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Chen M, Gerges M, Raynor WY, Park PSU, Nguyen E, Chan DH, Gholamrezanezhad A. State of the Art Imaging of Osteoporosis. Semin Nucl Med 2024; 54:415-426. [PMID: 38087745 DOI: 10.1053/j.semnuclmed.2023.10.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 10/24/2023] [Accepted: 10/24/2023] [Indexed: 05/18/2024]
Abstract
Osteoporosis is a common disease, particularly prevalent in geriatric populations, which causes significant worldwide morbidity due to increased bone fragility and fracture risk. Currently, the gold-standard modality for diagnosis and evaluation of osteoporosis progression and treatment relies on dual-energy x-ray absorptiometry (DXA), which measures bone mineral density (BMD) and calculates a score based upon standard deviation of measured BMD from the mean. However, other imaging modalities can also be used to evaluate osteoporosis. Here, we review historical as well as current research into development of new imaging modalities that can provide more nuanced or opportunistic analyses of bone quality, turnover, and density that can be helpful in triaging severity and determining treatment success in osteoporosis. We discuss the use of opportunistic computed tomography (CT) scans, as well as the use of quantitative CT to help determine fracture risk and perform more detailed bone quality analysis than would be allowed by DXA . Within magnetic resonance imaging (MRI), new developments include the use of advanced MRI techniques such as quantitative susceptibility mapping (QSM), magnetic resonance spectroscopy, and chemical shift encoding-based water-fat MRI (CSE-MRI) to enable clinicians improved assessment of nonmineralized bone compartments as well as a way to longitudinally assess bone quality without the repeated exposure to ionizing radiation. Within ultrasound, development of quantitative ultrasound shows promise particularly in future low-cost, broadly available screening tools. We focus primarily on historical and recent developments within radiotracer use as applicable to osteoporosis, particularly in the use of hybrid methods such as NaF-PET/CT, wherein patients with osteoporosis show reduced uptake of radiotracers such as NaF. Use of radiotracers may provide clinicians with even earlier detection windows for osteoporosis than would traditional biomarkers. Given the metabolic nature of this disease, current investigation into the role molecular imaging can play in the prediction of this disease as well as in replacing invasive diagnostic procedures shows particular promise.
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Affiliation(s)
- Michelle Chen
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Maria Gerges
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA; Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL
| | - William Y Raynor
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA; Department of Radiology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Peter Sang Uk Park
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA; Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Edward Nguyen
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - David H Chan
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Ali Gholamrezanezhad
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA.
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Qin M, Gao Y, Zhang M, Wu J, Liu Y, Jiang Y, Zhang X, Wang X, Yang Y, Gao Y. Association between ADAMTS14_rs4747096 gene polymorphism and bone mineral density of Chinese Han population residing in fluorine exposed areas in ShanXi Province, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:106059-106067. [PMID: 37725302 DOI: 10.1007/s11356-023-29698-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 08/31/2023] [Indexed: 09/21/2023]
Abstract
This study aimed to investigate the effects of fluorine and ADAMTS14_rs4747096 on bone mineral density (BMD). The survey was explored in a cross-sectional case-control study conducted in Shanxi, China. The BMD was measured by an ultrasonic bone mineral density instrument. The urine fluoride concentration was detected using the fluoride ion electrode. ADAMTS14_rs4747096 polymorphism was examined by multiplex polymerase chain reaction (PCR) and sequencing. The multinomial logistic regressions found that the urine fluoride was a risk factor for osteopenia (OR = 1.379, 95% CI: 1.127-1.687, P = 0.0018), osteoporosis (OR = 1.480, 95% CI: 1.1138-1.926, P = 0.0035), and rs4747096 AG + GG genotype increased the risk of osteoporosis (OR = 2.017, 95% CI: 1.208-3.369, P = 0.0073). In addition, the interaction between urine fluoride and rs4747096 polymorphism on the risk of decreased BMD also was observed. The study suggests that fluoride exposure and mutation G allele in ADAMTS14_rs4747096 may be risk factors for the decrease of BMD. And there is an interaction between the two influencing factors.
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Affiliation(s)
- Ming Qin
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Heilongjiang Province, Harbin, 150081, China
- Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province, Ministry of Health of P. R. China, Harbin Medical University, Heilongjiang Province, Harbin, 150081, China
| | - Yue Gao
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Heilongjiang Province, Harbin, 150081, China
- Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province, Ministry of Health of P. R. China, Harbin Medical University, Heilongjiang Province, Harbin, 150081, China
| | - Meichen Zhang
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Heilongjiang Province, Harbin, 150081, China
- Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province, Ministry of Health of P. R. China, Harbin Medical University, Heilongjiang Province, Harbin, 150081, China
| | - Junhua Wu
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Heilongjiang Province, Harbin, 150081, China
- Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province, Ministry of Health of P. R. China, Harbin Medical University, Heilongjiang Province, Harbin, 150081, China
| | - Yang Liu
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Heilongjiang Province, Harbin, 150081, China
- Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province, Ministry of Health of P. R. China, Harbin Medical University, Heilongjiang Province, Harbin, 150081, China
| | - Yuting Jiang
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Heilongjiang Province, Harbin, 150081, China
- Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province, Ministry of Health of P. R. China, Harbin Medical University, Heilongjiang Province, Harbin, 150081, China
| | - Xiaodi Zhang
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Heilongjiang Province, Harbin, 150081, China
- Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province, Ministry of Health of P. R. China, Harbin Medical University, Heilongjiang Province, Harbin, 150081, China
| | - Xin Wang
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Heilongjiang Province, Harbin, 150081, China
- Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province, Ministry of Health of P. R. China, Harbin Medical University, Heilongjiang Province, Harbin, 150081, China
| | - Yanmei Yang
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Heilongjiang Province, Harbin, 150081, China
- Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province, Ministry of Health of P. R. China, Harbin Medical University, Heilongjiang Province, Harbin, 150081, China
| | - Yanhui Gao
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Heilongjiang Province, Harbin, 150081, China.
- Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province, Ministry of Health of P. R. China, Harbin Medical University, Heilongjiang Province, Harbin, 150081, China.
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He T, Pang Z, Yin Y, Xue H, Pang Y, Song H, Li J, Bai R, Qin A, Kong X. Micron-resolution Imaging of Cortical Bone under 14 T Ultrahigh Magnetic Field. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2023; 10:e2300959. [PMID: 37339792 PMCID: PMC10460861 DOI: 10.1002/advs.202300959] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 05/11/2023] [Indexed: 06/22/2023]
Abstract
Compact, mineralized cortical bone tissues are often concealed on magnetic resonance (MR) images. Recent development of MR instruments and pulse techniques has yielded significant advances in acquiring anatomical and physiological information from cortical bone despite its poor 1 H signals. This work demonstrates the first MR research on cortical bones under an ultrahigh magnetic field of 14 T. The 1 H signals of different mammalian species exhibit multi-exponential decays of three characteristic T2 or T2 * values: 0.1-0.5 ms, 1-4 ms, and 4-8 ms. Systematic sample comparisons attribute these T2 /T2 * value ranges to collagen-bound water, pore water, and lipids, respectively. Ultrashort echo time (UTE) imaging under 14 T yielded spatial resolutions of 20-80 microns, which resolves the 3D anatomy of the Haversian canals. The T2 * relaxation characteristics further allow spatial classifications of collagen, pore water and lipids in human specimens. The study achieves a record of the spatial resolution for MR imaging in bone and shows that ultrahigh-field MR has the unique ability to differentiate the soft and organic compartments in bone tissues.
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Affiliation(s)
- Tian He
- Department of ChemistryZhejiang UniversityHangzhou310027China
| | - Zhenfeng Pang
- Department of ChemistryZhejiang UniversityHangzhou310027China
| | - Yu Yin
- Department of ChemistryZhejiang UniversityHangzhou310027China
| | - Huadong Xue
- Department of ChemistryZhejiang UniversityHangzhou310027China
- Department of RehabilitationSir Run Run Shaw HospitalCollege of MedicineZhejiang UniversityHangzhou310016China
| | - Yichuan Pang
- Shanghai Key Laboratory of Orthopedic ImplantsDepartment of OrthopaedicsShanghai Ninth People's HospitalShanghai Jiao Tong University School of MedicineShanghai200011China
| | - Haixin Song
- Department of RehabilitationSir Run Run Shaw HospitalCollege of MedicineZhejiang UniversityHangzhou310016China
| | - Jianhua Li
- Department of RehabilitationSir Run Run Shaw HospitalCollege of MedicineZhejiang UniversityHangzhou310016China
| | - Ruiliang Bai
- Interdisciplinary Institute of Neuroscience and Technology (ZIINT)College of Biomedical Engineering and Instrument ScienceZhejiang UniversityHangzhou310027China
- School of MedicineZhejiang UniversityHangzhou310058China
| | - An Qin
- Shanghai Key Laboratory of Orthopedic ImplantsDepartment of OrthopaedicsShanghai Ninth People's HospitalShanghai Jiao Tong University School of MedicineShanghai200011China
| | - Xueqian Kong
- Department of ChemistryZhejiang UniversityHangzhou310027China
- Department of RehabilitationSir Run Run Shaw HospitalCollege of MedicineZhejiang UniversityHangzhou310016China
- Institute of Translational MedicineShanghai Jiaotong UniversityShanghai200240China
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Ogawa R, Ogura I. AI-based computer-aided diagnosis for panoramic radiographs: Quantitative analysis of mandibular cortical morphology in relation to age and gender. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2022; 123:383-387. [PMID: 35772701 DOI: 10.1016/j.jormas.2022.06.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 06/26/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE This study aimed to investigate AI-based computer-aided diagnosis (AI-CAD) for panoramic radiographs, especially quantitative evaluation of mandibular cortical morphology in relation to age and gender. METHODS 321 patients with jaw lesions who underwent panoramic radiography were prospectively included. The mandibular cortical morphology was analyzed with an AI-CAD that evaluated the degree of deformation of mandibular inferior cortex and mandibular cortical index (MCI) automatically. Those were analyzed in relation to age and gender, such as younger (≦ 20 years), middle (21-60 years) and older group (≧ 61 years) in men and women. RESULTS The degree of deformation in older men (33.0 ± 18.5) was higher than those of middle (25.0 ± 15.3, p = 0.030) and younger (32.5 ± 16.9, p = 0.993), and those in older women (46.2 ± 22.5) was higher than those of middle (19.4 ± 16.5, p < 0.001) and younger (22.4 ± 14.5, p < 0.001). The MCI of women was a significant difference for aging (p < 0.001), although those of men was not significant difference for aging (p = 0.189). CONCLUSION The AI-CAD could be a useful tool for the quantitative analysis of mandibular cortical morphology.
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Affiliation(s)
- Ruri Ogawa
- Quantitative Diagnostic Imaging, Field of Oral and Maxillofacial Imaging and Histopathological Diagnostics, Course of Applied Science, The Nippon Dental University Graduate School of Life Dentistry at Niigata, Niigata, Japan
| | - Ichiro Ogura
- Quantitative Diagnostic Imaging, Field of Oral and Maxillofacial Imaging and Histopathological Diagnostics, Course of Applied Science, The Nippon Dental University Graduate School of Life Dentistry at Niigata, Niigata, Japan; Department of Oral and Maxillofacial Radiology, The Nippon Dental University School of Life Dentistry at Niigata, Niigata, Japan.
