined, medially there was higher Vo.V/TV and void surface area/TV than anteriorly (+48%, p = 0.018; +33%, p = 0.018) and laterally (+56%, p = 0.062; +36%, p = 0.043). There is regional heterogeneity in the 3D microarchitecture of the intracortical canals of the femoral shaft. The higher void volume in advanced age appears to be due to larger, rather than more, pores. However, creation of new canals from existing canals may contribute, depending on the location. High-resolution micro-computed tomography scanning of entire bone segments enables quantification of the 3D microanatomy of the intracortical void network at multiple locations.
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Affiliation(s)
- Egon Perilli
- Medical Device Research Institute, School of Computer Science, Engineering and Mathematics, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia.
| | - Yohann Bala
- Department of Endocrinology, Austin Health, University of Melbourne, Melbourne, VIC, Australia
| | - Roger Zebaze
- Department of Endocrinology, Austin Health, University of Melbourne, Melbourne, VIC, Australia
| | - Karen J Reynolds
- Medical Device Research Institute, School of Computer Science, Engineering and Mathematics, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | - Ego Seeman
- Departments of Endocrinology and Medicine, Austin Health, University of Melbourne, Melbourne, VIC, Australia
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34
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Cole JM, Wood JC, Lopes NC, Poder K, Abel RL, Alatabi S, Bryant JSJ, Jin A, Kneip S, Mecseki K, Symes DR, Mangles SPD, Najmudin Z. Laser-wakefield accelerators as hard x-ray sources for 3D medical imaging of human bone. Sci Rep 2015; 5:13244. [PMID: 26283308 PMCID: PMC5289072 DOI: 10.1038/srep13244] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Accepted: 07/20/2015] [Indexed: 12/22/2022] Open
Abstract
A bright μm-sized source of hard synchrotron x-rays (critical energy Ecrit > 30 keV) based on the betatron oscillations of laser wakefield accelerated electrons has been developed. The potential of this source for medical imaging was demonstrated by performing micro-computed tomography of a human femoral trabecular bone sample, allowing full 3D reconstruction to a resolution below 50 μm. The use of a 1 cm long wakefield accelerator means that the length of the beamline (excluding the laser) is dominated by the x-ray imaging distances rather than the electron acceleration distances. The source possesses high peak brightness, which allows each image to be recorded with a single exposure and reduces the time required for a full tomographic scan. These properties make this an interesting laboratory source for many tomographic imaging applications.
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Affiliation(s)
- J M Cole
- The John Adams Institute for Accelerator Science, Blackett Laboratory, Imperial College London, London SW7 2BZ, UK
| | - J C Wood
- The John Adams Institute for Accelerator Science, Blackett Laboratory, Imperial College London, London SW7 2BZ, UK
| | - N C Lopes
- 1] The John Adams Institute for Accelerator Science, Blackett Laboratory, Imperial College London, London SW7 2BZ, UK [2] GoLP, Instituto de Plasmas e Fusão Nuclear, Instituto Superior Técnico, Universidade de Lisboa, 1049-001, Portugal
| | - K Poder
- The John Adams Institute for Accelerator Science, Blackett Laboratory, Imperial College London, London SW7 2BZ, UK
| | - R L Abel
- Department of Surgery and Cancer, MSk Laboratory, Charing Cross Hospital, Imperial College London, London W6 8RF, UK
| | - S Alatabi
- The John Adams Institute for Accelerator Science, Blackett Laboratory, Imperial College London, London SW7 2BZ, UK
| | - J S J Bryant
- The John Adams Institute for Accelerator Science, Blackett Laboratory, Imperial College London, London SW7 2BZ, UK
| | - A Jin
- Department of Mechanical Engineering, City and Guilds Building, Imperial College London, London SW7 2AZ, UK
| | - S Kneip
- The John Adams Institute for Accelerator Science, Blackett Laboratory, Imperial College London, London SW7 2BZ, UK
| | - K Mecseki
- The John Adams Institute for Accelerator Science, Blackett Laboratory, Imperial College London, London SW7 2BZ, UK
| | - D R Symes
- Central Laser Facility, Rutherford Appleton Laboratory, Didcot OX11 0QX, UK
| | - S P D Mangles
- The John Adams Institute for Accelerator Science, Blackett Laboratory, Imperial College London, London SW7 2BZ, UK
| | - Z Najmudin
- The John Adams Institute for Accelerator Science, Blackett Laboratory, Imperial College London, London SW7 2BZ, UK
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35
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Nirody JA, Cheng KP, Parrish RM, Burghardt AJ, Majumdar S, Link TM, Kazakia GJ. Spatial distribution of intracortical porosity varies across age and sex. Bone 2015; 75:88-95. [PMID: 25701139 PMCID: PMC4454740 DOI: 10.1016/j.bone.2015.02.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2014] [Revised: 01/15/2015] [Accepted: 02/06/2015] [Indexed: 11/25/2022]
Abstract
