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Jullienne A, Malo M, Shaw K, Zheng Y, Johnston JD, Kontulainen S, Chilibeck PD, Dadachova E, Obenaus A, Sarty GE. Musculoskeletal perturbations of deep space radiation: Assessment using a Gateway MRI. LIFE SCIENCES IN SPACE RESEARCH 2024; 42:74-83. [PMID: 39067994 DOI: 10.1016/j.lssr.2024.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 05/25/2024] [Accepted: 05/27/2024] [Indexed: 07/30/2024]
Abstract
Human space exploration expansion from Low-Earth Orbit to deep space is accelerating the need to monitor and address the known health concerns related to deep space radiation. The human musculoskeletal system is vulnerable to these risks (alongside microgravity) and its health reflects the well-being of other body systems. Multiparametric magnetic resonance imaging (MRI) is an important approach for assessing temporal physiological changes in the musculoskeletal system. We propose that ultra-low-field MRI provides an optimal low Size Weight and Power (SwaP) solution for non-invasively monitoring muscle and bone changes on the planned Gateway lunar space station. Our proposed ultra-low-field Gateway MRI meets low SWaP design specifications mandated by limited room in the lunar space station. This review summarizes the current state of our knowledge on musculoskeletal consequences of spaceflight, especially with respect to radiation, and then elaborates how MRI can be used to monitor the deleterious effects of space travel and the efficacy of putative countermeasures. We argue that an ultra-low-field MRI in cis-lunar space on the Gateway can provide valuable research and medical insights into the effects of deep space radiation exposure on astronauts. Such an MRI would also allow the development of imaging protocols that would facilitate Earth-bound teams to monitor space personnel musculoskeletal changes during future interplanetary spaceflight. It will especially have a role in monitoring countermeasures, such as the use of melanin, in protecting space explorers.
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Affiliation(s)
- Amandine Jullienne
- School of Medicine, University of California Irvine, 1001 Health Sciences Rd, Irvine, CA 92617, United States
| | - Mackenzie Malo
- College of Pharmacy and Nutrition, University of Saskatchewan, 107 Wiggins Rd, Saskatoon, SK S7N 5E5, Canada
| | - Keely Shaw
- College of Kinesiology, University of Saskatchewan, 87 Campus Dr, Saskatoon, SK S7N 5B2, Canada
| | - Yuwen Zheng
- College of Kinesiology, University of Saskatchewan, 87 Campus Dr, Saskatoon, SK S7N 5B2, Canada
| | - James D Johnston
- College of Engineering, University of Saskatchewan, 57 Campus Dr, Saskatoon, SK S7N 5A9, Canada
| | - Saija Kontulainen
- College of Kinesiology, University of Saskatchewan, 87 Campus Dr, Saskatoon, SK S7N 5B2, Canada
| | - Philip D Chilibeck
- College of Kinesiology, University of Saskatchewan, 87 Campus Dr, Saskatoon, SK S7N 5B2, Canada
| | - Ekaterina Dadachova
- College of Pharmacy and Nutrition, University of Saskatchewan, 107 Wiggins Rd, Saskatoon, SK S7N 5E5, Canada
| | - Andre Obenaus
- School of Medicine, University of California Irvine, 1001 Health Sciences Rd, Irvine, CA 92617, United States; School of Medicine, University of California Riverside, United States
| | - Gordon E Sarty
- Space MRI Lab, University of Saskatchewan, QuanTA Centre, 9 Campus Dr, Saskatoon, SK S7N 5A5, Canada.
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Dai J, Liu T, Torigian DA, Tong Y, Han S, Nie P, Zhang J, Li R, Xie F, Udupa JK. GA-Net: A geographical attention neural network for the segmentation of body torso tissue composition. Med Image Anal 2024; 91:102987. [PMID: 37837691 PMCID: PMC10841506 DOI: 10.1016/j.media.2023.102987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 07/27/2023] [Accepted: 09/28/2023] [Indexed: 10/16/2023]
Abstract
PURPOSE Body composition analysis (BCA) of the body torso plays a vital role in the study of physical health and pathology and provides biomarkers that facilitate the diagnosis and treatment of many diseases, such as type 2 diabetes mellitus, cardiovascular disease, obstructive sleep apnea, and osteoarthritis. In this work, we propose a body composition tissue segmentation method that can automatically delineate those key tissues, including subcutaneous adipose tissue, skeleton, skeletal muscle tissue, and visceral adipose tissue, on positron emission tomography/computed tomography scans of the body torso. METHODS To provide appropriate and precise semantic and spatial information that is strongly related to body composition tissues for the deep neural network, first we introduce a new concept of the body area and integrate it into our proposed segmentation network called Geographical Attention Network (GA-Net). The body areas are defined following anatomical principles such that the whole body torso region is partitioned into three non-overlapping body areas. Each body composition tissue of interest is fully contained in exactly one specific minimal body area. Secondly, the proposed GA-Net has a novel dual-decoder schema that is composed of a tissue decoder and an area decoder. The tissue decoder segments the body composition tissues, while the area decoder segments the body areas as an auxiliary task. The features of body areas and body composition tissues are fused through a soft attention mechanism to gain geographical attention relevant to the body tissues. Thirdly, we propose a body composition tissue annotation approach that takes the body area labels as the region of interest, which significantly improves the reproducibility, precision, and efficiency of delineating body composition tissues. RESULTS Our evaluations on 50 low-dose unenhanced CT images indicate that GA-Net outperforms other architectures statistically significantly based on the Dice metric. GA-Net also shows improvements for the 95% Hausdorff Distance metric in most comparisons. Notably, GA-Net exhibits more sensitivity to subtle boundary information and produces more reliable and robust predictions for such structures, which are the most challenging parts to manually mend in practice, with potentially significant time-savings in the post hoc correction of these subtle boundary placement errors. Due to the prior knowledge provided from body areas, GA-Net achieves competitive performance with less training data. Our extension of the dual-decoder schema to TransUNet and 3D U-Net demonstrates that the new schema significantly improves the performance of these classical neural networks as well. Heatmaps obtained from attention gate layers further illustrate the geographical guidance function of body areas for identifying body tissues. CONCLUSIONS (i) Prior anatomic knowledge supplied in the form of appropriately designed anatomic container objects significantly improves the segmentation of bodily tissues. (ii) Of particular note are the improvements achieved in the delineation of subtle boundary features which otherwise would take much effort for manual correction. (iii) The method can be easily extended to existing networks to improve their accuracy for this application.