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Ogawa R, Ogura I. Change in the mandibular cortical morphology at pre- and postdental implant operations using artificial intelligence-based computer-aided diagnosis for panoramic radiography. JOURNAL OF ORAL AND MAXILLOFACIAL RADIOLOGY 2022. [DOI: 10.4103/jomr.jomr_23_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
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Guha I, Klintström B, Klintström E, Zhang X, Smedby Ö, Moreno R, Saha PK. A comparative study of trabecular bone micro-structural measurements using different CT modalities. Phys Med Biol 2020; 65:10.1088/1361-6560/abc367. [PMID: 33086213 PMCID: PMC8058110 DOI: 10.1088/1361-6560/abc367] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 10/21/2020] [Indexed: 01/23/2023]
Abstract
Osteoporosis, characterized by reduced bone mineral density and micro-architectural degeneration, significantly enhances fracture-risk. There are several viable methods for trabecular bone micro-imaging, which widely vary in terms of technology, reconstruction principle, spatial resolution, and acquisition time. We have performed an excised cadaveric bone specimen study to evaluate different computed tomography (CT)-imaging modalities for trabecular bone micro-structural analysis. Excised cadaveric bone specimens from the distal radius were scanned using micro-CT and fourin vivoCT imaging modalities: high-resolution peripheral quantitative computed tomography (HR-pQCT), dental cone beam CT (CBCT), whole-body multi-row detector CT (MDCT), and extremity CBCT. A new algorithm was developed to optimize soft thresholding parameters for individualin vivoCT modalities for computing quantitative bone volume fraction maps. Finally, agreement of trabecular bone micro-structural measures, derived from differentin vivoCT imaging, with reference measures from micro-CT imaging was examined. Observed values of most trabecular measures, including trabecular bone volume, network area, transverse and plate-rod micro-structure, thickness, and spacing, forin vivoCT modalities were higher than their micro-CT-based reference values. In general, HR-pQCT-based trabecular bone measures were closer to their reference values as compared to otherin vivoCT modalities. Despite large differences in observed values of measures among modalities, high linear correlation (rε [0.94 0.99]) was found between micro-CT andin vivoCT-derived measures of trabecular bone volume, transverse and plate micro-structural volume, and network area. All HR-pQCT-derived trabecular measures, except the erosion index, showed high correlation (rε [0.91 0.99]). The plate-width measure showed a higher correlation (rε [0.72 0.91]) amongin vivoand micro-CT modalities than its counterpart binary plate-rod characterization-based measure erosion index (rε [0.65 0.81]). Although a strong correlation was observed between micro-structural measures fromin vivoand micro-CT imaging, large shifts in their values forin vivomodalities warrant proper scanner calibration prior to adopting in multi-site and longitudinal studies.
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Affiliation(s)
- Indranil Guha
- Department of Electrical and Computer Engineering, College of Engineering, University of Iowa, Iowa City, IA, United States of America
| | - Benjamin Klintström
- Department of Biomedical Engineering and Health Systems, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Eva Klintström
- Department of Medical and Health Sciences and Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
| | - Xiaoliu Zhang
- Department of Electrical and Computer Engineering, College of Engineering, University of Iowa, Iowa City, IA, United States of America
| | - Örjan Smedby
- Department of Biomedical Engineering and Health Systems, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Rodrigo Moreno
- Department of Biomedical Engineering and Health Systems, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Punam K Saha
- Department of Electrical and Computer Engineering, College of Engineering, University of Iowa, Iowa City, IA, United States of America
- Department of Radiology, Carver College of Medicine, University of Iowa, Iowa City, IA, United States of America
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Sun R, Zhou G, Liu L, Ren L, Xi Y, Zhu J, Huang H, Li Z, Li Y, Cheng X, Ba Y. Fluoride exposure and CALCA methylation is associated with the bone mineral density of Chinese women. CHEMOSPHERE 2020; 253:126616. [PMID: 32283421 DOI: 10.1016/j.chemosphere.2020.126616] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 03/22/2020] [Accepted: 03/23/2020] [Indexed: 06/11/2023]
Abstract
Excessive exposure to fluoride has been reported to affect bone mineral density (BMD). CALCA expression plays a critical part in bone formation. However, the role of CALCA in the association between fluoride and BMD is not known. We conducted a cross-sectional study and recruited 722 women in rural areas of Henan Province, China, to assess the relationship between fluoride exposure, CALCA methylation, and BMD. Urinary levels of fluoride, CALCA methylation, and BMD were measured by a fluoride ion-selective electrode, standalone ultrasound bone densitometer, and quantitative methylation-specific polymerases chain reaction, respectively. The association among fluoride exposure, CALCA methylation, and BMD was age-specific. Specifically, BMD was negatively correlated with methylation (β: -0.008; 95% CI: -0.016, 0.000) and fluoride exposure (β: -0.063; 95% CI: -0.129, -0.002) in women over 45 years and 50-54 years of age, respectively, whereas methylation was positively correlated with fluoride exposure (β: 4.953; 95% CI: 1.162, 8.743) in women aged 40-44 years. Besides, increased BMD in women aged 45-49 years induced by the interactive effect of the highest methylation of CALCA exon 1 (tertile 3) and fluoride exposure was observed (P for interaction < 0.05). Our findings suggest an age-specific association between exposure to excessive fluoride, CALCA methylation, and BMD in a rural population of women in China. Notably, the susceptibility of BMD to fluoride exposure may be modified by CALCA methylation.
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Affiliation(s)
- Renjie Sun
- Department of Environmental Health, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, China; Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, China
| | - Guoyu Zhou
- Department of Environmental Health, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, China; Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, China
| | - Lihua Liu
- Department of Environmental Health, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, China
| | - Lijun Ren
- Department of Endemic Disease, Kaifeng Center for Disease Control and Prevention, Kaifeng, Henan, 475000, China
| | - Yu Xi
- Tongxu Center for Disease Control and Prevention, Kaifeng, Henan, 475400, China
| | - Jingyuan Zhu
- Department of Environmental Health, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, China
| | - Hui Huang
- Department of Environmental Health, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, China; Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, China
| | - Zhiyuan Li
- Department of Environmental Health, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, China
| | - Yan Li
- Department of Environmental Health, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, China; Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, China
| | - Xuemin Cheng
- Department of Environmental Health, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, China; Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, China
| | - Yue Ba
- Department of Environmental Health, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, China; Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, China.
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Shafiee G, Sharifi F, Heshmat R, Ostovar A, Ebrahimpur M, Sheidaei A, Nabipour I, Larijani B. The reference value of trabecular bone score (TBS) in the Iranian population. J Diabetes Metab Disord 2020; 19:493-498. [PMID: 32550201 DOI: 10.1007/s40200-020-00537-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 04/23/2020] [Accepted: 04/28/2020] [Indexed: 01/14/2023]
Abstract
Background Trabecular bone score (TBS), as a tool for measurement of bone microarchitecture, represents fracture risk independently of bone density. The aim of this study was to estimate the reference values of TBS in both genders among the Iranian population to evaluate osteoporotic fractures in the future. Methods The study was performed on healthy Iranian subjects who live in urban areas of Bushehr city, the capital of Bushehr province in southwestern Iran. The participants in this study were selected through a multistage, age and sex stratified, cluster random sampling. The TBS of L1-L4 was assessed by spine DXA images using TBS iNsight software (Discovery WI, Hologic Inc, USA). Age-related models of TBS were constructed using piecewise linear regression analysis. Results In total, 691 participants aged ≥ 18 years (381 men and 310 women) were selected for the study. The mean and standard deviation (SD) of TBS value for men was 1.420 ± 0.094 and the age at the peak TBS was 30.0 years. Among women, the corresponding value for the mean of TBS was 1.428 ± 0.070 and the age at the peak TBS was 24.5 years. Two SDs below the mean of TBS were 1.326 in men and 1.357 in women. Therefore, the following normal range for TBS values has been proposed: Among men, TBS ≥ 1.326 is considered to be normal; TBS between 1.231 and 1.326 is considered to be partially degraded microarchitecture; and TBS ≤ 1.231defined degraded microarchitecture. Among women, TBS categories are defined as normal ≥ 1.357, partially degraded between 1.287 and 1.357 and degraded ≤ 1.287. Conclusions This was the first study to propose evaluation of the normal range for TBS values in both genders in the Middle- East and Iran. According to our results: TBS ≤ 1.231 in men and TBS ≤ 1.287 in women is considered to be degraded microarchitecture among the Iranian population.
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Affiliation(s)
- Gita Shafiee
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, NO 10, Jalale-Al-Ahmad Ave, Chamran Highway, Tehran, Iran
| | - Farshad Sharifi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, NO 10, Jalale-Al-Ahmad Ave, Chamran Highway, Tehran, Iran
| | - Afshin Ostovar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, NO 10, Jalale-Al-Ahmad Ave, Chamran Highway, Tehran, Iran
| | - Mahbube Ebrahimpur
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Sheidaei
- Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Iraj Nabipour
- The Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Ogura I, Kobayashi E, Nakahara K, Haga-Tsujimura M, Igarashi K, Katsumata A. Computer programme to assess mandibular cortex morphology in cases of medication-related osteonecrosis of the jaw with osteoporosis or bone metastases. Imaging Sci Dent 2019; 49:281-286. [PMID: 31915613 PMCID: PMC6941839 DOI: 10.5624/isd.2019.49.4.281] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 07/25/2019] [Accepted: 08/11/2019] [Indexed: 11/18/2022] Open
Abstract
Purpose The purpose of this study was to evaluate the morphology of the mandibular cortex in cases of medication-related osteonecrosis of the jaw (MRONJ) in patients with osteoporosis or bone metastases using a computer programme. Materials and Methods Fifty-four patients with MRONJ (35 with osteoporosis and 19 with bone metastases) were examined using panoramic radiography. The morphology of the mandibular cortex was evaluated using a computer programme that scanned the mandibular inferior cortex and automatically assessed the mandibular cortical index (MCI) according to the thickness and roughness of the mandibular cortex, as follows: normal (class 1), mildly to moderately eroded (class 2), or severely eroded (class 3). The MCI classifications of MRONJ patients with osteoporosis or bone metastases were evaluated with the Pearson chi-square test. In these analyses, a 5% significance level was used. Results The MCI of MRONJ patients with osteoporosis (class 1: 6, class 2: 15, class 3: 14) tended to be higher than that of patients with bone metastases (class 1: 14, class 2: 5, class 3: 0) (P=0.000). Conclusion The use of a computer programme to assess mandibular cortex morphology may be an effective technique for the objective and quantitative evaluation of the MCI in MRONJ patients with osteoporosis or bone metastases.
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Affiliation(s)
- Ichiro Ogura
- Department of Oral and Maxillofacial Radiology, The Nippon Dental University School of Life Dentistry at Niigata, Niigata, Japan
| | - Eizaburo Kobayashi
- Department of Oral and Maxillofacial Surgery, The Nippon Dental University School of Life Dentistry at Niigata, Niigata, Japan
| | - Ken Nakahara
- Advanced Research Center, The Nippon Dental University School of Life Dentistry at Niigata, Niigata, Japan
| | - Maiko Haga-Tsujimura
- Department of Histology, The Nippon Dental University School of Life Dentistry at Niigata, Niigata, Japan
| | - Kensuke Igarashi
- Department of Life Science Dentistry, The Nippon Dental University, Niigata, Japan
| | - Akitoshi Katsumata
- Department of Oral Radiology, Asahi University School of Dentistry, Mizuho, Japan
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Li Y, Li B, Li Y, Liu C, Xu F, Zhang R, Ta D, Wang W. The Ability of Ultrasonic Backscatter Parametric Imaging to Characterize Bovine Trabecular Bone. ULTRASONIC IMAGING 2019; 41:271-289. [PMID: 31307317 DOI: 10.1177/0161734619862190] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The ultrasonic backscatter technique holds the promise of characterizing bone density and microstructure. This paper conducts ultrasonic backscatter parametric imaging based on measurements of apparent integrated backscatter (AIB), spectral centroid shift (SCS), frequency slope of apparent backscatter (FSAB), and frequency intercept of apparent backscatter (FIAB) for representing trabecular bone mass and microstructure. We scanned 33 bovine trabecular bone samples using a 7.5 MHz focused transducer in a 20 mm × 20 mm region of interest (ROI) with a step interval of 0.05 mm. Images based on the ultrasonic backscatter parameters (i.e., AIB, SCS, FSAB, and FIAB) were constructed to compare with photographic images of the specimens as well as two-dimensional (2D) μ-CT images from approximately the same depth and location of the specimen. Similar structures and trabecular alignments can be observed among these images. Statistical analyses demonstrated that the means and standard deviations of the ultrasonic backscatter parameters exhibited significant correlations with bone density (|R| = 0.45-0.78, p < 0.01) and bone microstructure (|R| = 0.44-0.87, p < 0.001). Some bovine trabecular bone microstructure parameters were independently associated with the ultrasonic backscatter parameters (ΔR2 = 4.18%-44.45%, p < 0.05) after adjustment for bone apparent density (BAD). The results show that ultrasonic backscatter parametric imaging can provide a direct view of the trabecular microstructure and can reflect information about the density and microstructure of trabecular bone.