Cortical bone porosity is a major determinant of strength, stiffness, and fracture toughness of cortical tissue. The goal of this work was to investigate changes in spatial distribution and microstructure of cortical porosity associated with aging in men and women. The specific aims were to: 1) develop an automated technique for spatial analysis of cortical microstructure based on HR-pQCT data, and; 2) apply this technique to explore sex- and age-specific spatial distribution and microstructure of porosity within the cortex. We evaluated HR-pQCT images of the distal tibia from a cross-sectional cohort of 145 individuals, characterizing detectable pores as being in the endosteal, midcortical, or periosteal layers of the cortex. Metrics describing porosity, pore number, and pore size were quantified within each layer and compared across sexes, age groups, and cortical layers. The elderly cohort (65-78 years, n=22) displayed higher values than the young cohort (20-29 years, n=29) for all parameters both globally and within each layer. While all three layers displayed significant age-related porosity increases, the greatest difference in porosity between the young and elderly cohort was in the midcortical layer (+344%, p<0.001). Similarly, the midcortical layer reflected the greatest differences between young and elderly cohorts in both pore number (+243%, p<0.001) and size (+28%, p<0.001). Females displayed greater age-related changes in porosity and pore number than males. Females and males displayed comparable small to non-significant changes with age in pore size. In summary, considerable variability exists in the spatial distribution of detectable cortical porosity at the distal tibia, and this variability is dependent on age and sex. Intracortical pore distribution analysis may ultimately provide insight into both mechanisms of pore network expansion and biomechanical consequences of pore distribution.
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Affiliation(s)
- Jasmine A Nirody
- Biophysics Graduate Group, University of California, Berkeley, CA, USA.
| | - Karen P Cheng
- Musculoskeletal Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA; Department of Bioengineering, University of California, Berkeley, CA.
| | - Robin M Parrish
- Musculoskeletal Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA.
| | - Andrew J Burghardt
- Musculoskeletal Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA.
| | - Sharmila Majumdar
- Musculoskeletal Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA.
| | - Thomas M Link
- Musculoskeletal Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA.
| | - Galateia J Kazakia
- Musculoskeletal Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA.
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36
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Tong X, Burton IS, Isaksson H, Jurvelin JS, Kröger H. Cortical bone histomorphometry in male femoral neck: the investigation of age-association and regional differences. Calcif Tissue Int 2015; 96:295-306. [PMID: 25646589 DOI: 10.1007/s00223-015-9957-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Accepted: 01/06/2015] [Indexed: 11/28/2022]
Abstract
Low bone volume and changes in bone quality or microarchitecture may predispose individuals to fragility fractures. As the dominant component of the human skeleton, cortical bone plays a key role in protecting bones from fracture. However, histological investigations of the underlying structural changes, which might predispose to fracture, have been largely limited to the cancellous bone. The aim of this study was to investigate the age-association and regional differences of histomorphometric properties in the femoral neck cortical bone. Undecalcified histological sections of the femoral neck (n = 20, aged 18-82 years, males) were cut (15 μm) and stained using modified Masson-Goldner stain. Complete femoral neck images were scanned, and cortical bone boundaries were defined using our previously established method. Cortical bone histomorphometry was performed with low (×50) and high magnification (×100). Most parameters related to cortical width (Mean Ct.Wi, Inferior Ct.Wi, Superior Ct.Wi) were negatively associated with age both before and after adjustment for height. The inferior cortex was the thickest (P < 0.001) and the superior cortex was the thinnest (P < 0.008) of all cortical regions. Both osteonal size and pores area were negatively associated with age. Osteonal area and number were higher in the antero-inferior area (P < 0.002) and infero-posterior area (P = 0.002) compared to the postero-superior area. The Haversian canal area was higher in the infero-posterior area compared to the postero-superior area (P = 0.002). Moreover, porosity was higher in the antero-superior area (P < 0.002), supero-anterior area (P < 0.002) and supero-posterior area (P < 0.002) compared to the infero-anterior area. Eroded endocortical perimeter (E.Pm/Ec.Pm) correlated positively with superior cortical width. This study describes the changes in cortical bone during ageing in healthy males. Further studies are needed to investigate whether these changes explain the increased susceptibility to femoral neck fractures.