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Affiliation(s)
- Jian Dai
- School of Information Science and Engineering, Yanshan University, Qinhuangdao 066004, Hebei, China; The Key Laboratory for Computer Virtual Technology and System Integration of Hebei Province, Yanshan University, Qinhuangdao 066004, Hebei, China.
| | - Tiange Liu
- School of Information Science and Engineering, Yanshan University, Qinhuangdao 066004, Hebei, China; The Key Laboratory for Computer Virtual Technology and System Integration of Hebei Province, Yanshan University, Qinhuangdao 066004, Hebei, China.
| | - Drew A Torigian
- Medical Image Processing Group, Department of Radiology, University of Pennsylvania, Philadelphia 19104, PA, United States of America.
| | - Yubing Tong
- Medical Image Processing Group, Department of Radiology, University of Pennsylvania, Philadelphia 19104, PA, United States of America.
| | - Shiwei Han
- School of Information Science and Engineering, Yanshan University, Qinhuangdao 066004, Hebei, China; The Key Laboratory for Computer Virtual Technology and System Integration of Hebei Province, Yanshan University, Qinhuangdao 066004, Hebei, China.
| | - Pengju Nie
- School of Information Science and Engineering, Yanshan University, Qinhuangdao 066004, Hebei, China; The Key Laboratory for Computer Virtual Technology and System Integration of Hebei Province, Yanshan University, Qinhuangdao 066004, Hebei, China.
| | - Jing Zhang
- School of Information Science and Engineering, Yanshan University, Qinhuangdao 066004, Hebei, China; The Key Laboratory for Computer Virtual Technology and System Integration of Hebei Province, Yanshan University, Qinhuangdao 066004, Hebei, China.
| | - Ran Li
- School of Information Science and Engineering, Yanshan University, Qinhuangdao 066004, Hebei, China; The Key Laboratory for Computer Virtual Technology and System Integration of Hebei Province, Yanshan University, Qinhuangdao 066004, Hebei, China.
| | - Fei Xie
- School of AOAIR, Xidian University, Xi'an 710071, Shaanxi, China.
| | - Jayaram K Udupa
- Medical Image Processing Group, Department of Radiology, University of Pennsylvania, Philadelphia 19104, PA, United States of America.
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Bae WC. Advances and Shortfalls in MRI Evaluation of Osteoporosis. Radiology 2023; 307:e223144. [PMID: 36692406 PMCID: PMC10102620 DOI: 10.1148/radiol.223144] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 12/09/2022] [Accepted: 12/12/2022] [Indexed: 01/25/2023]
Affiliation(s)
- Won C. Bae
- From the Department of Radiology, University of California San Diego, 9427 Health Sciences Dr, La Jolla, CA 92093
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Zaia A, Maponi P, Sallei M, Galeazzi R, Scendoni P. Measuring Drug Therapy Effect on Osteoporotic Fracture Risk by Trabecular Bone Lacunarity: The LOTO Study. Biomedicines 2023; 11:781. [PMID: 36979760 PMCID: PMC10044723 DOI: 10.3390/biomedicines11030781] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 02/28/2023] [Accepted: 03/02/2023] [Indexed: 03/08/2023] Open
Abstract
An MRI method providing one parameter (TBLβ: trabecular-bone-lacunarity-parameter-β) that is sensitive to trabecular bone architecture (TBA) changes with aging and osteoporosis is under study as a new tool in the early diagnosis of bone fragility fracture. A cross-sectional and prospective observational study (LOTO: Lacunarity Of Trabecular bone in Osteoporosis) on over-50s women, at risk for bone fragility fracture, was designed to validate the method. From the baseline data, we observed that in women with prevalent vertebral fractures (VF+), TBA was differently characterized by TBLβ when osteoporosis treatment is considered. Here we verify the potential of TBLβ as an index of osteoporosis treatment efficacy. Untreated (N = 156) and treated (N = 123) women were considered to assess differences in TBLβ related to osteoporosis treatment. Prevalent VFs were found in 31% of subjects, 63% of which were under osteoporosis medications. The results show that TBLβ discriminates between VF+ and VF- patients (p = 0.004). This result is mostly stressed in untreated subjects. Treatment, drug therapy in particular (89% Bisphosphonates), significantly counteracts the difference between VF+ and VF- within and between groups: TBLβ values in treated patients are comparable to untreated VF- and statistically higher than untreated VF+ (p = 0.014) ones. These results highlight the potential role of TBLβ as an index of treatment efficacy.
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Affiliation(s)
- Annamaria Zaia
- Centre of Innovative Models and Technology for Ageing Care, Scientific Direction, IRCCS INRCA, 60121 Ancona, Italy
| | - Pierluigi Maponi
- School of Science and Technology, University of Camerino, 62032 Camerino, Italy
| | - Manuela Sallei
- Medical Imaging Division, Geriatric Hospital, IRCCS INRCA, 60121 Ancona, Italy
| | - Roberta Galeazzi
- Analysis Laboratory, Geriatric Hospital, IRCCS INRCA, 60121 Ancona, Italy
| | - Pietro Scendoni
- Rheumatology Division, Geriatric Hospital, IRCCS INRCA, 63900 Fermo, Italy
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Huang S, Cui X, Han H, Zhang Y, Gao B, Yu W. Study on the scanning protocols for measuring bone mineral density by gemstone CT spectral imaging based on European spine phantom. Acta Radiol 2023; 64:346-352. [PMID: 34877886 DOI: 10.1177/02841851211063014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Gemstone spectral computed tomography (GSCT) has been used to measure bone mineral density (BMD) in human vertebrae and animal models gradually. PURPOSE To investigate the effect of scanning protocols for BMD measurements by GSCT using the European spine phantom (ESP) and its accuracy and precision. MATERIAL AND METHODS The ESP number 145 containing three hydroxyapatite (HAP) inserts with densities of 50, 100, and 200 mg/cm3 were labeled as L1, L2, and L3, respectively. Quantitative CT (QCT) protocol and 14 groups of scanning protocols configured by GSCT were used to repeatedly scan the ESP 10 times. Their measurements were compared with the true values of ESP and their relative standard deviation and relative error were calculated. RESULTS The measured values of the three inserts at different exposure levels were statistically significant (P < 0.05). The measured values in the 0.8 s/r 260 mA group, 0.5 s/r 630 mA group, and 0.6 s/r 640 mA group were not significantly different from the actual ESP values for L1 and L2. However, the measured values at all the parameters were significantly different from the actual values for the L3. CONCLUSION CT gemstone spectral imaging can accurately and quantitatively measure the HAP value of ESP, but the results of BMD will be affected by the scanning protocols. The best scanning parameter of ESP measured by GSCT was 0.8 s/r 260 mA, taking dose into consideration, and the measurement accuracy of vertebrae with low BMD was higher than that of QCT under this parameter.