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Affiliation(s)
- Ying Li
- 1 Department of Electronic Engineering, Fudan University, Shanghai, China
| | - Boyi Li
- 1 Department of Electronic Engineering, Fudan University, Shanghai, China
| | - Yifang Li
- 1 Department of Electronic Engineering, Fudan University, Shanghai, China
| | - Chengcheng Liu
- 2 Institute of Acoustics, Tongji University, Shanghai, China
| | - Feng Xu
- 1 Department of Electronic Engineering, Fudan University, Shanghai, China
| | - Rong Zhang
- 3 Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
| | - Dean Ta
- 1 Department of Electronic Engineering, Fudan University, Shanghai, China
- 4 Key Laboratory of Medical Imaging Computing and Computer Assisted Intervention (MICCAI) of Shanghai, Shanghai, China
- 5 Human Phenome Institute, Fudan University, Shanghai, China
| | - Weiqi Wang
- 1 Department of Electronic Engineering, Fudan University, Shanghai, China
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11
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Balto KA, Gomaa MM, Feteih RM, AlAmoudi NM, Elsamanoudy AZ, Hassanien MA, Ardawi MSM. Dental Panoramic Radiographic Indices as a Predictor of Osteoporosis in Postmenopausal Saudi Women. J Bone Metab 2018; 25:165-173. [PMID: 30237996 PMCID: PMC6135653 DOI: 10.11005/jbm.2018.25.3.165] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Revised: 08/13/2018] [Accepted: 08/15/2018] [Indexed: 01/27/2023] Open
Abstract
Background Many oral presentations of osteoporosis-a bone metabolic disease-were recorded. Thus, we aimed to assess panoramic radiomorphometric indices with bone mineral density (BMD) values among Saudi postmenopausal women and its importance in the prediction of osteoporosis. Methods A total of 431 Saudi women were enrolled in this study. Panoramic radiographs were obtained at the time of BMD measurement. Subjects were fatherly classified into; normal BMD, osteopenia, and osteoporosis groups. Serum follicle-stimulating hormone, luteinizing hormone (LH), estradiol (E2), 25-hydroxy-vitamin D (25[OH]D) and intact-parathyroid hormone were measured. Moreover, serum creatinine, calcium, and phosphate, together with serum osteocalcin (s-OC), procollagen type I N-terminal propeptide (s-PINP) and cross-linked C-terminal telopeptide of type 1 collagen (s-CTX) were measured. Receiver-operator curve (ROC) curve analysis for use of mandibular cortical width (MCW), panoramic mandibular index (PMI), and maxillary-mandibular ratio (M/M ratio) to differentiate women with osteoporosis or osteopenia from normal subjects was calculated. Cut off values of 4.6 at T score <−1 and 4.1 at T score ≤−2.5 were used. Results Body mass index is significantly low in the osteoporotic group. There is no significant difference in serum levels of LH, E2, calcium, phosphate, and 25(OH)D between the studied groups. Moreover, s-OC, C-terminal propeptide of procollagen type I, s-PINP, s-CTX, and urinary-CTX are significantly higher in osteoporosis than normal and osteopenia groups. ROC curve analysis revealed that MCW and PMI showed significant data while M/M ratio is non-significant. Conclusions It could be concluded that MCW as an important panoramic radiographic parameter can be used for prediction and diagnosis of osteoporosis in postmenopausal Saudi women with low BMD.
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Affiliation(s)
- Khaled Abdullah Balto
- Center of Excellence for Osteoporosis Research, Faculty of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Endodontics, Faculty of Dentistry, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Madiha Mahmoud Gomaa
- Center of Excellence for Osteoporosis Research, Faculty of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Endodontics, Faculty of Dentistry, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Rabab Mohammed Feteih
- Center of Excellence for Osteoporosis Research, Faculty of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Orthodontics and Maxillofacial Orthopedics, Faculty of Dentistry, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Najlaa Mohammed AlAmoudi
- Center of Excellence for Osteoporosis Research, Faculty of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Pediatric Dentistry, Faculty of Dentistry, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ayman Zaky Elsamanoudy
- Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohammed Ahmed Hassanien
- Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohammed-Salleh M Ardawi
- Center of Excellence for Osteoporosis Research, Faculty of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia
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12
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Mookiah MRK, Subburaj K, Mei K, Kopp FK, Kaesmacher J, Jungmann PM, Foehr P, Noel PB, Kirschke JS, Baum T. Multidetector Computed Tomography Imaging: Effect of Sparse Sampling and Iterative Reconstruction on Trabecular Bone Microstructure. J Comput Assist Tomogr 2018; 42:441-447. [PMID: 29489591 DOI: 10.1097/rct.0000000000000710] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Multidetector computed tomography-based trabecular bone microstructure analysis ensures promising results in fracture risk prediction caused by osteoporosis. Because multidetector computed tomography is associated with high radiation exposure, its clinical routine use is limited. Hence, in this study, we investigated in 11 thoracic midvertebral specimens whether trabecular texture parameters are comparable derived from (1) images reconstructed using statistical iterative reconstruction (SIR) and filtered back projection as criterion standard at different exposures (80, 150, 220, and 500 mAs) and (2) from SIR-based sparse sampling projections (12.5%, 25%, 50%, and 100%) and equivalent exposures as criterion standard. Twenty-four texture features were computed, and those that showed similar values between (1) filtered back projection and SIR at the different exposure levels and (2) sparse sampling and equivalent exposures and reconstructed with SIR were identified. These parameters can be of equal value in determining trabecular bone microstructure with lower radiation exposure using sparse sampling and SIR.
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Affiliation(s)
| | | | | | | | | | | | - Peter Foehr
- Orthopaedics and Sports Orthopaedics, Biomechanical Laboratory, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
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13
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Methoxsalen supplementation attenuates bone loss and inflammatory response in ovariectomized mice. Chem Biol Interact 2017; 278:135-140. [PMID: 29074052 DOI: 10.1016/j.cbi.2017.10.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 10/03/2017] [Accepted: 10/11/2017] [Indexed: 02/07/2023]
Abstract
Methoxsalen (MTS) is a natural bioactive compound found in a variety of plants that has many known biofunctions; however, its effects on osteoporosis and related mechanisms are not clear. This study examined whether MTS exhibited preventive effects against postmenopausal osteoporosis. Female C3H/HeN mice were divided into four groups: Sham, ovariectomy (OVX), OVX with MTS (0.02% in diet), and OVX with estradiol (0.03 μg/day, s.c). After 6 weeks, MTS supplementation significantly increased femur bone mineral density and bone surface along with bone surface/total volume. MTS significantly elevated the levels of serum formation markers (estradiol, osteocalcin and bone-alkaline phosphatase) such as estradiol in OVX mice. Tartrate resistant acid phosphatase staining revealed that MTS suppressed osteoclast numbers and formation in femur tissues compared with the OVX group. Supplementation of MTS slightly up-regulated osteoblastogenesis-related genes (Runx-2, osterix, osteocalcin, and Alp) expression, whereas it significantly down-regulated inflammatory genes (Nfκb and Il6) expression in femur tissue compared with the OVX group. These results indicate that MTS supplementation effectively prevented OVX-induced osteoporosis via enhancement of bone formation and suppression of inflammatory response in OVX mice. Our study provides valid scientific information regarding the development and application of MTS as a food ingredient, a food supplement or an alternative agent for preventing postmenopausal osteoporosis.
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14
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Li S, Chen R, Luo K, Guo Y, Xiao M, Du G. Areca nut extract protects against ovariectomy-induced osteoporosis in mice. Exp Ther Med 2017; 13:2893-2899. [PMID: 28587356 PMCID: PMC5450612 DOI: 10.3892/etm.2017.4362] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 02/10/2017] [Indexed: 01/18/2023] Open
Abstract
Estrogen deficiency increases the generation of reactive oxygen species (ROS), which is a crucial pathogenic factor for osteoporosis. Areca nuts are rich in phenolics, which have high antioxidant activity. In the present study, an ovariectomy (OVX)-induced osteoporosis mouse model was used to investigate the protective effects of areca nut extract (ANE) on bone loss and related processes. A total of 24 8-week-old female mice were randomly divided into three groups (n=8 per group): I Sham-operated control; II, bilateral OVX; and III, bilateral OVX + ANE. Group III were treated orally with ANE at a single dose of 300 mg/kg body weight daily for 6 months. ANE supplementation for 6 months improved trabecular bone microarchitecture and significantly increased bone mineral density in the distal femur (P<0.05) compared with Group II. Furthermore, serum levels of the osteoclast differentiation-inducing factors, receptor activator of nuclear factor-κB ligand and osteoprotegerin were significantly increased and decreased, respectively (both P<0.05), in OVX mice and these effects were significantly inhibited by ANE treatment (both P<0.05). ANE supplementation also resulted in significantly decreased serum hydrogen peroxide and malondialdehyde levels compared with Group II, while the levels of glutathione and catalase activity were significantly increased (P<0.05 and P<0.01, respectively). The current study indicated that the protective effects of ANE against bone loss were mediated, at least in part, via inhibition of the release of ROS and bone resorption. These results suggested that ANE could have therapeutic value in the treatment of osteoporosis.
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Affiliation(s)
- Shuyu Li
- Clinical College of Hainan Medical College, Haikou, Hainan 571199, P.R. China
| | - Rong Chen
- Department of Orthopedics, Hainan Agribusiness Central Hospital, Haikou, Hainan 570311, P.R. China
| | - Kaili Luo
- Department of Biochemistry and Molecular Biology, Hainan Medical College, Haikou, Hainan 571199, P.R. China
| | - Yang Guo
- Department of Biochemistry and Molecular Biology, Hainan Medical College, Haikou, Hainan 571199, P.R. China
| | - Man Xiao
- Department of Biochemistry and Molecular Biology, Hainan Medical College, Haikou, Hainan 571199, P.R. China
| | - Guankui Du
- Department of Biochemistry and Molecular Biology, Hainan Medical College, Haikou, Hainan 571199, P.R. China
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15
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Fujii M, Aoki T, Okada Y, Mori H, Kinoshita S, Hayashida Y, Hajime M, Tanaka K, Tanaka Y, Korogi Y. Prediction of Femoral Neck Strength in Patients with Diabetes Mellitus with Trabecular Bone Analysis and Tomosynthesis Images. Radiology 2016; 281:933-939. [DOI: 10.1148/radiol.2016151657] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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16
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Li L, Qu Y, Jin X, Guo XQ, Wang Y, Qi L, Yang J, Zhang P, Li LZ. Protective effect of salidroside against bone loss via hypoxia-inducible factor-1α pathway-induced angiogenesis. Sci Rep 2016; 6:32131. [PMID: 27558909 PMCID: PMC4997314 DOI: 10.1038/srep32131] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 08/03/2016] [Indexed: 12/02/2022] Open
Abstract
Hypoxia-inducible factor (HIF)-1α plays a critical role in coupling angiogenesis with osteogenesis during bone development and regeneration. Salidroside (SAL) has shown anti-hypoxic effects in vitro and in vivo. However, the possible roles of SAL in the prevention of hypoxia-induced osteoporosis have remained unknown. Two osteoblast cell lines, MG-63 and ROB, were employed to evaluate the effects of SAL on cell viability, apoptosis, differentiation and mineralization in vitro. Rats subjected to ovariectomy-induced bone loss were treated with SAL in vivo. Our results showed that pre-treatment with SAL markedly attenuated the hypoxia-induced reductions in cell viability, apoptosis, differentiation and mineralization. SAL down-regulated HIF-1α expression and inhibited its translocation; however, SAL increased its transcriptional activity and, consequently, up-regulated vascular endothelial growth factor (VEGF). In vivo studies further demonstrated that SAL caused decreases in the mineral, alkaline phosphatase (ALP), and BGP concentrations in the blood of ovariectomized (OVX) rats. Moreover, SAL improved the trabecular bone microarchitecture and increased bone mineral density in the distal femur. Additionally, SAL administration partially ameliorated this hypoxia via the HIF-1α-VEGF signalling pathway. Our results indicate that SAL prevents bone loss by enhancing angiogenesis and osteogenesis and that these effects are associated with the activation of HIF-1α signalling.