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Affiliation(s)
- Xiaoyu Tong
- Bone and Cartilage Research Unit (BCRU), Institute of Clinical Medicine, University of Eastern Finland, POB 1627, 70211, Kuopio, Finland,
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37
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Tong XY, Malo M, Tamminen IS, Isaksson H, Jurvelin JS, Kröger H. Development of new criteria for cortical bone histomorphometry in femoral neck: intra- and inter-observer reproducibility. J Bone Miner Metab 2015; 33:109-18. [PMID: 24570270 DOI: 10.1007/s00774-014-0562-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Accepted: 12/24/2013] [Indexed: 10/25/2022]
Abstract
Histomorphometry is commonly applied to study bone remodeling. Histological definitions of cortical bone boundaries have not been consistent. In this study, new criteria for specific definition of the transitional zone between the cortical and cancellous bone in the femoral neck were developed. The intra- and inter-observer reproducibility of this method was determined by quantitative histomorphometry and areal overlapping analysis. The undecalcified histological sections of femoral neck specimens (n = 6; from men aged 17-59 years) were processed and scanned to acquire histological images of complete bone sections. Specific criteria were applied to define histological boundaries. "Absolute cortex area" consisted of pure cortical bone tissue only, and was defined mainly based on the size of composite canals and their distance to an additional "guide" boundary (so-called "preliminary cortex boundary," the clear demarcation line of density between compact cortex and sparse trabeculae). Endocortical bone area was defined by recognizing characteristic endocortical structures adjacent to the preliminary cortical boundary. The present results suggested moderate to high reproducibility for low-magnification parameters (e.g., cortical bone area). The coefficient of variation (CV %) ranged from 0.02 to 5.61 in the intra-observer study and from 0.09 to 16.41 in the inter-observer study. However, the intra-observer reproducibility of some high-magnification parameters (e.g., osteoid perimeter/endocortical perimeter) was lower (CV %, 0.33-87.9). The overlapping of three histological areas in repeated analyses revealed highest intra- and inter-observer reproducibility for the absolute cortex area. This study provides specific criteria for the definition of histological boundaries for femoral neck bone specimens, which may aid more precise cortical bone histomorphometry.