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Affiliation(s)
- Shihao Huang
- Dalian Medical University, Dalian, Liaoning, PR China
| | - Xuan Cui
- Department of Medical Imaging, Weifang Medical College, Weifang, Shandong, PR China
| | - Heli Han
- Radiological Department, 12648Qingdao Municipal Hospital, Qingdao University, Qingdao, Shandong, PR China
| | - Yuan Zhang
- Dalian Medical University, Dalian, Liaoning, PR China
| | - Bing Gao
- Dalian Medical University, Dalian, Liaoning, PR China
| | - Wanjiang Yu
- Radiological Department, 12648Qingdao Municipal Hospital, Qingdao University, Qingdao, Shandong, PR China
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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: 3] [Impact Index Per Article: 1.5] [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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Trentadue M, Sozzi C, Idolazzi L, Lazzarini G, Murano RS, Gatti D, Rossini M, Piovan E. Magnetic resonance imaging at 3.0-T in postmenopausal osteoporosis: a prospective study and review of the literature. Radiol Bras 2022; 55:216-224. [PMID: 35983340 PMCID: PMC9380604 DOI: 10.1590/0100-3984.2021.0124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 09/07/2021] [Indexed: 12/03/2022] Open
Abstract
Objective To promote advanced research using magnetic resonance imaging (MRI) in the diagnosis of and screening for osteoporosis by looking for correlations among the T-scores measured by dual-energy X-ray absorptiometry (DEXA), the apparent diffusion coefficient (ADC) values on diffusion-weighted imaging (DWI), and the T1-weighted signal intensity values. Materials and Methods This was a prospective study of postmenopausal women with no contraindications to MRI and no history of cancer who underwent DEXA within 30 days before or after the MRI examination. A 3.0-T scanner was used in order to acquire sagittal sequences targeting the lumbar spine. Results Thirteen women underwent DEXA and MRI. In two cases, the MRI was discontinued early. Therefore, the final sample comprised 11 patients. The ADC values and T1-weighted signal intensity were found to be higher in patients with osteoporosis. However, among the patients > 60 years of age with osteoporosis, ADC values were lower and T1-weighted signal intensity was even higher. Conclusion It is unlikely that MRI will soon replace DEXA for the diagnostic workup of osteoporosis. Although DWI and ADC mapping are useful for understanding the pathophysiology of osteoporosis, we believe that T1-weighted sequences are more sensitive than is DWI as a means of performing a qualitative analysis of vertebral alterations.
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Affiliation(s)
- Mirko Trentadue
- Radiology Unit, Azienda ULSS 9 Scaligera, Hospital M. Magalini, Villafranca di Verona, Italy
| | - Carlo Sozzi
- SC Neuroradiology, ASST Carlo Poma, Mantova, Italy
| | - Luca Idolazzi
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Gianluigi Lazzarini
- Independent Researcher, self-employed Occupational Medicine specialist, Peschiera del Garda, Italy
| | - Riccardo Sante Murano
- Radiology Unit, Azienda ULSS 9 Scaligera, Hospital M. Magalini, Villafranca di Verona, Italy
| | - Davide Gatti
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Maurizio Rossini
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
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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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Fleischhacker E, Gleich J, Hesse E, Bücking B, Liener UC, Neuerburg C. [Individual aspects in eldery patients with fragility fractures]. Radiologe 2021; 61:1107-1114. [PMID: 34767032 DOI: 10.1007/s00117-021-00928-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Due to our ageing population, the number of elderly patients who are treated in the emergency department due to low-energy trauma (e.g., tripping) continues to rise. These minor accidents often result in fragility fractures classically located in the proximal humerus, distal radius, spine, pelvis, and near the hip joint. Pre-existing conditions, polypharmacy, and general frailty increase the risk of fragility fractures in this patient population. METHODS Geriatric trauma fractures and especially insufficiency fractures of the posterior pelvic ring are often difficult to diagnose by plain X‑ray. Therefore, in geriatric trauma patients, cross-sectional imaging, e.g., computed tomography (CT), dual-energy CT (DECT), or magnetic resonance imaging (MRI), should be considered early for reliable evaluation of a suspected fracture. This also allows for the identification of older fractures. Particularly in cognitively impaired elderly patients, difficult examination conditions or an unclear fall event, cross-sectional imaging is often indicated. However, this may also involve risks, e.g., use of contrast medium in patients with impaired renal function, so that each case must be considered individually. Furthermore, the diagnosis and treatment of osteoporosis, which is an underlying disease that leads to fragility fractures, is of particular importance. In the diagnostic workup, measurement of bone density using dual energy X‑ray absorptiometry (DXA) is the standard method according to guidelines. In specific situations, high-resolution peripheral quantitative CT (HR-pQCT) may also be used. CONCLUSION Due to the special challenges of correctly detecting fragility fractures and being able to quickly initiate adequate therapy, good cooperation between radiologists and trauma surgeons is necessary.
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Affiliation(s)
- E Fleischhacker
- Klinik für Orthopädie und Unfallchirurgie, Muskuloskelettales Universitätszentrum München (MUM), Klinikum der Universität München, Ludwig-Maximilians-Universität München, Campus Großhadern, München, Deutschland
| | - J Gleich
- Klinik für Orthopädie und Unfallchirurgie, Muskuloskelettales Universitätszentrum München (MUM), Klinikum der Universität München, Ludwig-Maximilians-Universität München, Campus Großhadern, München, Deutschland
| | - E Hesse
- Institut für Molekulare Muskuloskelettale Forschung, Klinikum der Ludwig-Maximilians-Universität München, München, Deutschland
| | - B Bücking
- Klinik für Unfallchirurgie, Klinikum Hochsauerland GmbH, Arnsberg, Deutschland
| | - U C Liener
- Klinik für Orthopädie, Unfallchirurgie und Sporttraumatologie, Vinzenz von Paul Kliniken gGmbH Marienhospital Stuttgart, Stuttgart, Deutschland
| | - Carl Neuerburg
- Klinik für Orthopädie und Unfallchirurgie, Muskuloskelettales Universitätszentrum München (MUM), Klinikum der Universität München, Ludwig-Maximilians-Universität München, Campus Großhadern, München, Deutschland.