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Affiliation(s)
- Ling Li
- Tianjin Key Laboratory for Prevention and Control of Occupational and Environmental Hazard, Tianjin, People's Republic of China.,Department of Pharmacology, Logistics College of Chinese People's Armed Police Forces, Tianjin, People's Republic of China
| | - Ye Qu
- Department of Pathogenic Biology and Immunology, Logistics College of Chinese People's Armed Police Forces, Tianjin, People's Republic of China
| | - Xin Jin
- Department of Pharmacology, Logistics College of Chinese People's Armed Police Forces, Tianjin, People's Republic of China
| | - Xiao Qin Guo
- Department of Pathogenic Biology and Immunology, Logistics College of Chinese People's Armed Police Forces, Tianjin, People's Republic of China
| | - Yue Wang
- Tianjin Key Laboratory for Prevention and Control of Occupational and Environmental Hazard, Tianjin, People's Republic of China.,Department of Pathogenic Biology and Immunology, Logistics College of Chinese People's Armed Police Forces, Tianjin, People's Republic of China
| | - Lin Qi
- Department of Pathogenic Biology and Immunology, Logistics College of Chinese People's Armed Police Forces, Tianjin, People's Republic of China
| | - Jing Yang
- Department of Pathogenic Biology and Immunology, Logistics College of Chinese People's Armed Police Forces, Tianjin, People's Republic of China
| | - Peng Zhang
- Department of Orthopaedics, Affiliated Hospital of Logistics College of Chinese People's Armed Police Forces, Tianjin, People's Republic of China
| | - Ling Zhi Li
- Tianjin Key Laboratory for Prevention and Control of Occupational and Environmental Hazard, Tianjin, People's Republic of China.,Department of Pharmaceutical Chemistry, Logistics College of Chinese People's Armed Police Forces, Tianjin, People's Republic of China
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17
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Mostafa RA, Arnout EA, Abo El-Fotouh MM. Feasibility of cone beam computed tomography radiomorphometric analysis and fractal dimension in assessment of postmenopausal osteoporosis in correlation with dual X-ray absorptiometry. Dentomaxillofac Radiol 2016; 45:20160212. [PMID: 27418348 DOI: 10.1259/dmfr.20160212] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES The aim of the present study was to assess the feasibility of using mandibular CBCT radiomorphometric indices and box-counting fractal dimension (FD) to detect osteoporosis in post-menopausal females, compare them with the healthy control group and to correlate the findings with the bone mineral density measured by dual X-ray absorptiometry (DXA). METHODS This study consisted of 50 post-menopausal females, with age ranging from 55 to 70 years. Based on their DXA results, they were classified into osteoporotic and control groups. Mandibular CBCT radiomorphomertic indices and FD analysis were measured. RESULTS Significant differences were found for the CT cortical index scores (CTCI), CT mental index (CTMI) and CT mandibular index (CTI) between the control and osteoporotic groups. The control group showed higher mean values than the osteoporotic group. For FD values, no significant differences were found between the two groups. CONCLUSIONS CBCT radiomorphometric indices could be used as an adjuvant tool to refer patients at risk of osteoporosis for further assessment.
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Affiliation(s)
- Raghdaa A Mostafa
- Department of Oral Medicine, Periodontology, Diagnosis and Oral Radiology, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Eman A Arnout
- Department of Oral Medicine, Periodontology, Diagnosis and Oral Radiology, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Mona M Abo El-Fotouh
- Department of Oral Medicine, Periodontology, Diagnosis and Oral Radiology, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
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18
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Mostafa RA, Arnout EA, Abo El-Fotouh MM. Feasibility of cone beam computed tomography radiomorphometric analysis and fractal dimension in assessment of postmenopausal osteoporosis in correlation with dual X-ray absorptiometry. Dentomaxillofac Radiol 2016. [PMID: 27418348 DOI: 10.1259/dmfr.20160212.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The aim of the present study was to assess the feasibility of using mandibular CBCT radiomorphometric indices and box-counting fractal dimension (FD) to detect osteoporosis in post-menopausal females, compare them with the healthy control group and to correlate the findings with the bone mineral density measured by dual X-ray absorptiometry (DXA). METHODS This study consisted of 50 post-menopausal females, with age ranging from 55 to 70 years. Based on their DXA results, they were classified into osteoporotic and control groups. Mandibular CBCT radiomorphomertic indices and FD analysis were measured. RESULTS Significant differences were found for the CT cortical index scores (CTCI), CT mental index (CTMI) and CT mandibular index (CTI) between the control and osteoporotic groups. The control group showed higher mean values than the osteoporotic group. For FD values, no significant differences were found between the two groups. CONCLUSIONS CBCT radiomorphometric indices could be used as an adjuvant tool to refer patients at risk of osteoporosis for further assessment.
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Affiliation(s)
- Raghdaa A Mostafa
- Department of Oral Medicine, Periodontology, Diagnosis and Oral Radiology, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Eman A Arnout
- Department of Oral Medicine, Periodontology, Diagnosis and Oral Radiology, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Mona M Abo El-Fotouh
- Department of Oral Medicine, Periodontology, Diagnosis and Oral Radiology, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
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19
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Akbari A, Abbasi-Rad S, Rad HS. T1 correlates age: A short-TE MR relaxometry study in vivo on human cortical bone free water at 1.5T. Bone 2016; 83:17-22. [PMID: 26475122 DOI: 10.1016/j.bone.2015.10.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 10/03/2015] [Accepted: 10/12/2015] [Indexed: 11/30/2022]
Abstract
Large pores of human cortical bone (>30μm) are filled with fluids, essentially consisting of water, suggesting that cortical bone free water can be considered as a reliable surrogate measure of cortical bone porosity and hence quality. Signal from such pores can be reliably captured using Short Echo Time (STE) pulse sequence with echo-time in the range of 1-1.5msec (which should be judiciously selected correspond to T2(⁎) value of free water molecules). Furthermore, it is well-known that cortical bone T1-relaxivity is a function of its geometry, suggesting that cortical bone free water increases with age. In this work, we quantified cortical bone free water longitudinal relaxation time (T1) by a Dual-TR technique using STE pulse sequence. In the sequel, we investigated relationship between STE-derived cortical bone free water T1-values and age in a group of healthy volunteers (thirty subjects covering the age range of 20-70years) at 1.5T. Preliminary results showed that cortical bone free water T1 highly correlates with age (r(2)=0.73, p<0.0001), representing cortical bone free water T1 as a reliable indicator of cortical bone porosity and age-related deterioration. It can be concluded that STE-MRI can be utilized as proper alternative in quantifying cortical bone porosity parameters in-vivo, with the advantages of widespread clinical availability and being cost-effective.
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Affiliation(s)
- Atena Akbari
- Quantitative MR Imaging and Spectroscopy Group, Research Center for Cellular and Molecular Imaging, Tehran University of Medical Sciences, Tehran, Iran; Medical Physics and Biomedical Engineering Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahrokh Abbasi-Rad
- Quantitative MR Imaging and Spectroscopy Group, Research Center for Cellular and Molecular Imaging, Tehran University of Medical Sciences, Tehran, Iran; Medical Physics and Biomedical Engineering Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Saligheh Rad
- Quantitative MR Imaging and Spectroscopy Group, Research Center for Cellular and Molecular Imaging, Tehran University of Medical Sciences, Tehran, Iran; Medical Physics and Biomedical Engineering Department, Tehran University of Medical Sciences, Tehran, Iran.
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20
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Temmerman A, Rasmusson L, Kübler A, Thor A, Quirynen M. An open, prospective, non-randomized, controlled, multicentre study to evaluate the clinical outcome of implant treatment in women over 60 years of age with osteoporosis/osteopenia: 1-year results. Clin Oral Implants Res 2016; 28:95-102. [DOI: 10.1111/clr.12766] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2015] [Indexed: 01/03/2023]
Affiliation(s)
- Andy Temmerman
- Section of Periodontology; Department of Oral Health Sciences; KU Leuven & Dentistry; University Hospitals; KU Leuven; Leuven Belgium
| | - Lars Rasmusson
- Department of Oral and Maxillofacial Surgery; The Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - Alexander Kübler
- Department of Oral and Maxillofacial Plastic Surgery; University of Wuerzburg; Würzburg Germany
| | - Andreas Thor
- Department of Oral and Maxillofacial Surgery; Institute of Surgical Sciences; Uppsala University; Uppsala Sweden
| | - Marc Quirynen
- Section of Periodontology; Department of Oral Health Sciences; KU Leuven & Dentistry; University Hospitals; KU Leuven; Leuven Belgium
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21
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Bazzocchi A, Ponti F, Diano D, Amadori M, Albisinni U, Battista G, Guglielmi G. Trabecular bone score in healthy ageing. Br J Radiol 2015; 88:20140865. [PMID: 26148778 DOI: 10.1259/bjr.20140865] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE The main aim of this work was to report on trabecular bone score (TBS) by dual-energy X-ray absorptiometry (DXA) of healthy Italian subjects to be used as a reference standard for future study in clinical and research settings. The secondary aim was to investigate the link between TBS and conventional parameters of bone and body composition by DXA. METHODS 250 individuals of 5 age bands (spanning from 18 to 70 years of age, equally distributed for both age and sex) were prospectively recruited. A lumbar spine (LS) DXA scan (Lunar iDXA™; GE Healthcare, Madison, WI) was acquired for each subject and then analysed with the latest version of TBS iNsight v. 2.1 (Med-Imaps, Pessac, France) software. LS bone mineral density (LS BMD), Z-score, T-score and TBS values were collected. Pearson's test was used to investigate the correlations between TBS and LS BMD and the influence of age, body mass index (BMI) and body composition on these parameters. RESULTS A significant decrease of TBS and LS BMD was observed with ageing in both males (TBS mean values from 1.486 to 1.374; LS BMD mean values from 1.219 to 1.187) and females (TBS mean values from 1.464 to 1.306; LS BMD mean values from 1.154 to 1.116). No statistically significant difference was achieved among males and females of the same age group for both TBS and LS BMD, with the exception of the fifth age group. A significant correlation was found between LS BMD and TBS values in both sexes (r = 0.555-0.655, p < 0.0001). BMI influenced LS BMD but not TBS. TBS values were inversely correlated with some fat mass parameters, in particular with visceral adipose tissue (in males: r = -0.332, p < 0.001; in females: r = -0.348, p < 0.0001). No significant correlation was found between TBS and total lean mass, opposite to LS BMD (in males: r = 0.418; p < 0.0001; in females: r = -0.235; p < 0.001). CONCLUSION This report is an attempt to start building a database for healthy Italian people providing age- and sex-specific reference curves for TBS. This could help clinicians to improve patient management in the detection of impaired bone mineral status and to monitor bone changes. ADVANCES IN KNOWLEDGE The study reports TBS values of a selectively enrolled Italian healthy population, ranging from younger to older ages and including males as a reference standard. Moreover, links between body composition and TBS are explored.
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Affiliation(s)
- A Bazzocchi
- 1 Diagnostic and Interventional Radiology, The "Rizzoli" Orthopaedic Institute, Bologna, Italy
| | - F Ponti
- 2 Department of Specialized, Diagnostic, and Experimental Medicine, University of Bologna, Sant'Orsola-Malpighi Hospital, Bologna, Italy
| | - D Diano
- 2 Department of Specialized, Diagnostic, and Experimental Medicine, University of Bologna, Sant'Orsola-Malpighi Hospital, Bologna, Italy
| | - M Amadori
- 2 Department of Specialized, Diagnostic, and Experimental Medicine, University of Bologna, Sant'Orsola-Malpighi Hospital, Bologna, Italy
| | - U Albisinni
- 1 Diagnostic and Interventional Radiology, The "Rizzoli" Orthopaedic Institute, Bologna, Italy
| | - G Battista
- 2 Department of Specialized, Diagnostic, and Experimental Medicine, University of Bologna, Sant'Orsola-Malpighi Hospital, Bologna, Italy
| | - G Guglielmi
- 3 Department of Radiology, University of Foggia, Foggia, Italy.,4 Department of Radiology, Scientific Institute "Casa Sollievo della Sofferenza" Hospital, Foggia, Italy
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22
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VAN DEN MUNCKHOF SVEN, NIKOOYAN ALIASADI, ZADPOOR AMIRABBAS. ASSESSMENT OF OSTEOPOROTIC FEMORAL FRACTURE RISK: FINITE ELEMENT METHOD AS A POTENTIAL REPLACEMENT FOR CURRENT CLINICAL TECHNIQUES. J MECH MED BIOL 2015. [DOI: 10.1142/s0219519415300033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Femoral fracture risk prediction is a necessary step preceding effective pharmacological intervention or pre-operative planning. Current clinical methods for fracture risk prediction rely on 2D imaging methods and have limited predictive value. Researchers are therefore trying to find improved methods for fracture prediction. During last few decades, many studies have focused on integration of 3D imaging techniques and the finite element (FE) method to improve the accuracy of fracture assessment techniques. In this paper, we review the recent advances in FE and other techniques for predicting the risk of femoral fractures. Based on a number of selected studies, the different steps that are involved in generation of patient-specific FE models are reviewed with particular emphasis on the fracture criteria. The inaccuracies that might arise due to the imperfections of the involved steps are also discussed. It is concluded that compared to image- and geometry-based techniques, FE is a more promising approach for prediction of fracture loads. However, certain technological advancements in FE modeling protocols are required before FE modeling can be recruited in clinical settings.