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Affiliation(s)
- Xiao-Yu Tong
- Bone and Cartilage Research Unit (BCRU), Institute of Clinical Medicine, University of Eastern Finland, POB 1627, 70211, Kuopio, Finland,
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38
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Zebaze R, Seeman E. Cortical bone: a challenging geography. J Bone Miner Res 2015; 30:24-9. [PMID: 25431247 DOI: 10.1002/jbmr.2419] [Citation(s) in RCA: 104] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Revised: 11/18/2014] [Accepted: 11/22/2014] [Indexed: 12/25/2022]
Affiliation(s)
- Roger Zebaze
- Departments of Endocrinology and Medicine, Austin Health, University of Melbourne, Melbourne, Australia
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39
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Chen H, Kubo KY. Bone three-dimensional microstructural features of the common osteoporotic fracture sites. World J Orthop 2014; 5:486-495. [PMID: 25232524 PMCID: PMC4133454 DOI: 10.5312/wjo.v5.i4.486] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Revised: 04/03/2014] [Accepted: 06/03/2014] [Indexed: 02/06/2023] Open
Abstract
Osteoporosis is a common metabolic skeletal disorder characterized by decreased bone mass and deteriorated bone structure, leading to increased susceptibility to fractures. With aging population, osteoporotic fractures are of global health and socioeconomic importance. The three-dimensional microstructural information of the common osteoporosis-related fracture sites, including vertebra, femoral neck and distal radius, is a key for fully understanding osteoporosis pathogenesis and predicting the fracture risk. Low vertebral bone mineral density (BMD) is correlated with increased fracture of the spine. Vertebral BMD decreases from cervical to lumbar spine, with the lowest BMD at the third lumbar vertebra. Trabecular bone mass of the vertebrae is much lower than that of the peripheral bone. Cancellous bone of the vertebral body has a complex heterogeneous three-dimensional microstructure, with lower bone volume in the central and anterior superior regions. Trabecular bone quality is a key element to maintain the vertebral strength. The increased fragility of osteoporotic femoral neck is attributed to low cancellous bone volume and high compact porosity. Compared with age-matched controls, increased cortical porosity is observed at the femoral neck in osteoporotic fracture patients. Distal radius demonstrates spatial inhomogeneous characteristic in cortical microstructure. The medial region of the distal radius displays the highest cortical porosity compared with the lateral, anterior and posterior regions. Bone strength of the distal radius is mainly determined by cortical porosity, which deteriorates with advancing age.
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40
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Tjong W, Nirody J, Burghardt AJ, Carballido-Gamio J, Kazakia GJ. Structural analysis of cortical porosity applied to HR-pQCT data. Med Phys 2014; 41:013701. [PMID: 24387533 DOI: 10.1118/1.4851575] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE The investigation of cortical porosity is an important aspect of understanding biological, pathoetiological, and biomechanical processes occurring within the skeleton. With the emergence of HR-pQCT as a noninvasive tool suitable for clinical use, cortical porosity at appendicular sites can be directly visualized in vivo. The aim of this study was to introduce a novel topological analysis of the cortical pore network for HR-pQCT data and determine the influence of resolution on measures of cortical pore network microstructure and topology. METHODS Cadaveric radii were scanned using HR-pQCT at two different voxel sizes (41 and 82 μm) and also using μCT at a voxel size of 18 μm. HR-pQCT and μCT image sets were spatially coregistered. Segmentation and quantification of cortical porosity (Ct.Po) and mean pore diameter (Ct.Po.Dm) were achieved using an established extended cortical analysis technique. Topological classification of individual pores was performed using topology-preserving skeletonization and multicolor dilation algorithms. Based on the pore skeleton topological classification, the following parameters were quantified: total number of planar surface-skeleton canals (N.Slabs), tubular curve-skeleton canals (N.Tubes), and junction elements (N.Junctions), mean slab volume (Slab.Vol), mean tube volume (Tube.Vol), mean slab orientation (Slab.θ), mean tube orientation (Tube.θ), N.Slabs/N.Tubes, and integral (total) slab volume/integral tube volume (iSlab.Vol/iTube.Vol). An in vivo reproducibility study was also conducted to assess short-term precision of the topology parameters. Precision error was characterized using root mean square coefficient of variation (RMSCV%). RESULTS Correlations to μCT values for Ct.Po were significant for both the 41 and 82 μm HR-pQCT data (41: r(2) = 0.82, p < 0.001, 82: r(2) = 0.75, p < 0.001). For Ct.Po.Dm, only the 41 μm data were significantly predictive of μCT values (r(2) = 0.72, p < 0.01) Data at both HR-pQCT voxel sizes were strongly predictive of the μCT values for N.Slabs (41: r(2) = 0.93, p < 0.001; 82: r(2) = 0.84, p < 0.001), N.Tubes (41: r(2) = 0.94, p < 0.001; 82: r(2) = 0.84, p < 0.001), and N.Junctions (41: r(2) = 0.93, p < 0.001; 82: r(2) = 0.78, p < 0.001), though proportional bias was evident in these correlations. Weak correlations were seen for iSlab.Vol/iTube.Vol at both voxel sizes (41: r(2) = 0.52, p < 0.01; 82: r(2) = 0.39, p < 0.05). Slab.Vol was significantly correlated to μCT data at 41 μm (r(2) = 0.60, p < 0.01) but not at 82 μm, while Tube.Vol was significantly correlated at both voxel sizes (41: r(2) = 0.79, p < 0.001; 82: r(2) = 0.68, p < 0.01). In vivo precision error for these parameters ranged from 2.31 to 9.68 RMSCV%. CONCLUSIONS Strong correlations between μCT- and HR-pQCT-derived measurements were found, particularly in HR-pQCT images obtained at 41 μm. These data are in agreement with our previous study investigating the effect of voxel size on standard HR-pQCT metrics of trabecular and cortical microstructure, and extend our previous findings to include topological descriptors of the cortical pore network.