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Bone Organic-Inorganic Phase Ratio Is a Fundamental Determinant of Bone Material Quality. Appl Bionics Biomech 2021; 2021:4928396. [PMID: 34754330 PMCID: PMC8572605 DOI: 10.1155/2021/4928396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 10/02/2021] [Accepted: 10/21/2021] [Indexed: 11/17/2022] Open
Abstract
Background Bone mineral density is widely used by clinicians for screening osteoporosis and assessing bone strength. However, its effectiveness has been reported unsatisfactory. In this study, it is demonstrated that bone organic-inorganic phase ratio is a fundamental determinant of bone material quality measured by stiffness, strength, and toughness. Methods and Results Two-hundred standard bone specimens were fabricated from bovine legs, with a specialized manufacturing method that was designed to reduce the effect of bone anisotropy. Bone mechanical properties of the specimens, including Young's modulus, yield stress, peak stress, and energy-to-failure, were measured by mechanical testing. Organic and inorganic mass contents of the specimens were then determined by bone ashing. Bone density and organic-inorganic phase ratio in the specimens were calculated. Statistical methods were applied to study relationships between the measured mechanical properties and the organic-inorganic phase ratios. Statistical characteristics of organic-inorganic phase ratios in the specimens with top material quality were investigated. Bone organic-inorganic phase ratio had strong Spearman correlation with bone material properties. Bone specimens that had the highest material quality had a very narrow scope of organic-inorganic phase ratio, which could be considered as the “optimal” ratio among the tested specimens. Conclusion Bone organic-inorganic phase ratio is a fundamental determinant of bone material quality. There may exist an “optimal” ratio for the bone to achieve top material quality. Deviation from the “optimal” ratio is probably the fundamental cause of various bone diseases. This study suggests that bone organic-inorganic phase ratio should be considered in clinical assessment of fracture risk.
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Brunetti G, Faienza MF, Piacente L, Storlino G, Oranger A, D’Amato G, De Filippo G, Colucci S, Grano M. Shedding "LIGHT" on the Link between Bone and Fat in Obese Children and Adolescents. Int J Mol Sci 2020; 21:E4739. [PMID: 32635185 PMCID: PMC7370129 DOI: 10.3390/ijms21134739] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 06/30/2020] [Accepted: 07/01/2020] [Indexed: 12/15/2022] Open
Abstract
Obesity may affect bone health, but literature reports are contradictory about the correlation of body mass index (BMI) and bone markers. LIGHT, one of the immunostimulatory cytokines regulating the homeostasis of bone and adipose tissue, could be involved in obesity. The study involved 111 obese subjects (12.21 ± 3.71 years) and 45 controls. Patients underwent the evaluation of bone status by quantitative ultrasonography (QUS). LIGHT amounts were evaluated in sera by ELISA, whereas its expression on peripheral blood cells was evaluated by flow cytometry. Osteoclastogenesis was performed by culturing peripheral blood mononuclear cells (PBMCs) with or without anti-LIGHT antibodies. Obese patients showed significant high BMI-standard deviation score (SDS), weight-SDS, and Homeostatic model assessment for insulin resistance (HOMA-IR) that negatively correlated with the reduced Amplitude Dependent Speed of Sound (AD-SoS)-Z-score and Bone Transmission Time (BTT-Z)-score. They displayed significantly higher serum levels of LIGHT compared with controls (497.30 ± 363.45 pg/mL vs. 186.06 ± 101.41 pg/mL, p < 0.001). LIGHT expression on monocytes, CD3+-T-cells, and neutrophils was also higher in obese patients than in the controls. Finally, in PBMC cultures, the addition of anti-LIGHT antibodies induced a significant osteoclastogenesis inhibition. Our study highlighted the high serum levels of LIGHT in obese children and adolescents, and its relationship with both the grade of obesity and bone impairment.
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Affiliation(s)
- Giacomina Brunetti
- Department of Basic and Medical Sciences, Neurosciences and Sense Organs, Section of Human Anatomy and Histology, University of Bari, 70124 Bari, Italy;
| | - Maria Felicia Faienza
- Department of Biomedical Science and Human Oncology, Paediatric Unit, University of Bari, 70100 Bari, Italy; (M.F.F.); (L.P.)
| | - Laura Piacente
- Department of Biomedical Science and Human Oncology, Paediatric Unit, University of Bari, 70100 Bari, Italy; (M.F.F.); (L.P.)
| | - Giuseppina Storlino
- Department of Emergency and Organ Transplantation, Section of Human Anatomy and Histology, University of Bari, 70124 Bari, Italy; (G.S.); (A.O.); (M.G.)
| | - Angela Oranger
- Department of Emergency and Organ Transplantation, Section of Human Anatomy and Histology, University of Bari, 70124 Bari, Italy; (G.S.); (A.O.); (M.G.)
| | - Gabriele D’Amato
- Neonatal Intensive Care Unit, Di Venere Hospital, 70131 Bari, Italy;
| | - Gianpaolo De Filippo
- Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, Service d’Endocrinologie Diabétologie Pédiatrique, 75019 Paris, France;
| | - Silvia Colucci
- Department of Basic and Medical Sciences, Neurosciences and Sense Organs, Section of Human Anatomy and Histology, University of Bari, 70124 Bari, Italy;
| | - Maria Grano
- Department of Emergency and Organ Transplantation, Section of Human Anatomy and Histology, University of Bari, 70124 Bari, Italy; (G.S.); (A.O.); (M.G.)
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Zhang Y, Luo Y. Femoral bone mineral density distribution is dominantly regulated by strain energy density in remodeling. Biomed Mater Eng 2020; 31:179-190. [PMID: 32597795 DOI: 10.3233/bme-206000] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND It is well known that there is a relationship between bone strength and the forces that are daily applied to the bone. However, bone is a highly heterogeneous material and it is still not clear how mechanical variables regulate the distribution of bone mass in a femur. METHODS We studied the role of four mechanical variables, i.e. principal tensile/compressive stress, von Mises stress, and strain energy density (SED), in the regulation of bone mineral density (BMD) distribution in the human femur. The actual BMD in a femur was extracted from quantitative computed tomography (QCT) and used as a reference for comparison. A finite element model of the femur was constructed from the same set of QCT scans and then used in iterative simulations of femur remodeling under stance and walking loading. The finite element model was initially assigned a homogeneous BMD distribution. During the remodeling, femur BMD was locally modified according to one of the four mechanical variables. The simulations were stopped when BMD change in two consecutive iterations was adequately small. The four simulated BMD patterns were then compared with the actual BMD. RESULTS It was found that the BMD pattern regulated by SED had the best similarity with the actual BMD. The medullary canal was successfully reproduced by simulated remodeling, indicating that in addition to its biological functions, the medullary canal has important biomechanical functions. CONCLUSIONS Both the actual and simulated BMD distributions showed that the proximal femur has much lower BMD than the femur shaft, which may explain why hip fractures most often occur at the proximal femur.