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Affiliation(s)
- SVEN VAN DEN MUNCKHOF
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology (TU Delft), Mekelweg 2, Delft 2628 CD, The Netherlands
| | - ALI ASADI NIKOOYAN
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology (TU Delft), Mekelweg 2, Delft 2628 CD, The Netherlands
- Department of Integrative Physiology, University of Colorado, Boulder, CO 80309, USA
| | - AMIR ABBAS ZADPOOR
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology (TU Delft), Mekelweg 2, Delft 2628 CD, The Netherlands
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Modlesky CM, Whitney DG, Singh H, Barbe MF, Kirby JT, Miller F. Underdevelopment of trabecular bone microarchitecture in the distal femur of nonambulatory children with cerebral palsy becomes more pronounced with distance from the growth plate. Osteoporos Int 2015; 26:505-12. [PMID: 25199575 DOI: 10.1007/s00198-014-2873-4] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Accepted: 08/21/2014] [Indexed: 11/28/2022]
Abstract
SUMMARY We found that the underdeveloped trabecular bone microarchitecture in the distal femur of children with cerebral palsy (CP) who are unable to ambulate independently becomes more pronounced with increased distance from the growth plate. This suggests that the degree of underdevelopment in trabecular bone in children with CP is greater than previously understood. INTRODUCTION Children with CP who are unable to ambulate independently have severely underdeveloped trabecular bone microarchitecture in the distal femur. The aim of the study was to determine if the level of underdevelopment in trabecular bone microarchitecture is consistent across the distal femur in children with CP. METHODS Children with quadriplegic CP and typically developing children were studied (n=12/group, 5-14 years). Apparent bone volume to total volume (appBV/TV), trabecular number (appTb.N), trabecular thickness (appTb.Th), and trabecular separation (appTb.Sp) were estimated in each of 20 magnetic resonance images collected above the growth plate in the distal femur. RESULTS For the total region, appBV/TV, appTb.N, and appTb.Th were lower (30, 21, and 12%, respectively) and appTb.Sp was higher (52%) (all p≤0.001) in children with CP than in controls. Distance from the growth plate was inversely related to appBV/TV and appTb.N and was positively related to appTb.Sp at the same distance in children with CP and controls (all p<0.01). However, the relationships were stronger (r2=0.87 to 0.92 versus 0.36 to 0.65) and the slopes were steeper in children with CP (all p<0.01). Furthermore, the steepness of the slopes in children with CP was positively related to appBV/TV, appTb.N, appTb.Th, and appTb.Sp for the total region (r2=0.37 to 0.75, p<0.05). CONCLUSIONS The underdeveloped trabecular bone microarchitecture in the metaphysis of the distal femur in children with CP becomes more pronounced with greater distance from the growth plate. This pattern is most profound in children with the least developed trabecular bone microarchitecture.
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Affiliation(s)
- C M Modlesky
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, 19716, USA,
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Jackuliak P, Payer J. Osteoporosis, fractures, and diabetes. Int J Endocrinol 2014; 2014:820615. [PMID: 25050121 PMCID: PMC4094869 DOI: 10.1155/2014/820615] [Citation(s) in RCA: 133] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2014] [Revised: 04/19/2014] [Accepted: 06/09/2014] [Indexed: 12/11/2022] Open
Abstract
It is well established that osteoporosis and diabetes are prevalent diseases with significant associated morbidity and mortality. Patients with diabetes mellitus have an increased risk of bone fractures. In type 1 diabetes, the risk is increased by ∼6 times and is due to low bone mass. Despite increased bone mineral density (BMD), in patients with type 2 diabetes the risk is increased (which is about twice the risk in the general population) due to the inferior quality of bone. Bone fragility in type 2 diabetes, which is not reflected by bone mineral density, depends on bone quality deterioration rather than bone mass reduction. Thus, surrogate markers and examination methods are needed to replace the insensitivity of BMD in assessing fracture risks of T2DM patients. One of these methods can be trabecular bone score. The aim of the paper is to present the present state of scientific knowledge about the osteoporosis risk in diabetic patient. The review also discusses the possibility of problematic using the study conclusions in real clinical practice.
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Affiliation(s)
- Peter Jackuliak
- 5th Department of Internal Medicine, Comenius University Faculty of Medicine and University Hospital in Bratislava, Ruzinovska 6, 826 06 Bratislava, Slovakia
| | - Juraj Payer
- 5th Department of Internal Medicine, Comenius University Faculty of Medicine and University Hospital in Bratislava, Ruzinovska 6, 826 06 Bratislava, Slovakia
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Lee IJ, Lee JJ, Bae JH, Hwang E, Lee S, Cho M, Kim JH, Kim HJ. Significance of osteoporosis in facial bone density using computed tomography. J Craniofac Surg 2014; 24:428-31. [PMID: 23524708 DOI: 10.1097/scs.0b013e3182801333] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES The objectives of this study were to compare the variations of bone density in the midfacial bones as measured by computed tomography (CT) scans between the osteoporosis and control groups and to evaluate the regions that facial trauma and iatrogenic problem often occur in the midface. METHODS The 96 patients who underwent both osteomeatal unit CT scans and dual-energy x-ray absorptiometry at our hospital were included in this study retrospectively. Seven skeletal regions were chosen for evaluation: group A (orbital floor, nasal bone), group B (zygomaticomaxillary suture, zygomatic arch, zygomaticofrontal suture), and group C (anterior wall of the maxillary sinus, maxillary process). Forty-seven patients were in the osteoporosis group, and 49 patients were in the control group. On a PACS (picture archiving communication system), the region of interest was analyzed, and the Hounsfield units were measured. RESULTS There was a significant difference in the mean bone density of the midfacial bones between the osteoporosis group and the control group (P < 0.01). For both groups, each of comparison of the 7 skeletal regions was greater as group A < group B < group C in this order (P < 0.01). CONCLUSIONS We can see the independent effects of osteoporosis on the midfacial bones using CT scans. Estimated Hounsfield unit through CT scan is able to explain osteoporosis, which may be useful in the clinical fields in the future.
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Affiliation(s)
- Il Jae Lee
- Department of Plastic and Reconstructive Surgery, Ajou University Hospital, Suwon City, Gyeonggi Province, Republic of Korea
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Thevenot J, Hirvasniemi J, Pulkkinen P, Määttä M, Korpelainen R, Saarakkala S, Jämsä T. Assessment of risk of femoral neck fracture with radiographic texture parameters: a retrospective study. Radiology 2014; 272:184-91. [PMID: 24620912 DOI: 10.1148/radiol.14131390] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To investigate whether femoral neck fracture can be predicted retrospectively on the basis of clinical radiographs by using the combined analysis of bone geometry, textural analysis of trabecular bone, and bone mineral density (BMD). MATERIALS AND METHODS Formal ethics committee approval was obtained for the study, and all participants gave informed written consent. Pelvic radiographs and proximal femur BMD measurements were obtained in 53 women aged 79-82 years in 2006. By 2012, 10 of these patients had experienced a low-impact femoral neck fracture. A Laplacian-based semiautomatic custom algorithm was applied to the radiographs to calculate the texture parameters along the trabecular fibers in the lower neck area for all subjects. Intra- and interobserver reproducibility was calculated by using the root mean square average coefficient of variation to evaluate the robustness of the method. RESULTS The best predictors of hip fracture were entropy (P = .007; reproducibility coefficient of variation < 1%), the neck-shaft angle (NSA) (P = .017), and the BMD (P = .13). For prediction of fracture, the area under the receiver operating characteristic curve was 0.753 for entropy, 0.608 for femoral neck BMD, and 0.698 for NSA. The area increased to 0.816 when entropy and NSA were combined and to 0.902 when entropy, NSA, and BMD were combined. CONCLUSION Textural analysis of pelvic radiographs enables discrimination of patients at risk for femoral neck fracture, and our results show the potential of this conventional imaging method to yield better prediction than that achieved with dual-energy x-ray absorptiometry-based BMD. The combination of the entropy parameter with NSA and BMD can further enhance predictive accuracy.
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Affiliation(s)
- Jérôme Thevenot
- From the Department of Medical Technology (J.T., J.H., P.P., M.M., R.K., S.S., T.J.) and Institute of Health Sciences (R.K.), University of Oulu, PO Box 5000, Oulu 90014, Finland; Department of Sports and Exercise Medicine, Oulu Deaconess Institute, Oulu, Finland (R.K.); Institute of Health Sciences (R.K.) and Department of Diagnostic Radiology (S.S., T.J.), Medical Research Center Oulu, Oulu University Hospital and University of Oulu (J.T., J.H., P.P., M.M., R.K., S.S., T.J.)
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Abstract
The definition of osteoporosis has evolved beyond low bone mineral density to include impaired bone morphology and matrix properties. As such, the subsequent bone density insufficiencies extend beyond the skeletal risks of fracture and have implications for oral health management patients. As our population ages there is a worldwide increase in the risk of decreased bone mineral density and its subsequent morbidity. This makes age an independent risk factor for fracture and decreased bone mineral density. Multiple examinations and diagnostic tests are currently used in combination to develop an algorithm to assess osteoporotic risk. Oral health care professionals should follow these principles and caution should be used in applying a single independent assessment to determine a patient's osteoporotic or bone metabolism risk. Therapeutic approaches for osteoporosis are often divided into nonpharmacological interventions and pharmacological therapies. The periodontist and other oral health care professionals should have a full understanding of the therapeutic options, benefits and implementation of preventive therapies. Bone turnover is a coupled event of bone formation and bone resorption and it is the imbalance of this homeostasis that results in osteoporosis. Based on this uncoupling of bone resorption and formation, osteoporosis or decreased bone mineral density and osteopenia, may be a risk factor for alveolar bone loss in periodontitis. The role of prevention and maintenance with a history of periodontitis and oesteopenia extends beyond biofilm control and should include management of bone mineral density. The chronic periodontal infection in a patient with osteopenia may place the patient at greatly increased risk for alveolar bone loss, gingival recession and root caries. A key component in the management is the oral health professional's knowledge of the interrelationship between skeletal health and periodontal health.
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Thevenot J, Hirvasniemi J, Finnilä M, Pulkkinen P, Kuhn V, Link T, Eckstein F, Jämsä T, Saarakkala S. Trabecular homogeneity index derived from plain radiograph to evaluate bone quality. J Bone Miner Res 2013; 28:2584-91. [PMID: 23677814 DOI: 10.1002/jbmr.1987] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Revised: 05/02/2013] [Accepted: 05/06/2013] [Indexed: 11/06/2022]
Abstract
Radiographic texture analysis has been developed lately to improve the assessment of bone architecture as a determinant of bone quality. We validate here an algorithm for the evaluation of trabecular homogeneity index (HI) in the proximal femur from hip radiographs, with a focus on the impact of the principal compressive system of the trabecular bone, and evaluate its correlation with femoral strength, bone mineral density (BMD), and volumetric trabecular structure parameters. A semiautomatic custom-made algorithm was applied to calculate the HI in the femoral neck and trochanteric areas from radiographs of 178 femoral bone specimens (mean age 79.3 ± 10.4 years). Corresponding neck region was selected in CT scans to calculate volumetric parameters of trabecular structure. The site-specific BMDs were assessed from dual-energy X-ray absorptiometry (DXA), and the femoral strength was experimentally tested in side-impact configuration. Regression analysis was performed between the HI and biomechanical femoral strength, BMD, and volumetric parameters. The correlation between HI and failure load was R(2) = 0.50; this result was improved to R(2) = 0.58 for cervical fractures alone. The discrimination of bones with high risk of fractures (load <3000 N) was similar for HI and BMD (AUC = 0.87). Regression analysis between the HIs versus site-specific BMDs yielded R(2) = 0.66 in neck area, R(2) = 0.60 in trochanteric area, and an overall of R(2) = 0.66 for the total hip. Neck HI and BMD correlated significantly with volumetric structure parameters. We present here a method to assess HI that can explain 50% of an experimental failure load and determines bones with high fracture risk with similar accuracy as BMD. The HI also had good correlation with DXA and computed tomography-derived data.