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Affiliation(s)
- Willy Tjong
- Musculoskeletal Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California, San Francisco, California 94107
| | - Jasmine Nirody
- Musculoskeletal Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California, San Francisco, California 94107
| | - Andrew J Burghardt
- Musculoskeletal Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California, San Francisco, California 94107
| | - Julio Carballido-Gamio
- Musculoskeletal Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California, San Francisco, California 94107
| | - Galateia J Kazakia
- Musculoskeletal Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California, San Francisco, California 94107
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41
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Bala Y, Zebaze R, Ghasem-Zadeh A, Atkinson EJ, Iuliano S, Peterson JM, Amin S, Bjørnerem Å, Melton LJ, Johansson H, Kanis JA, Khosla S, Seeman E. Cortical porosity identifies women with osteopenia at increased risk for forearm fractures. J Bone Miner Res 2014; 29:1356-62. [PMID: 24519558 PMCID: PMC4156822 DOI: 10.1002/jbmr.2167] [Citation(s) in RCA: 146] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Revised: 12/09/2013] [Accepted: 12/11/2013] [Indexed: 11/10/2022]
Abstract
Most fragility fractures arise among the many women with osteopenia, not the smaller number with osteoporosis at high risk for fracture. Thus, most women at risk for fracture assessed only by measuring areal bone mineral density (aBMD) will remain untreated. We measured cortical porosity and trabecular bone volume/total volume (BV/TV) of the ultradistal radius (UDR) using high-resolution peripheral quantitative computed tomography, aBMD using densitometry, and 10-year fracture probability using the country-specific fracture risk assessment tool (FRAX) in 68 postmenopausal women with forearm fractures and 70 age-matched community controls in Olmsted County, MN, USA. Women with forearm fractures had 0.4 standard deviations (SD) higher cortical porosity and 0.6 SD lower trabecular BV/TV. Compact-appearing cortical porosity predicted fracture independent of aBMD; odds ratio (OR) = 1.92 (95% confidence interval [CI] 1.10–3.33). In women with osteoporosis at the UDR, cortical porosity did not distinguish those with fractures from those without because high porosity was present in 92% and 86% of each group, respectively. By contrast, in women with osteopenia at the UDR, high porosity of the compact-appearing cortex conferred an OR for fracture of 4.00 (95% CI 1.15–13.90). In women with osteoporosis, porosity is captured by aBMD, so measuring UDR cortical porosity does not improve diagnostic sensitivity. However, in women with osteopenia, cortical porosity was associated with forearm fractures.