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Affiliation(s)
- Yichen Zhang
- Department of Mechanical Engineering, University of Manitoba, Winnipeg, Canada
| | - Yunhua Luo
- Department of Mechanical Engineering, University of Manitoba, Winnipeg, Canada.,Department of Biomedical Engineering, University of Manitoba, Winnipeg, Canada
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Association between osteoporotic femoral neck fractures and DXA-derived 3D measurements at lumbar spine: a case-control study. Arch Osteoporos 2020; 15:8. [PMID: 31897775 DOI: 10.1007/s11657-019-0680-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 12/15/2019] [Indexed: 02/03/2023]
Abstract
UNLABELLED A case-control study assessing the association of DXA-derived 3D measurements at lumbar spine with osteoporotic hip fractures was performed. Stronger association was found between transcervical hip fractures and integral (AUC = 0.726), and cortical (AUC = 0.696) measurements at the lumbar spine compared with measurements at the trabecular bone (AUC = 0.617); although femur areal bone mineral density (aBMD) remains the referent measurement for hip fracture risk evaluation (AUC = 0.838). PURPOSE The aim of the present study was to evaluate the association between DXA-derived 3D measurements at lumbar spine and osteoporotic hip fractures. METHODS We analyzed a case-control database composed by 61 women with transcervical hip fractures and 61 age-matched women without any type of fracture. DXA scans at lumbar spine were acquired, and areal bone mineral density (aBMD) was measured. Integral, trabecular and cortical volumetric BMD (vBMD), cortical thickness, and cortical surface BMD (sBMD) at different regions of interest were assessed using a DXA-based 3D modeling software. Descriptive statistics, tests of difference, odds ratio (OR), and area under the receiver operating curve (AUC) were used to compare hip fracture and control groups. RESULTS Integral vBMD, cortical vBMD, cortical sBMD, and cortical thickness were the DXA-derived 3D measurements at lumbar spine that showed the stronger association with transcervical hip fractures, with AUCs in the range of 0.685-0.726, against 0.670 for aBMD. The highest AUC (0.726) and OR (2.610) at the lumbar spine were found for integral vBMD at the posterior vertebral elements. Significantly, lower AUC (0.617) and OR (1.607) were found for trabecular vBMD at the vertebral body. Overall, total femur aBMD remains the DXA-derived measurement showing the highest AUC (0.838) and OR (6.240). CONCLUSION This study showed the association of DXA-derived measurements at lumbar spine with transcervical hip fractures. A strong association between vBMD at the posterior vertebral elements and transcervical hip fractures was observed, probably because of global deterioration of the cortical bone. Further studies should be carried out to investigate on the relative risk of transcervical fracture in patients with long-term cortical structural deterioration.
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Maciel JG, de Araújo IM, Trazzi LC, de Azevedo-Marques PM, Salmon CEG, de Paula FJA, Nogueira-Barbosa MH. Association of bone mineral density with bone texture attributes extracted using routine magnetic resonance imaging. Clinics (Sao Paulo) 2020; 75:e1766. [PMID: 32876107 PMCID: PMC7442400 DOI: 10.6061/clinics/2020/e1766] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 05/26/2020] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Dual-energy X-ray absorptiometry (DXA)-derived bone mineral density (BMD) often fails to predict fragility fractures. Quantitative textural analysis using magnetic resonance imaging (MRI) may potentially yield useful radiomic features to predict fractures. We aimed to investigate the correlation between BMD and texture attributes (TAs) extracted from MRI scans and the interobserver reproducibility of the analysis. METHODS Forty-nine volunteers underwent lumbar spine 1.5-T MRI and DXA. Three-dimensional (3-D) gray-level co-occurrence matrices were measured from routine sagittal T2 fast spin-echo images using the IBEX software. Twenty-two TAs were extracted from 3-D segmented L3 vertebrae. The estimated concordance coefficient was calculated using linear regression analysis. A Pearson correlation coefficient analysis was performed to evaluate the correlation between BMD and the TAs. Interobserver reproducibility was assessed with the concordance coefficient described by Lin. RESULTS The results revealed a fair-to-moderate significant correlation between BMD and 13 TAs (r=-0.20 to 0.39; p<0.05). Eight TAs (autocorrelation, energy, homogeneity 1, homogeneity 1.1, maximum probability, sum average, sum variance, and inverse difference normalized) negatively correlated with BMD (r=-0.20 to -0.38; p<0.05), whereas five TAs (dissimilarity, difference entropy, entropy, sum entropy, and information measure corr 1) positively correlated with BMD (r=0.29-0.39; p<0.05). The interobserver agreement was almost perfect for all significant TAs (95% confidence interval, 0.92-1.00; p<0.05). CONCLUSION Specific TAs could be reliably extracted from routine MRI and correlated with BMD. Our results encourage future evaluation of the potential usefulness of quantitative texture measurements from MRI scans for predicting fragility fractures.