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Affiliation(s)
- Jérôme Thevenot
- Department of Medical Technology, University of Oulu, Oulu, Finland
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Hadjipanteli A, Kourkoumelis N, Fromme P, Olivo A, Huang J, Speller R. A new technique for the assessment of the 3D spatial distribution of the calcium/phosphorus ratio in bone apatite. Physiol Meas 2013; 34:1399-410. [DOI: 10.1088/0967-3334/34/11/1399] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Radiographic bone texture analysis is correlated with 3D microarchitecture in the femoral head, and improves the estimation of the femoral neck fracture risk when combined with bone mineral density. Eur J Radiol 2013; 82:1494-8. [DOI: 10.1016/j.ejrad.2013.04.042] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Revised: 03/28/2013] [Accepted: 04/19/2013] [Indexed: 11/21/2022]
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Alghamdi HS, Jansen JA. Bone Regeneration Associated with Nontherapeutic and Therapeutic Surface Coatings for Dental Implants in Osteoporosis. TISSUE ENGINEERING PART B-REVIEWS 2013; 19:233-53. [DOI: 10.1089/ten.teb.2012.0400] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Hamdan S. Alghamdi
- Department of Biomaterials, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - John A. Jansen
- Department of Biomaterials, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
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Zhang JK, Yang L, Meng GL, Yuan Z, Fan J, Li D, Chen JZ, Shi TY, Hu HM, Wei BY, Luo ZJ, Liu J. Protection by salidroside against bone loss via inhibition of oxidative stress and bone-resorbing mediators. PLoS One 2013; 8:e57251. [PMID: 23437352 PMCID: PMC3577746 DOI: 10.1371/journal.pone.0057251] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Accepted: 01/23/2013] [Indexed: 01/23/2023] Open
Abstract
Oxidative stress is a pivotal pathogenic factor for bone loss in mouse model. Salidroside, a phenylpropanoid glycoside extracted from Rhodiola rosea L, exhibits potent antioxidative effects. In the present study, we used an in vitro oxidative stress model induced by hydrogen peroxide (H2O2) in MC3T3-E1 cells and a murine ovariectomized (OVX) osteoporosis model to investigate the protective effects of salidroside on bone loss and the related mechanisms. We demonstrated that salidroside caused a significant (P<0.05) elevation of cell survival, alkaline phosphatase (ALP) staining and activity, calcium deposition, and the transcriptional expression of Alp, Col1a1 and Osteocalcin (Ocn) in the presence of H2O2. Moreover, salidroside decreased the production of intracellular reactive oxygen species (ROS), and osteoclast differentiation inducing factors such as receptor activator of nuclear factor-kB ligand (RANKL) and IL-6 induced by H2O2. In vivo studies further demonstrated that salidroside supplementation for 3 months caused a decrease in malondialdehyde (MDA) and an increase in reduced glutathione (GSH) concentration in blood of ovariectomized mouse (P<0.05), it also improved trabecular bone microarchitecture and bone mineral density in the fourth lumbar vertebra and distal femur. Our study indicated that the protection provided by salidroside in alleviating bone loss was mediated, at least in part, via inhibition of the release of bone-resorbing mediators and oxidative damage to bone-forming cells, suggesting that salidroside can be used as an effective remedy in the treatment or prevention of osteoporosis.
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Affiliation(s)
- Jin-Kang Zhang
- Institute of Orthopedic Surgery, Xijing Hospital, Fourth Military Medical University, Xi′an, People's Republic of China
| | - Liu Yang
- Institute of Orthopedic Surgery, Xijing Hospital, Fourth Military Medical University, Xi′an, People's Republic of China
| | - Guo-Lin Meng
- Institute of Orthopedic Surgery, Xijing Hospital, Fourth Military Medical University, Xi′an, People's Republic of China
| | - Zhi Yuan
- Institute of Orthopedic Surgery, Xijing Hospital, Fourth Military Medical University, Xi′an, People's Republic of China
| | - Jing Fan
- Institute of Orthopedic Surgery, Xijing Hospital, Fourth Military Medical University, Xi′an, People's Republic of China
| | - Dan Li
- Institute of Orthopedic Surgery, Xijing Hospital, Fourth Military Medical University, Xi′an, People's Republic of China
| | - Jian-Zong Chen
- Research Center of Traditional Chinese Medicine, Xijing Hospital, Fourth Military Medical University, Xi′an, People's Republic of China
| | - Tian-Yao Shi
- Department of Pharmacology, School of Pharmacy, Fourth Military Medical University, Xi'an, People's Republic of China
| | - Hui-Min Hu
- Institute of Orthopedic Surgery, Xijing Hospital, Fourth Military Medical University, Xi′an, People's Republic of China
| | - Bo-Yuan Wei
- Institute of Orthopedic Surgery, Xijing Hospital, Fourth Military Medical University, Xi′an, People's Republic of China
| | - Zhuo-Jing Luo
- Institute of Orthopedic Surgery, Xijing Hospital, Fourth Military Medical University, Xi′an, People's Republic of China
- * E-mail: (JL); (ZJL)
| | - Jian Liu
- Institute of Orthopedic Surgery, Xijing Hospital, Fourth Military Medical University, Xi′an, People's Republic of China
- * E-mail: (JL); (ZJL)
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Narra N, Nikander R, Viik J, Hyttinen J, Sievänen H. Femoral neck cross-sectional geometry and exercise loading. Clin Physiol Funct Imaging 2013; 33:258-66. [PMID: 23692614 DOI: 10.1111/cpf.12022] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2012] [Accepted: 12/20/2012] [Indexed: 12/23/2022]
Abstract
The aim of this study was to examine the association between different types of exercise loading and femoral neck cross-sectional geometry. Our data comprised proximal femur magnetic resonance (MR) images obtained from 91 female athletes and their 20 age-matched controls. The athletes were categorized according to typical training activity - high impact (high and triple jumping), odd impact (racket and soccer playing), high magnitude (power lifting), repetitive low impact (endurance running) and repetitive non-impact (swimming). Segmented MR images at two locations, narrowest cross-section of the femoral neck (narrowFN) and the cross-section at insertion of articular capsule (distalFN), were investigated to detect between group differences in shape, curvature and buckling ratio derived using image and signal analysis tools. The narrowFN results indicated that the high-impact group had weaker antero-superior (33% larger buckling ratio than controls) but stronger inferior weight-bearing region (32% smaller than controls), while the odd-impact group had stronger superior, posterior and anterior region (21% smaller buckling ratio than controls). The distalFN results indicated that the high-impact group had stronger inferior region (37% smaller buckling ratio), but the odd-impact group had stronger superior region (22% smaller buckling ratio) than the controls. Overall, the results point towards odd-impact exercise loading, with inherently varying directions of impact, associated with more robust cross-sectional geometry along the femoral neck. In conclusion, our one-dimensional polar treatment for geometrical traits and intuitive presentation of differences in trends between exercise groups and controls provides a basis for analysis with high angular accuracy.
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Affiliation(s)
- Nathaniel Narra
- Department of Biomedical Engineering, Tampere University of Technology, Tampere, Finland.
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Le Corroller T, Pithioux M, Chaari F, Rosa B, Parratte S, Maurel B, Argenson JN, Champsaur P, Chabrand P. Bone texture analysis is correlated with three-dimensional microarchitecture and mechanical properties of trabecular bone in osteoporotic femurs. J Bone Miner Metab 2013; 31:82-8. [PMID: 22886379 DOI: 10.1007/s00774-012-0375-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Accepted: 06/26/2012] [Indexed: 01/23/2023]
Abstract
Fracture of the proximal femur is a major public health problem in elderly persons. It has recently been suggested that combining texture analysis and bone mineral density measurement improves the failure load prediction in human femurs. In this study, we aimed to compare bone texture analysis with three-dimensional (3D) microarchitecture and mechanical properties of trabecular bone in osteoporotic femurs. Eight femoral heads from osteoporotic patients who fractured their femoral neck provided 31 bone cores. Bone samples were studied using a new high-resolution digital X-ray device (BMA™, D3A Medical Systems) allowing for texture analysis with fractal parameter H (mean), and were examined using micro-computed tomography (microCT) for 3D microarchitecture. Finally, uniaxial compression tests to failure were performed to estimate failure load and apparent modulus of bone samples. The fractal parameter H (mean) was strongly correlated with bone volume fraction (BV/TV) (r = 0.84) and trabecular thickness (Tb.Th) (r = 0.91) (p < 0.01). H (mean) was also markedly correlated with failure load (r = 0.84) and apparent modulus (r = 0.71) of core samples (p < 0.01). Bone volume fraction (BV/TV) and trabecular thickness (Tb.Th) demonstrated significant correlations with failure load (r = 0.85 and 0.72, respectively) and apparent modulus (r = 0.72 and 0.64, respectively) (p < 0.01). Overall, the best predictors of failure load were H (mean), bone volume fraction, and trabecular thickness, with r (2) coefficients of 0.83, 0.76, and 0.80 respectively. This study shows that the fractal parameter H (mean) is correlated with 3D microCT parameters and mechanical properties of femoral head bone samples, which suggests that radiographic texture analysis is a suitable approach for trabecular bone microarchitecture assessment in osteoporotic femurs.
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Affiliation(s)
- Thomas Le Corroller
- Radiology Department, Hôpital Sainte-Marguerite, 270 Boulevard de Sainte-Marguerite, 13009, Marseille, France.
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Chappard C. [Microarchitecture assessment of human trabecular bone: description of methods]. Med Sci (Paris) 2012; 28:1111-5. [PMID: 23290412 DOI: 10.1051/medsci/20122812022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Trabecular bone microarchitecture changes in relation to mechanical stress, effects of age, osteoporosis and anti-osteoporotic drugs. In vivo, these anomalies can be evaluated using textural parameters on high resolution radiographs and images of DXA. It is possible to extract morphological and topological parameters: apparent on MRI images and 3D with a dedicated device called High resolution peripheral quantitative computed tomography (HR-pQCT) with a resolution close to the size of the trabeculae. In vitro, it is possible to obtain on bone samples a 2D analysis by histomorphometry and a 3D analysis from 10 µm images obtained by synchrotron radiation or conventional micro-CT.
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Affiliation(s)
- Christine Chappard
- Laboratoire de biomécanique et biomatériaux ostéo-articulaires (B2OA), UMR 7052 CNRS, Université Paris Diderot-PRES Sorbonne Paris Cité, 10, avenue de Verdun, 75010 Paris, France.
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Gois MB, Salvatori R, Aguiar-Oliveira MH, Pereira FA, Oliveira CRP, Oliveira-Neto LA, Pereira RMC, Souza AHO, Melo EV, de Paula FJA. The consequences of growth hormone-releasing hormone receptor haploinsufficiency for bone quality and insulin resistance. Clin Endocrinol (Oxf) 2012; 77:379-84. [PMID: 21995288 PMCID: PMC3272308 DOI: 10.1111/j.1365-2265.2011.04263.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Growth hormone (GH)/insulin-like growth factor (IGF) axis and insulin are key determinants of bone remodelling. Homozygous mutations in the GH-releasing hormone receptor (GHRHR) gene (GHRHR) are a frequent cause of genetic isolated GH deficiency (IGHD). Heterozygosity for GHRHR mutation causes changes in body composition and possibly an increase in insulin sensitivity, but its effects on bone quality are still unknown. The objective of this study was to assess the bone quality and metabolism and its correlation with insulin sensitivity in subjects heterozygous for a null mutation in the GHRHR. PATIENTS AND METHODS A cross-sectional study was performed on 76 normal subjects (68·4% females) (N/N) and 64 individuals (64·1% females) heterozygous for a mutation in the GHRHR (MUT/N). Anthropometric features, quantitative ultrasound (QUS) of the heel, bone markers [osteocalcin (OC) and CrossLaps], IGF-I, glucose and insulin were measured, and homeostasis model assessment of insulin resistance (HOMA(IR) ) was calculated. RESULTS There were no differences in age or height between the two groups, but weight (P = 0·007) and BMI (P = 0·001) were lower in MUT/N. There were no differences in serum levels of IGF-I, glucose, T-score or absolute values of stiffness and OC, but insulin (P = 0·01), HOMA(IR) (P = 0·01) and CrossLaps (P = 0·01) were lower in MUT/N. There was no correlation between OC and glucose, OC and HOMA(IR) in the 140 individuals as a whole or in the separate MUT/N or N/N groups. CONCLUSIONS This study suggests that one allele mutation in the GHRHR gene has a greater impact on energy metabolism than on bone quality.