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42
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Ostertag A, Peyrin F, Fernandez S, Laredo JD, de Vernejoul MC, Chappard C. Cortical measurements of the tibia from high resolution peripheral quantitative computed tomography images: a comparison with synchrotron radiation micro-computed tomography. Bone 2014; 63:7-14. [PMID: 24582804 DOI: 10.1016/j.bone.2014.02.009] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Revised: 02/18/2014] [Accepted: 02/18/2014] [Indexed: 10/25/2022]
Abstract
High resolution-peripheral quantitative computed tomography (HR-pQCT) measurements are carried out in clinical research protocols to analyze cortical bone. Micro-computed tomography (micro-CT) is a standard tool for ex vivo examination of bone in 3D. The aim of this work was to evaluate cortical measurements derived from HR-pQCT images compared to those from synchrotron radiation (SR) micro-CT in a distal position (4.2 cm from the distal pilon). Twenty-nine tibia specimens were scanned with HR-pQCT using protocols provided by the manufacturer. The standard measured outcomes included volumetric bone density (gHA/cm(3)) of the cortical region (Dcomp), and the cortical thickness (Ct.Th, mm). New features, such as cortical porosity (Ct.Po) and mean pore diameter (Ct.Po.Dm), were measured by an auto-contouring process. All tibias were harvested from the posterior region and imaged with SR micro-CT (voxel size=7.5 μm). The cortical thickness, (Ct.Thmicro-CT), porosity (PoV/TV), pore diameter, pore spacing, pore number, and degree of mineralization of bone (DMB) were obtained for SR micro-CT images. For standard measurements on HR-pQCT images, site matched analyses with micro-CT were completed to obtain Dcomplocal and Ct.Thlocal. Dcomp was highly correlated to PoV/TV (r=-0.84, p<10(-4)) but not to DMB. Dcomplocal was correlated to PoV/TV (r=-0.72, p<10(-4)) and to DMB (r=0.40, p>0.05). Ct.Thlocal and Ct.Thmicro-CT were moderately correlated (r=0.53, p<0.01). Ct.Th and Ct.Po results from the autocontouring process are influenced by the level of trabecularization of the cortical bone and need manual correction of the endosteal contour. Distal tibia is a reliable region to study cortical bone with Dcomp as the best parameter because it reflects both the micro-porosity (Havers canals) and macro-porosity (resorption lacunae) of the cortical bone.
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Affiliation(s)
- Agnès Ostertag
- INSERM 606 University Paris Diderot, PRES Sorbonne Paris Cité, 75010 Paris France
| | - Françoise Peyrin
- CREATIS, INSERM U1044, CNRS 5220, Université de Lyon, 69621 Villeurbanne Cedex, France; ESRF, X-ray Imaging Group, 38043 Grenoble Cedex, France
| | - Sylvie Fernandez
- INSERM 606 University Paris Diderot, PRES Sorbonne Paris Cité, 75010 Paris France
| | - Jean Denis Laredo
- B2OA, UMR CNRS7052, University Denis Diderot, PRES Sorbonne Paris Cité, 75010 Paris, France
| | | | - Christine Chappard
- B2OA, UMR CNRS7052, University Denis Diderot, PRES Sorbonne Paris Cité, 75010 Paris, France.
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Milovanovic P, Rakocevic Z, Djonic D, Zivkovic V, Hahn M, Nikolic S, Amling M, Busse B, Djuric M. Nano-structural, compositional and micro-architectural signs of cortical bone fragility at the superolateral femoral neck in elderly hip fracture patients vs. healthy aged controls. Exp Gerontol 2014; 55:19-28. [PMID: 24614625 DOI: 10.1016/j.exger.2014.03.001] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Revised: 02/18/2014] [Accepted: 03/02/2014] [Indexed: 12/13/2022]
Abstract
To unravel the origins of decreased bone strength in the superolateral femoral neck, we assessed bone structural features across multiple length scales at this cortical fracture initiating region in postmenopausal women with hip fracture and in aged-matched controls. Our combined methodological approach encompassed atomic force microscopy (AFM) characterization of cortical bone nano-structure, assessment of mineral content/distribution via quantitative backscattered electron imaging (qBEI), measurement of bone material properties by reference point indentation, as well as evaluation of cortical micro-architecture and osteocyte lacunar density. Our findings revealed a wide range of differences between the fracture group and the controls, suggesting a number of detrimental changes at various levels of cortical bone hierarchical organization that may render bone fragile. Namely, mineral crystals at external cortical bone surfaces of the fracture group were larger (65.22nm±41.21nm vs. 36.75nm±18.49nm, p<0.001), and a shift to a higher mineral content and more homogenous mineralization profile as revealed via qBEI were found in the bone matrix of the fracture group. Fracture cases showed nearly 35% higher cortical porosity and showed significantly reduced osteocyte lacunar density compared to controls (226±27 vs. 247±32#/mm(2), p=0.05). Along with increased crystal size, a shift towards higher mineralization and a tendency to increased cortical porosity and reduced osteocyte lacunar number delineate that cortical bone of the superolateral femoral neck bears distinct signs of fragility at various levels of its structural organization. These results contribute to the understanding of hierarchical bone structure changes in age-related fragility.