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Affiliation(s)
- Jamilly Gomes Maciel
- Departamento de Imagens Medicas, Hematologia e Oncologia Clinica, Faculdade de Medicina de Ribeirao Preto (FMRP), Universidade de Sao Paulo, Ribeirao Preto, SP, BR
- *Corresponding author. E-mails: /
| | - Iana Mizumukai de Araújo
- Medicina Interna, Faculdade de Medicina de Ribeirao Preto (FMRP), Universidade de Sao Paulo, Ribeirao Preto, SP, BR
| | - Lucio C. Trazzi
- Departamento de Imagens Medicas, Hematologia e Oncologia Clinica, Faculdade de Medicina de Ribeirao Preto (FMRP), Universidade de Sao Paulo, Ribeirao Preto, SP, BR
| | - Paulo Mazzoncini de Azevedo-Marques
- Departamento de Imagens Medicas, Hematologia e Oncologia Clinica, Faculdade de Medicina de Ribeirao Preto (FMRP), Universidade de Sao Paulo, Ribeirao Preto, SP, BR
| | - Carlos Ernesto Garrido Salmon
- Departamento de Fisica, Faculdade de Filosofia, Ciencias e Letras (FFCL), Universidade de São Paulo, Ribeirao Preto, SP, BR
| | | | - Marcello Henrique Nogueira-Barbosa
- Departamento de Imagens Medicas, Hematologia e Oncologia Clinica, Faculdade de Medicina de Ribeirao Preto (FMRP), Universidade de Sao Paulo, Ribeirao Preto, SP, BR
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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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Abstract
Despite today's good diagnostic and therapeutic options for osteoporosis, the number of unidentified cases is very high and therapy is therefore usually inadequate. Frequently, the diagnosis of osteoporosis is made only after the occurrence of a fracture. The reason for this, apart from the costs incurred as well as the additional radiation exposure of the diagnostics, is certainly the limited availability of dual energy X‑ray absorptiometry (DEXA) as well as quantitative computed tomography (q-CT). In search of an alternative technique, Hounsfield units (HU) of the clinical CT examination proved to be ground-breaking: the results of previous investigations demonstrated a reliable correlation between the T values of the DEXA measurement and the HU of the same vertebral body. Due to the widespread use of clinical CT scans of the thorax and the abdomen for a variety of indications, it is expected that the number of unidentified cases of osteoporosis can be significantly reduced-without additional costs and radiation exposure associated with osteoporosis screening. In addition to osteoporosis diagnostics, the calculated HU may also provide better preoperative planning as well as predicting the further course of the disease. Thus, the risk for vertebral body fractures, screw loosening and cage sintering after ventral fusion operations can be sufficiently predicted. In this way, preoperative modifications to the surgical procedure can be made to reduce the risk of implant failure.
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Using texture analysis of head CT images to differentiate osteoporosis from normal bone density. Eur J Radiol 2019; 116:212-218. [DOI: 10.1016/j.ejrad.2019.05.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 04/01/2019] [Accepted: 05/07/2019] [Indexed: 11/18/2022]
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Quantitative analysis of modified functional muscle-bone unit and back muscle density in patients with lumbar vertebral fracture in Chinese elderly men: a case-control study. Aging Clin Exp Res 2019; 31:637-644. [PMID: 30128661 DOI: 10.1007/s40520-018-1024-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 08/10/2018] [Indexed: 12/25/2022]
Abstract
OBJECTIVES Bone mineral density (BMD) is associated with muscle mass and quality, but little research has been done on functional muscle-bone unit and back muscle density in patients with lumbar vertebral fracture. This study used the "modified functional muscle-bone unit" concept and measured back muscle density to investigate muscle-bone interaction difference between the fracture and control group. METHODS This was a case-control study. A total of 52 elderly male patients (mean age 75 years) with lumbar vertebral fracture (cases) and 52 control healthy subjects were enrolled. Cross-sectional area (CSA) and density of paravertebral muscle were measured in quantitative computed tomography (QCT) images to represent the muscle mass, while the bone mineral density measured by QCT was used to represent the bone mass. The modified functional muscle-bone unit was calculated as the value of volumetric BMD divided by muscle area. RESULTS People with vertebral fractures reported significantly lower values in the cross-sectional area and density of paravertebral muscle compared to control group. In the multivariate analysis, BMD (odds ratio, OR = 0.929; 95% confidence intervals, CIs 0.888-0.971), erector muscle density (OR = 0.698; 95% CI 0.547-0.892), and summated muscle CSA (OR = 0.963; 95% CI 0.93-0.991) were independent protective factors for the presence of a fracture. BMD resulted significantly and moderately associated with cross-sectional area and density of paravertebral muscle (r = 0.329-0.396). CONCLUSIONS There were significant differences between the modified functional muscle-bone unit and back muscle density between the fracture group and control group in elderly men. Lower BMD, loss of muscle mass and density are associated with increased presence of the lumbar vertebral fracture.
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Lopez Picazo M, Magallon Baro A, Del Rio Barquero LM, Di Gregorio S, Martelli Y, Romera J, Steghofer M, Gonzalez Ballester MA, Humbert L. 3-D Subject-Specific Shape and Density Estimation of the Lumbar Spine From a Single Anteroposterior DXA Image Including Assessment of Cortical and Trabecular Bone. IEEE TRANSACTIONS ON MEDICAL IMAGING 2018; 37:2651-2662. [PMID: 29994113 DOI: 10.1109/tmi.2018.2845909] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Dual Energy X-ray Absorptiometry (DXA) is the standard exam for osteoporosis diagnosis and fracture risk evaluation at the spine. However, numerous patients with bone fragility are not diagnosed as such. In fact, standard analysis of DXA images does not differentiate between trabecular and cortical bone; neither specifically assess of the bone density in the vertebral body, which is where most of the osteoporotic fractures occur. Quantitative computed tomography (QCT) is an alternative technique that overcomes limitations of DXA-based diagnosis. However, due to the high cost and radiation dose, QCT is not used for osteoporosis management. We propose a method that provides a 3-D subject-specific shape and density estimation of the lumbar spine from a single anteroposterior (AP) DXA image. A 3-D statistical shape and density model is built, using a training set of QCT scans, and registered onto the AP DXA image so that its projection matches it. Cortical and trabecular bone compartments are segmented using a model-based algorithm. Clinical measurements are performed at different bone compartments. Accuracy was evaluated by comparing DXA-derived to QCT-derived 3-D measurements for a validation set of 180 subjects. The shape accuracy was 1.51 mm at the total vertebra and 0.66 mm at the vertebral body. Correlation coefficients between DXA and QCT-derived measurements ranged from 0.81 to 0.97. The method proposed offers an insightful 3-D analysis of the lumbar spine, which could potentially improve osteoporosis and fracture risk assessment in patients who had an AP DXA scan of the lumbar spine without any additional examination.