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Affiliation(s)
- Miburge B Gois
- Department of Internal Medicine, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
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Macintyre NJ, Lorbergs AL. Imaging-Based Methods for Non-invasive Assessment of Bone Properties Influenced by Mechanical Loading. Physiother Can 2012; 64:202-15. [PMID: 23449969 DOI: 10.3138/ptc.2011-08bh] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To describe the most common in vivo imaging-based research tools used to assess bone properties that are influenced by mechanical loading associated with exercise, habitual physical activity, or disease states. Bone is a complex metabolically active tissue that adapts to changes in mechanical loading by altering the amount and spatial organization of mineral. METHOD Using a narrative review design, the authors provide an overview of bone biology and biomechanics to emphasize the importance of bone size scale, porosity, and degree of mineralization when interpreting measures acquired using quantitative ultrasound (QUS), dual-energy X-ray absorptiometry (DXA), computed tomography (CT), magnetic resonance imaging (MRI), and finite element analysis (FEA). For each imaging modality, basic imaging principles, typical outcome measures associated with changes in mechanical loading, and salient features for physiotherapists are described. MAIN RESULTS While each imaging modality has strengths and limitations, currently CT-based methods are best suited for determining the effects of mechanical loading on bone properties-particularly in the peripheral skeleton. CONCLUSIONS Regardless of the imaging technology used, the physiotherapist must carefully consider the assumptions of the imaging-based method, the clinical context, the nature of the change in mechanical loading, and the expected time course for change in bone properties. Purpose: To describe the most common in vivo imaging-based research tools used to assess bone properties that are influenced by mechanical loading associated with exercise, habitual physical activity, or disease states. Bone is a complex metabolically active tissue that adapts to changes in mechanical loading by altering the amount and spatial organization of mineral. Method: Using a narrative review design, the authors provide an overview of bone biology and biomechanics to emphasize the importance of bone size scale, porosity, and degree of mineralization when interpreting measures acquired using quantitative ultrasound (QUS), dual-energy X-ray absorptiometry (DXA), computed tomography (CT), magnetic resonance imaging (MRI), and finite element analysis (FEA). For each imaging modality, basic imaging principles, typical outcome measures associated with changes in mechanical loading, and salient features for physiotherapists are described. Main Results: While each imaging modality has strengths and limitations, currently CT-based methods are best suited for determining the effects of mechanical loading on bone properties—particularly in the peripheral skeleton. Conclusions: Regardless of the imaging technology used, the physiotherapist must carefully consider the assumptions of the imaging-based method, the clinical context, the nature of the change in mechanical loading, and the expected time course for change in bone properties.
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Affiliation(s)
- Norma J Macintyre
- School of Rehabilitation Science, McMaster University, Hamilton, Ont
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Abstract
Osteoporosis is a major public health issue in the general population, particularly in postmenopausal women. Patients with cancer may not only be at risk for primary osteoporosis, but for secondary osteoporosis related to cancer therapies-particularly therapies that impair gonadal function, lead to loss of serum estrogen, and negatively affect bone turnover. Normal bone remodeling is influenced by the receptor activator for nuclear kappa-B ligand pathway, calcium, vitamin D, and other nutrition factors, as well as modifiable and nonmodifiable factors. Identifying which patients with cancer are at risk for bone mineral density loss is important and may include patients with breast or prostate cancer, some survivors of pediatric malignancies, and adults with other tumors. Nurses play a major role in identifying those patients and their risk for low-impact fractures, which can have a significant effect on patient morbidity and mortality. Counseling and teaching are central nursing functions, as well as safely administering therapies, particularly bisphosphonates and denosumab.
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Affiliation(s)
- Rita Wickham
- School of Nursing, Northern Michigan University, Marquette, MI, USA.
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Wu CC, Li XB, Han TS, Li P, Liu GW, Wang WZ, Wang Z. Dietary pseudopurpurin effects on bone mineral density and bone geometry architecture in rats. Int J Mol Sci 2012; 13:3431-3443. [PMID: 22489160 PMCID: PMC3317720 DOI: 10.3390/ijms13033431] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2012] [Revised: 03/01/2012] [Accepted: 03/02/2012] [Indexed: 11/25/2022] Open
Abstract
The objective of our study was to evaluate whether feeding pseudopurpurin affects bone mineral density and bone geometry architecture in rats. Pseudopurpurin was extracted, analyzed and purified using an HLPC-ESI-MS. Rats were given 0% and 0.5% pseudopurpurin powder in their diet. Femurs of rats were examined at 0.5, 1 and 2 months after pseudopurpurin feeding. Compared with rats in the group 0%, the bone mineral density, and the calcium, magnesium, zinc and manganese concentrations in the rats femur in the group 0.5% increased significantly at 1 month and 2 months after pseudopurpurin feeding. Analytical results of micro-computed tomography showed that the group 0.5% displayed an increase in the trabecular volume fraction, trabecular thickness and trabecular number of the distal femur at 1 and 2 months after pseudopurpurin feeding, and the mean thickness, inner perimeter, outer perimeter, and area of the femur diaphysis were significantly increased at 2 months after pseudopurpurin feeding compared with the group 0%. In parallel, the trabecular separation and structure model index of the distal femur were decreased, compared with the group 0% at 1 and 2 months after pseudopurpurin feeding. In the 0.5% and 0% groups, there was no damage to kidney and liver by histopathology analysis. The long-term feeding of pseudopurpurin is safe for rats. The feeding of 0.5% pseudopurpurin which has specific chemical affinities for calcium for bone improvement and level of bone mineral density, enhances the geometry architecture compared with the 0% group.
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Affiliation(s)
- Chen-Chen Wu
- College of Animal Science and Veterinary Medicine, Jilin University, Changchun 130062, China; E-Mails: (C.-C.W.); (X.-B.L.); (T.-S.H.); (P.L.)
| | - Xiao-Bing Li
- College of Animal Science and Veterinary Medicine, Jilin University, Changchun 130062, China; E-Mails: (C.-C.W.); (X.-B.L.); (T.-S.H.); (P.L.)
| | - Tie-Suo Han
- College of Animal Science and Veterinary Medicine, Jilin University, Changchun 130062, China; E-Mails: (C.-C.W.); (X.-B.L.); (T.-S.H.); (P.L.)
| | - Peng Li
- College of Animal Science and Veterinary Medicine, Jilin University, Changchun 130062, China; E-Mails: (C.-C.W.); (X.-B.L.); (T.-S.H.); (P.L.)
| | - Guo-Wen Liu
- College of Animal Science and Veterinary Medicine, Jilin University, Changchun 130062, China; E-Mails: (C.-C.W.); (X.-B.L.); (T.-S.H.); (P.L.)
| | - Wei-Zhong Wang
- College of Animal Food and Science Technology, Yunnan Agriculture University, Kunming 650201, China; E-Mail:
| | - Zhe Wang
- College of Animal Science and Veterinary Medicine, Jilin University, Changchun 130062, China; E-Mails: (C.-C.W.); (X.-B.L.); (T.-S.H.); (P.L.)
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Le Corroller T, Halgrin J, Pithioux M, Guenoun D, Chabrand P, Champsaur P. Combination of texture analysis and bone mineral density improves the prediction of fracture load in human femurs. Osteoporos Int 2012; 23:163-9. [PMID: 21739104 DOI: 10.1007/s00198-011-1703-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2011] [Accepted: 06/16/2011] [Indexed: 01/23/2023]
Abstract
UNLABELLED Twenty-one excised femurs were studied using (1) a high-resolution digital X-ray device to estimate three textural parameters, (2) dual-energy X-ray absorptiometry (DXA) to measure bone mineral density (BMD), and (3) mechanical tests to failure. Textural parameters significantly correlated with BMD (p < 0.05) and bone strength (p < 0.05). Combining texture parameters and BMD significantly improved the fracture load prediction from adjusted r(2) = 0.74 to adjusted r(2) =0.82 (p < 0.05). INTRODUCTION The purpose of this study is to determine if the combination of bone texture parameters using a new high-resolution X-ray device and BMD measurement by DXA provided a better prediction of femoral failure load than BMD evaluation alone. METHODS The proximal ends of 21 excised femurs were studied using (1) a high-resolution digital X-ray device (BMA, D3A Medical Systems) to estimate three textural parameters: fractal parameter Hmean, co-occurrence, and run-length matrices, (2) DXA to measure BMD, and (3) mechanical tests to failure in a side-impact configuration. Regions of interest in the femoral neck, intertrochanteric region, and greater trochanter were selected for DXA and bone texture analysis. Every specimen was scanned twice with repositioning before mechanical testing to assess reproducibility using intraclass correlation coefficient (ICC) with 95% confidence interval. The prediction of femoral failure load was evaluated using multiple regression analysis. RESULTS Thirteen femoral neck and 8 intertrochanteric fractures were observed with a mean failure load of 2,612 N (SD, 1,382 N). Fractal parameter Hmean, co-occurrence, and run-length matrices each significantly correlated with site-matched BMD (p < 0.05) and bone strength (p < 0.05). The ICC of the textural parameters varied between 0.65 and 0.90. Combining bone texture parameters and BMD significantly improved the fracture load prediction from adjusted r(2) =0.74 to adjusted r(2) = 0.82 (p < 0.05). CONCLUSION In these excised femurs, the combination of bone texture parameters with BMD demonstrated a better performance in the failure load prediction than that of BMD alone.
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Affiliation(s)
- T Le Corroller
- Department of Radiology, Hôpital Sainte Marguerite, 270 Boulevard de Sainte Marguerite, 13009 Marseille, France.
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Abstract
The age-related reduction in bone mass is disproportionally related to skeletal weakening, suggesting that microarchitectural changes are also important determinants of bone quality. The study of cortical and trabecular microstructure, which for many years was mainly based on two-dimensional histologic and scanning electron microscopy imaging, gained a tremendous momentum in the last decade and a half, due to the introduction of microcomputed tomography (μCT). This technology provides highly accurate qualitative and quantitative analyses based on three-dimensional images at micrometer resolution, which combined with finite elemental analysis predicts the biomechanical implications of microstructural changes. Global μCT analyses of trabecular bone have repeatedly suggested that the main age-related change in this compartment is a decrease in trabecular number with unaltered, or even increased, trabecular thickness. However, we show here that this may result from a bias whereby thick trabeculae near the cortex and the early clearance of thin struts mask authentic trabecular thinning. The main cortical age-related change is increased porosity due to negatively balanced osteonal remodeling and expansion of Haversian canals, which occasionally merge with endosteal and periosteal resorption bays, thus leading to rapid cortical thinning and cortical weakening. The recent emergence of CT systems with submicrometer resolution provides novel information on the age-related decrease in osteocyte lacunar density and related micropetrosis, the result of lacunar hypermineralization. Last but not least, the use of the submicrometer CT systems confirmed the occurrence of microcracks in the skeletal mineralized matrix and vastly advanced their morphologic characterization and mode of initiation and propagation.
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Affiliation(s)
- Yankel Gabet
- Department of Anatomy and Anthropology, Sackler School of Medicine, Tel Aviv University, Tel Aviv, 69978, Israel
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Modlesky CM, Bajaj D, Kirby JT, Mulrooney BM, Rowe DA, Miller F. Sex differences in trabecular bone microarchitecture are not detected in pre and early pubertal children using magnetic resonance imaging. Bone 2011; 49:1067-72. [PMID: 21851868 PMCID: PMC3583530 DOI: 10.1016/j.bone.2011.07.041] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2011] [Revised: 07/11/2011] [Accepted: 07/28/2011] [Indexed: 10/17/2022]
Abstract
INTRODUCTION Sex differences in trabecular bone microarchitecture have been reported in adults and adolescents, but studies in children are lacking. The primary aim of this study was to determine if there are sex differences in magnetic resonance imaging (MRI)-based measures of trabecular bone microarchitecture at the distal femur of children. MATERIALS AND METHODS Pre and early pubertal boys (n=23) and girls (n=20) between the 5th and 95th percentiles for height, body mass and BMI were studied. Apparent trabecular bone volume to total volume (appBV/TV), trabecular number (appTb.N), trabecular thickness (appTb.Th), trabecular separation (appTb.Sp) and a composite measure of trabecular bone microarchitecture (TBMcom) were assessed at the lateral aspect of the distal femur using MRI. Areal bone mineral density (aBMD), bone mineral content (BMC) and bone area were assessed at the distal femur using dual-energy X-ray absorptiometry (DXA). Tanner staging was used to assess pubertal development. Physical activity was assessed using an accelerometry-based activity monitor. Calcium intake was assessed using diet records. RESULTS There were no sex differences in age, height, femur length, body mass, physical activity or calcium intake (all P>0.05). There were no sex differences in any MRI-based measure of trabecular bone microarchitecture. Consistent with the MRI-based measures, there were no differences in aBMD, BMC or bone area from DXA at the distal femur (P>0.05). appBV/TV, appTb.N, appTb.Th, appTb.Sp and TBMcom were also moderately to strongly related to aBMD (r=0.73, 0.63, 0.51, -0.74 and 0.61, respectively, p<0.001) and BMC (r=0.84, 0.63, 0.66, -0.80 and 0.77, respectively, P<0.001). CONCLUSIONS The findings suggest that there are no differences in measures of trabecular bone microarchitecture at the distal femur of pre and early pubertal boys and girls who are similar in size, physical activity and calcium intake. Future studies with larger sample sizes that cover all pubertal stages are needed to determine if sex differences in trabecular bone microarchitecture emerge at the distal femur and other weight bearing bone sites.