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Affiliation(s)
- Petar Milovanovic
- Laboratory for Anthropology, Institute of Anatomy, School of Medicine, University of Belgrade, 4/2 Dr Subotica, 11000 Belgrade, Serbia; Department of Osteology & Biomechanics, University Medical Center Hamburg-Eppendorf, 59 Lottestr., D-22529 Hamburg, Germany.
| | - Zlatko Rakocevic
- Laboratory for Atomic Physics, Institute of Nuclear Sciences Vinca, University of Belgrade, 11001 Belgrade, Serbia.
| | - Danijela Djonic
- Laboratory for Anthropology, Institute of Anatomy, School of Medicine, University of Belgrade, 4/2 Dr Subotica, 11000 Belgrade, Serbia.
| | - Vladimir Zivkovic
- Institute of Forensic Medicine, School of Medicine, University of Belgrade, 31a Deligradska, 11000 Belgrade, Serbia.
| | - Michael Hahn
- Department of Osteology & Biomechanics, University Medical Center Hamburg-Eppendorf, 59 Lottestr., D-22529 Hamburg, Germany.
| | - Slobodan Nikolic
- Institute of Forensic Medicine, School of Medicine, University of Belgrade, 31a Deligradska, 11000 Belgrade, Serbia.
| | - Michael Amling
- Department of Osteology & Biomechanics, University Medical Center Hamburg-Eppendorf, 59 Lottestr., D-22529 Hamburg, Germany.
| | - Bjoern Busse
- Department of Osteology & Biomechanics, University Medical Center Hamburg-Eppendorf, 59 Lottestr., D-22529 Hamburg, Germany.
| | - Marija Djuric
- Laboratory for Anthropology, Institute of Anatomy, School of Medicine, University of Belgrade, 4/2 Dr Subotica, 11000 Belgrade, Serbia.
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Mathieu V, Chappard C, Vayron R, Michel A, Haïat G. Radial anatomic variation of ultrasonic velocity in human cortical bone. ULTRASOUND IN MEDICINE & BIOLOGY 2013; 39:2185-2193. [PMID: 23969161 DOI: 10.1016/j.ultrasmedbio.2013.06.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2012] [Revised: 05/03/2013] [Accepted: 06/06/2013] [Indexed: 06/02/2023]
Abstract
Quantitative ultrasound techniques can be used to retrieve cortical bone quality. The aim of this study was to investigate the anatomic variations in speed of sound (SOS) in the radial direction of cortical bone tissue. SOS measurements were realized in 17 human cortical bone samples with a 3.5-MHz transverse transmission device. The radial dependence of SOS was investigated in a direction perpendicular to the periosteum. For each sample, bone porosity was measured using an X-ray micro-computed tomography device. The mean SOS was 3586 ± 255 m/s. For 16 of 17 specimens, similar radial variations in SOS were observed. In the periosteal region, SOS first decreased in the direction of the endosteum and reached a minimum value approximately in the middle of the cortical bone. SOS then increased, moving to the endosteal region. A significant negative correlation was obtained between SOS and porosity (R = -0.54, p = 0.02).