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20
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Luo Y. Empirical Functions for Conversion of Femur Areal and Volumetric Bone Mineral Density. J Med Biol Eng 2018. [DOI: 10.1007/s40846-018-0394-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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21
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Open questions on the 3D structures of collagen containing vertebrate mineralized tissues: A perspective. J Struct Biol 2018; 201:187-198. [DOI: 10.1016/j.jsb.2017.11.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 11/19/2017] [Accepted: 11/20/2017] [Indexed: 12/29/2022]
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Neumeyer AM, Cano Sokoloff N, McDonnell E, Macklin EA, McDougle CJ, Misra M. Bone microarchitecture in adolescent boys with autism spectrum disorder. Bone 2017; 97:139-146. [PMID: 28088646 PMCID: PMC6309443 DOI: 10.1016/j.bone.2017.01.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 01/07/2017] [Accepted: 01/10/2017] [Indexed: 12/29/2022]
Abstract
BACKGROUND Boys with autism spectrum disorder (ASD) have lower areal bone mineral density (aBMD) than typically developing controls (TDC). Studies of volumetric BMD (vBMD) and bone microarchitecture provide information about fracture risk beyond that provided by aBMD but are currently lacking in ASD. OBJECTIVES To assess ultradistal radius and distal tibia vBMD, bone microarchitecture and strength estimates in adolescent boys with ASD compared to TDC. DESIGN/METHODS Cross-sectional study of 34 boys (16 ASD, 18 TDC) that assessed (i) aBMD at the whole body (WB), WB less head (WBLH), hip and spine using dual X-ray absorptiometry (DXA), (ii) vBMD and bone microarchitecture at the ultradistal radius and distal tibia using high-resolution peripheral quantitative CT (HRpQCT), and (iii) bone strength estimates (stiffness and failure load) using micro-finite element analysis (FEA). We controlled for age in all groupwise comparisons of HRpQCT and FEA measures. Activity questionnaires, food records, physical exam, and fasting levels of 25(OH) vitamin D and bone markers (C-terminal collagen crosslinks and N-terminal telopeptide (CTX and NTX) for bone resorption, N-terminal propeptide of Type 1 procollagen (P1NP) for bone formation) were obtained. RESULTS ASD participants were slightly younger than TDC participants (13.6 vs. 14.2years, p=0.44). Tanner stage, height Z-scores and fasting serum bone marker levels did not differ between groups. ASD participants had higher BMI Z-scores, percent body fat, IGF-1 Z-scores, and lower lean mass and aBMD Z-scores than TDC at the WB, WBLH, and femoral neck (P<0.1). At the radius, ASD participants had lower trabecular thickness (0.063 vs. 0.070mm, p=0.004), compressive stiffness (56.7 vs. 69.7kN/mm, p=0.030) and failure load (3.0 vs. 3.7kN, p=0.031) than TDC. ASD participants also had 61% smaller cortical area (6.6 vs. 16.4mm2, p=0.051) and thickness (0.08 vs. 0.22mm, p=0.054) compared to TDC. At the tibia, ASD participants had lower compressive stiffness (183 vs. 210kN/mm, p=0.048) and failure load (9.4 vs. 10.8kN, p=0.043) and 23% smaller cortical area (60.3 vs. 81.5mm2, p=0.078) compared to TDC. A lower proportion of ASD participants were categorized as "very physically active" (20% vs. 72%, p=0.005). Differences in physical activity, calcium intake and IGF-1 responsiveness may contribute to group differences in stiffness and failure load. CONCLUSION Bone microarchitectural parameters are impaired in ASD, with reductions in bone strength estimates (stiffness and failure load) at the ultradistal radius and distal tibia. This may result from lower physical activity and calcium intake, and decreased IGF-1 responsiveness.
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Affiliation(s)
- Ann M Neumeyer
- Lurie Center for Autism, Massachusetts General Hospital, Lexington, MA 02421, United States; Harvard Medical School, Boston, MA 02115, United States.
| | - Natalia Cano Sokoloff
- Lurie Center for Autism, Massachusetts General Hospital, Lexington, MA 02421, United States
| | - Erin McDonnell
- Biostatistics Center, Massachusetts General Hospital, Boston, MA 02114, United States
| | - Eric A Macklin
- Harvard Medical School, Boston, MA 02115, United States; Biostatistics Center, Massachusetts General Hospital, Boston, MA 02114, United States
| | - Christopher J McDougle
- Lurie Center for Autism, Massachusetts General Hospital, Lexington, MA 02421, United States; Harvard Medical School, Boston, MA 02115, United States
| | - Madhusmita Misra
- Harvard Medical School, Boston, MA 02115, United States; Pediatric Endocrine and Neuroendocrine Units, Massachusetts General Hospital, Boston, MA 02114, United States
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Garcia TC, Steffey MA, Zwingenberger AL, Daniel L, Stover SM. CT-derived indices of canine osteosarcoma-affected antebrachial strength. Vet Surg 2017; 46:549-558. [DOI: 10.1111/vsu.12645] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Revised: 11/10/2016] [Accepted: 12/06/2016] [Indexed: 01/23/2023]
Affiliation(s)
- Tanya C. Garcia
- Department of Anatomy, Physiology and Cell Biology Surgical, School of Veterinary Medicine; University of California-Davis; Davis California
| | - Michele A. Steffey
- Department of Radiological Sciences, School of Veterinary Medicine; University of California-Davis; Davis California
| | - Allison L. Zwingenberger
- Department of Radiological Sciences, School of Veterinary Medicine; University of California-Davis; Davis California
| | - Leticia Daniel
- Department of Radiological Sciences, School of Veterinary Medicine; University of California-Davis; Davis California
| | - Susan M. Stover
- Department of Anatomy, Physiology and Cell Biology Surgical, School of Veterinary Medicine; University of California-Davis; Davis California
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How can gynaecologists cope with the silent killer - osteoporosis? MENOPAUSE REVIEW 2017; 15:189-192. [PMID: 28250721 PMCID: PMC5327627 DOI: 10.5114/pm.2016.65682] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Accepted: 12/21/2016] [Indexed: 02/02/2023]
Abstract
Osteoporosis is a very common disease among women. It is frequently called a silent epidemic and, due to its impact on osteoporotic fractures with high morbidity and mortality, also a silent killer. There are a number of significant risk factors for osteoporosis, some of them very strongly related to the functioning of the reproductive system. These include menstrual irregularities, premature ovarian failure, early natural or surgical menopause, a high number of pregnancies, and long-term breast-feeding. Hence, there is every reason to include gynaecologists in the multidisciplinary team striving to cope with this dreadful disease. Calculation of the 10-year fracture risk, done by means of the FRAX calculator, and classification of women according to the level of risk could prove to be an effective method of limiting the negative effects of osteoporosis.