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Affiliation(s)
- Christopher M Modlesky
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE 19716, USA.
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43
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Zhao X, Wu ZX, Zhang Y, Yan YB, He Q, Cao PC, Lei W. Anti-osteoporosis activity of Cibotium barometz extract on ovariectomy-induced bone loss in rats. JOURNAL OF ETHNOPHARMACOLOGY 2011; 137:1083-1088. [PMID: 21782010 DOI: 10.1016/j.jep.2011.07.017] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2011] [Revised: 05/22/2011] [Accepted: 07/07/2011] [Indexed: 05/31/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Recent research has confirmed that Cibotium barometz could inhibits osteoclast formation with no affect on BMM cell viability. However, the influence of Cibotium barometz on osteoporosis in animals is relatively unknown. The purpose of this study is to systemically investigate the effects of Cibotium barometz extract (CBE) on ovariectomy-induced osteoporosis in rats. MATERIALS AND METHODS A total of Seventy-two 3-month-old female Sprague-Dawley rats were used and randomly divided into sham-operated group and five ovariectomized (OVX) groups: OVX with vehicle; OVX with 17β-estradiol (E2, 25 μg/kg/day); OVX with CBE of graded doses (100, 300, or 500 mg/kg/day). Daily oral administration of E2 or CBE began 4 weeks after the surgery and lasted for 16 weeks. Bone mass, bone turnover and strength were analyzed by DEXA, biochemical markers and three-point bending test. The trabecular bone microarchitecture was evaluated by MicroCT. RESULTS CBE prevented total BMD decrease in the femur induced by OVX, which was accompanied by a significant decrease in skeletal remodeling, as was evidenced by the decreased levels of the bone turnover markers, such as osteocalcin (OC), alkaline phosphatese (ALP), deoxypyridinoline (DPD), and urinary Ca and P excretions. The treatment could also enhance the bone strength and prevent the deterioration of trabecular microarchitecture. CONCLUSIONS The present study indicated that Cibotium barometz extract might be a potential alternative medicine for the prevention and treatment of postmenopausal osteoporosis.
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Affiliation(s)
- Xiong Zhao
- Department of Orthopeadics, Xijing Hospital, The Fourth Military Medical University, No 17 Changlexi Road, Xi'an 710032, China
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Affiliation(s)
- Adele L. Boskey
- Musculoskeletal Integrity Program, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA
| | - Eve Donnelly
- Musculoskeletal Integrity Program, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA
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45
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Abstract
BACKGROUND The skeleton plays a critical structural role in bearing functional loads, and failure to do so results in fracture. As we evaluate new therapeutics and consider treatments to prevent skeletal fractures, understanding the basic mechanics underlying whole bone testing and the key principles and characteristics contributing to the structural strength of a bone is critical. QUESTIONS/PURPOSES We therefore asked: (1) How are whole bone mechanical tests performed and what are the key outcomes measured? (2) How do the intrinsic characteristics of bone tissue contribute to the mechanical properties of a whole bone? (3) What are the effects of extrinsic characteristics on whole bone mechanical behavior? (4) Do environmental factors affect whole bone mechanical properties? METHODS We conducted a PubMed search using specific search terms and limiting our included articles to those related to in vitro testing of whole bones. Basic solid mechanics concepts are summarized in the context of whole bone testing and the determinants of whole bone behavior. RESULTS Whole bone mechanical tests measure structural stiffness and strength from load-deformation data. Whole bone stiffness and strength are a function of total bone mass and the tissue geometric distribution and material properties. Age, sex, genetics, diet, and activity contribute to bone structural performance and affect the incidence of skeletal fractures. CONCLUSIONS Understanding and preventing skeletal fractures is clinically important. Laboratory tests of whole bone strength are currently the only measures for in vivo fracture prediction. In the future, combined imaging and engineering models may be able to predict whole bone strength noninvasively.
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Abstract
BACKGROUND Bone mass, geometry, and tissue material properties contribute to bone structural integrity. Thus, bone strength arises from both bone quantity and quality. Bone quality encompasses the geometric and material factors that contribute to fracture resistance. QUESTIONS/PURPOSES This review presents an overview of the methods for assessing bone quality across multiple length scales, their outcomes, and their relative advantages and disadvantages. METHODS A PubMed search was conducted to identify methods related to bone mechanical testing, imaging, and compositional analysis. Using various exclusion criteria, articles were selected for inclusion. RESULTS Methods for assessing mechanical properties include whole-bone, bulk tissue, microbeam, and micro- and nanoindentation testing techniques. Outcomes include structural strength and material modulus. Advantages include direct assessment of bone strength; disadvantages include specimen destruction during testing. Methods for characterizing bone geometry and microarchitecture include quantitative CT, high-resolution peripheral quantitative CT, high-resolution MRI, and micro-CT. Outcomes include three-dimensional whole-bone geometry, trabecular morphology, and tissue mineral density. The primary advantage is the ability to image noninvasively; disadvantages include the lack of a direct measure of bone strength. Methods for measuring tissue composition include scanning electron microscopy, vibrational spectroscopy, nuclear magnetic resonance imaging, and chemical and physical analytical techniques. Outcomes include mineral density and crystallinity, elemental composition, and collagen crosslink composition. Advantages include the detailed material characterization; disadvantages include the need for a biopsy. CONCLUSIONS Although no single method can completely characterize bone quality, current noninvasive imaging techniques can be combined with ex vivo mechanical and compositional techniques to provide a comprehensive understanding of bone quality.
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Affiliation(s)
- Eve Donnelly
- Mineralized Tissues Laboratory, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA
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Evaluation of vertebral bone marrow fat content by chemical-shift MRI in osteoporosis. Skeletal Radiol 2011; 40:577-85. [PMID: 21069523 DOI: 10.1007/s00256-010-1048-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2010] [Revised: 08/09/2010] [Accepted: 09/29/2010] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To quantitatively evaluate vertebral bone marrow fat content and investigate its association with osteoporosis with chemical-shift magnetic resonance imaging (CS-MRI). MATERIALS AND METHODS Fifty-six female patients (age range 50-65 years) with varying bone mineral densities as documented with dual x-ray absorptiometry (DXA) were prospectively included in the study. According to the DXA results, the patients were grouped as normal bone density, osteopenic, or osteoporotic. In order to calculate fat content, the lumbar region was visualized in the sagittal plane by CS-MRI sequence. "Region of interest" (ROI)s were placed within L3 vertebral bodies and air (our reference point) at different time points by different radiologists. Fat content was calculated through "signal intensity (SI) suppression rate" and "SI Index". The quantitative values were compared statistically with those obtained from DXA examinations. Kruskal-Wallis, and Mann-Whitney U tests were used for comparisons between groups. The reliability of the measurements performed by two radiologists was evaluated with the "intraclass correlation coefficient". This study was approved by an institutional review board and all participants provided informed consent to participate in the study. RESULTS Eighteen subjects with normal bone density (mean T score, 0.39 ± 1.3 [standard deviation]), 20 subjects with osteopenia (mean T score, -1.79 ± 0.38), and 18 subjects with osteoporosis (mean T score, -3 ± 0.5) were determined according to DXA results. The median age was 55.9 (age range 50-64 years) in the normal group, 55.5 (age range 50-64 years) in the osteopenic group, and 55.1 (age range 50-65 years) in the osteoporotic group (p = 0.872). In the CS-MRI examination, the values of "SI suppression ratio" and "SI Index" (median [min:max]) were calculated by the first and second reader, independently. There was no statistically significant difference between the groups with regard to vertebral bone marrow fat content (p > 0.05). According to the "intraclass correlation coefficient", the measurements were reliable (0.55 and 0.60). CONCLUSIONS Vertebral bone marrow fat content calculated with CS-MRI is not a reliable parameter for predicting bone mineral density in female patients aged between 50 and 65 years.
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Podshivalov L, Fischer A, Bar-Yoseph PZ. 3D hierarchical geometric modeling and multiscale FE analysis as a base for individualized medical diagnosis of bone structure. Bone 2011; 48:693-703. [PMID: 21193070 DOI: 10.1016/j.bone.2010.12.022] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2010] [Revised: 12/13/2010] [Accepted: 12/17/2010] [Indexed: 10/18/2022]
Abstract
This paper describes a new alternative for individualized mechanical analysis of bone trabecular structure. This new method closes the gap between the classic homogenization approach that is applied to macro-scale models and the modern micro-finite element method that is applied directly to micro-scale high-resolution models. The method is based on multiresolution geometrical modeling that generates intermediate structural levels. A new method for estimating multiscale material properties has also been developed to facilitate reliable and efficient mechanical analysis. What makes this method unique is that it enables direct and interactive analysis of the model at every intermediate level. Such flexibility is of principal importance in the analysis of trabecular porous structure. The method enables physicians to zoom-in dynamically and focus on the volume of interest (VOI), thus paving the way for a large class of investigations into the mechanical behavior of bone structure. This is one of the very few methods in the field of computational bio-mechanics that applies mechanical analysis adaptively on large-scale high resolution models. The proposed computational multiscale FE method can serve as an infrastructure for a future comprehensive computerized system for diagnosis of bone structures. The aim of such a system is to assist physicians in diagnosis, prognosis, drug treatment simulation and monitoring. Such a system can provide a better understanding of the disease, and hence benefit patients by providing better and more individualized treatment and high quality healthcare. In this paper, we demonstrate the feasibility of our method on a high-resolution model of vertebra L3.
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Affiliation(s)
- L Podshivalov
- Laboratory for CAD, Faculty of Mechanical Engineering, Technion, Israel.
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Ranjanomennahary P, Ghalila SS, Malouche D, Marchadier A, Rachidi M, Benhamou C, Chappard C. Comparison of radiograph-based texture analysis and bone mineral density with three-dimensional microarchitecture of trabecular bone. Med Phys 2011; 38:420-8. [PMID: 21361210 DOI: 10.1118/1.3528125] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE Hip fracture is a serious health problem and textural methods are being developed to assess bone quality. The authors aimed to perform textural analysis at femur on high-resolution digital radiographs compared to three-dimensional (3D) microarchitecture comparatively to bone mineral density. METHODS Sixteen cadaveric femurs were imaged with an x-ray device using a C-MOS sensor. One 17 mm square region of interest (ROI) was selected in the femoral head (FH) and one in the great trochanter (GT). Two-dimensional (2D) textural features from the co-occurrence matrices were extracted. Site-matched measurements of bone mineral density were performed. Inside each ROI, a 16 mm diameter core was extracted. Apparent density (Dapp) and bone volume proportion (BV/TV(Arch)) were measured from a defatted bone core using Archimedes' principle. Microcomputed tomography images of the entire length of the core were obtained (Skyscan 1072) at 19.8 microm of resolution and usual 3D morphometric parameters were computed on the binary volume after calibration from BV/TV(Arch). Then, bone surface/bone volume, trabecular thickness, trabecular separation, and trabecular number were obtained by direct methods without model assumption and the structure model index was calculated. RESULTS In univariate analysis, the correlation coefficients between 2D textural features and 3D morphological parameters reached 0.83 at the FH and 0.79 at the GT. In multivariate canonical correlation analysis, coefficients of the first component reached 0.95 at the FH and 0.88 at the GT. CONCLUSIONS Digital radiographs, widely available and economically viable, are an alternative method for evaluating bone microarchitectural structure.
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Affiliation(s)
- P Ranjanomennahary
- Caractéristation du Tissu Osseux par Imagerie, U658 Inserm, Orleans, France
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50
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Texture analysis, bone mineral density, and cortical thickness of the proximal femur: fracture risk prediction. J Comput Assist Tomogr 2011; 34:949-57. [PMID: 21084915 DOI: 10.1097/rct.0b013e3181ec05e4] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The objectives of this study were to perform a clinical study analyzing bone quality in multidetector computed tomographic images of the femur using bone mineral density (BMD), cortical thickness, and texture algorithms in differentiating osteoporotic fracture and control subjects; to differentiate fracture types. METHODS Femoral head, trochanteric, intertrochanteric, and upper and lower neck were segmented (fracture, n = 30; control, n = 10). Cortical thickness, BMD, and texture analysis were obtained using co-occurrence matrices, Minkowski dimension, and functional and scaling index method. RESULTS Bone mineral density and cortical thickness performed best in the neck region, and texture measures performed best in the trochanter. Only cortical thickness and texture measures differentiated femoral neck and intertrochanteric fractures. CONCLUSIONS This study demonstrates that differentiation of osteoporotic fracture subjects and controls is achieved with texture measures, cortical thickness, and BMD; however, performance is region specific.
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