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Affiliation(s)
- Vincent Mathieu
- CNRS, Laboratoire Modélisation et Simulation Multi-Échelle, UMR CNRS 8208, Créteil, France
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Malo MKH, Rohrbach D, Isaksson H, Töyräs J, Jurvelin JS, Tamminen IS, Kröger H, Raum K. Longitudinal elastic properties and porosity of cortical bone tissue vary with age in human proximal femur. Bone 2013; 53:451-8. [PMID: 23334084 DOI: 10.1016/j.bone.2013.01.015] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2012] [Revised: 01/08/2013] [Accepted: 01/10/2013] [Indexed: 11/26/2022]
Abstract
Tissue level structural and mechanical properties are important determinants of bone strength. As an individual ages, microstructural changes occur in bone, e.g., trabeculae and cortex become thinner and porosity increases. However, it is not known how the elastic properties of bone change during aging. Bone tissue may lose its elasticity and become more brittle and prone to fractures as it ages. In the present study the age-dependent variation in the spatial distributions of microstructural and microelastic properties of the human femoral neck and shaft were evaluated by using acoustic microscopy. Although these properties may not be directly measured in vivo, there is a major interest to investigate their relationships with the linear elastic measurements obtained by diagnostic ultrasound at the most severe fracture sites, e.g., the femoral neck. However, before the validity of novel in vivo techniques can be established, it is essential to understand the age-dependent variation in tissue elastic properties and porosity at different skeletal sites. A total of 42 transverse cross-sectional bone samples were obtained from the femoral neck (Fn) and proximal femoral shaft (Ps) of 21 men (mean±SD age 47.1±17.8, range 17-82years). Samples were quantitatively imaged using a scanning acoustic microscope (SAM) equipped with a 50MHz ultrasound transducer. Distributions of the elastic coefficient (c33) of cortical (Ct) and trabecular (Tr) tissues and microstructure of cortex (cortical thickness Ct.Th and porosity Ct.Po) were determined. Variations in c33 were observed with respect to tissue type (c33Tr<c33Ct), location (c33(Ct.Ps)=37.7GPa>c33(Ct.Fn)=35.3GPa>c33(Tr.Ps)=33.8GPa>c33(Tr.Fn)=31.9GPa), and cadaver age (R(2)=0.28-0.46, p<0.05). Regional variations in porosity were found in the neck (superior 13.1%; inferior 6.1%; anterior 10.1%; posterior 8.6%) and in the shaft (medial 9.5%; lateral 7.7%; anterior 8.6%; posterior 12.0%). In conclusion, significant variations in elastic coefficients were detected between femoral neck and shaft as well as between the quadrants of the cross-sections of neck and shaft. Moreover, an age-related increase in cortical porosity and a stiffening of the bone tissue were observed. These findings may explain in part the increase in susceptibility to suffer low energy fractures during aging and highlight the potential of ultrasound in clinical osteoporosis diagnostics.
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Affiliation(s)
- M K H Malo
- Department of Applied Physics, University of Eastern Finland, POB 1627, FI-70211, Kuopio, Finland.
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Chen H, Zhou X, Fujita H, Onozuka M, Kubo KY. Age-related changes in trabecular and cortical bone microstructure. Int J Endocrinol 2013; 2013:213234. [PMID: 23573086 PMCID: PMC3614119 DOI: 10.1155/2013/213234] [Citation(s) in RCA: 157] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2012] [Accepted: 02/14/2013] [Indexed: 12/20/2022] Open
Abstract
The elderly population has substantially increased worldwide. Aging is a complex process, and the effects of aging are myriad and insidious, leading to progressive deterioration of various organs, including the skeleton. Age-related bone loss and resultant osteoporosis in the elderly population increase the risk for fractures and morbidity. Osteoporosis is one of the most common conditions associated with aging, and age is an independent risk factor for osteoporotic fractures. With the development of noninvasive imaging techniques such as computed tomography (CT), micro-CT, and high resolution peripheral quantitative CT (HR-pQCT), imaging of the bone architecture provides important information about age-related changes in bone microstructure and estimates of bone strength. In the past two decades, studies of human specimens using imaging techniques have revealed decreased bone strength in older adults compared with younger adults. The present paper addresses recently studied age-related changes in trabecular and cortical bone microstructure based primarily on HR-pQCT and micro-CT. We specifically focus on the three-dimensional microstructure of the vertebrae, femoral neck, and distal radius, which are common osteoporotic fracture sites.
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Affiliation(s)
- Huayue Chen
- Department of Anatomy, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu 501-1194, Japan
- *Huayue Chen:
| | - Xiangrong Zhou
- Department of Intelligent Image Information, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu 501-1194, Japan
| | - Hiroshi Fujita
- Department of Intelligent Image Information, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu 501-1194, Japan
| | - Minoru Onozuka
- Nittai Jusei Medical College for Judo Therapeutics, 2-2-7 Yoga, Setagaya-ku, Tokyo 158-0097, Japan
| | - Kin-Ya Kubo
- Seijoh University Graduate School of Health Care Studies, 2-172 Fukinodai, Tokai, Aichi 476-8588, Japan
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