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Steffey MA, Garcia TC, Daniel L, Zwingenberger AL, Stover SM. Mechanical properties of canine osteosarcoma-affected antebrachia. Vet Surg 2017; 46:539-548. [PMID: 28152185 DOI: 10.1111/vsu.12628] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Accepted: 11/08/2016] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To determine the influence of neoplasia on the biomechanical properties of canine antebrachia. STUDY DESIGN Ex vivo biomechanical study. SAMPLE POPULATION Osteosarcoma (OSA)-affected canine antebrachia (n = 12) and unaffected canine antebrachia (n = 9). METHODS Antebrachia were compressed in axial loading until failure. A load-deformation curve was used to acquire the structural mechanical properties of neoplastic and unaffected specimens. Structural properties and properties normalized by body weight (BW) and radius length were compared using analysis of variance (ANOVA). Modes of failure were compared descriptively. RESULTS Neoplastic antebrachia fractured at, or adjacent to, the OSA in the distal radial diaphysis. Unaffected antebrachia failed via mid-diaphyseal radial fractures with a transverse cranial component and an oblique caudal component. Structural mechanical properties were more variable in neoplastic antebrachia than unaffected antebrachia, which was partially attributable to differences in bone geometry related to dog size. When normalized by dog BW and radial length, strength, stiffness, and energy to yield and failure, were lower in neoplastic antebrachia than in unaffected antebrachia. CONCLUSIONS OSA of the distal radial metaphysis in dogs presented for limb amputation markedly compromises the structural integrity of affected antebrachia. However, biomechanical properties of affected bones was sufficient for weight-bearing, as none of the neoplastic antebrachia fractured before amputation. The behavior of tumor invaded bone under cyclic loading warrants further investigations to evaluate the viability of in situ therapies for bone tumors in dogs.
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Affiliation(s)
- Michele A Steffey
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, California
| | - Tanya C Garcia
- Department of Anatomy, Physiology and Cell Biology, School of Veterinary Medicine, University of California-Davis, Davis, California
| | - Leticia Daniel
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, California
| | - Allison L Zwingenberger
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, California
| | - Susan M Stover
- Department of Anatomy, Physiology and Cell Biology, School of Veterinary Medicine, University of California-Davis, Davis, California
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Maciel JG, de Araújo IM, Carvalho AL, Simão MN, Bastos CM, Troncon LEA, Salmon CEG, de Paula FJA, Nogueira-Barbosa MH. Marrow Fat Quality Differences by Sex in Healthy Adults. J Clin Densitom 2017; 20:106-113. [PMID: 27637728 DOI: 10.1016/j.jocd.2016.08.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 08/02/2016] [Accepted: 08/11/2016] [Indexed: 01/19/2023]
Abstract
Several studies have demonstrated the relationship between bone marrow adiposity (BMAT) and bone mass. 1H magnetic resonance spectroscopy is a noninvasive technique able to assess both BMAT quantity and quality. The aim of our study was to perform quantitative and qualitative analyses of BMAT and to investigate its association with bone mineral density (BMD) in healthy nonobese volunteers. Fifty-one healthy volunteers, 21 men and 30 women, underwent 1.5 T 1H magnetic resonance spectroscopy of the lumbar spine. BMD was determined by dual-energy X-ray absorptiometry of the lumbar spine. Correlation analysis was performed to evaluate association among lipids fractions, BMD, and age. The female and male volunteers had similar body mass index and BMD (p > 0.05). Our data demonstrated an inverse correlation of BMD and BMAT with age, with a stronger correlation of saturated lipids (r = 0.701; p < 0.0001) compared with unsaturated lipids (UL) (r = 0.278; p = 0.004). Importantly, female subjects had the highest amount of UL (confidence interval: 0.685%-1.722%; p < 0.001). Our study reports that men and women with similar BMD and body mass index have striking differences in bone marrow lipids composition, namely women have higher UL than men. In addition, we believe that our study brings new insights to the complex network involving BMAT and other factors that influence bone integrity.
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Affiliation(s)
- Jamilly G Maciel
- Department of Internal Medicine, Ribeirao Preto Medical School, University of Sao Paulo (USP), Ribeirão Preto, Brazil.
| | - Iana M de Araújo
- Department of Internal Medicine, Ribeirao Preto Medical School, University of Sao Paulo (USP), Ribeirão Preto, Brazil
| | - Adriana L Carvalho
- Department of Internal Medicine, Ribeirao Preto Medical School, University of Sao Paulo (USP), Ribeirão Preto, Brazil
| | - Marcelo N Simão
- Department of Internal Medicine, Ribeirao Preto Medical School, University of Sao Paulo (USP), Ribeirão Preto, Brazil
| | - Clara M Bastos
- Department of Internal Medicine, Ribeirao Preto Medical School, University of Sao Paulo (USP), Ribeirão Preto, Brazil
| | - Luiz E A Troncon
- Department of Internal Medicine, Ribeirao Preto Medical School, University of Sao Paulo (USP), Ribeirão Preto, Brazil
| | - Carlos E G Salmon
- Department of Physics, Faculty of Philosophy, Sciences and Arts of Ribeirao Preto, University of Sao Paulo (USP), Ribeirão Preto, Brazil
| | - Francisco J A de Paula
- Department of Internal Medicine, Ribeirao Preto Medical School, University of Sao Paulo (USP), Ribeirão Preto, Brazil
| | - Marcello H Nogueira-Barbosa
- Department of Internal Medicine, Ribeirao Preto Medical School, University of Sao Paulo (USP), Ribeirão Preto, Brazil
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Aufaure R, Hardouin J, Millot N, Motte L, Lalatonne Y, Guénin E. Tetrazine Click Chemistry for the Modification of 1-Hydroxy-1,1-methylenebisphosphonic Acids: Towards Bio-orthogonal Functionalization of Gold Nanoparticles. Chemistry 2016; 22:16022-16027. [DOI: 10.1002/chem.201602899] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Indexed: 12/29/2022]
Affiliation(s)
- Romain Aufaure
- Inserm, U1148; Laboratory for Vascular Translational Science; UFR SMBH; Université Paris 13, Sorbonne Paris Cité; 74 avenue M. Cachin 93017 Bobigny France
| | - Julie Hardouin
- Laboratoire PBS, CNRS (UMR 6270); Université de Rouen; Bd Maurice de Broglie 76821 Mont Saint Aignan Cedex France
| | - Nadine Millot
- Laboratoire Interdisciplinaire Carnot de Bourgogne; UMR 6303 CNRS/Université de Bourgogne Franche-Comté; 9 av. A. Savary, BP 47870 21 078 DIJON Cedex France
| | - Laurence Motte
- Inserm, U1148; Laboratory for Vascular Translational Science; UFR SMBH; Université Paris 13, Sorbonne Paris Cité; 74 avenue M. Cachin 93017 Bobigny France
| | - Yoann Lalatonne
- Inserm, U1148; Laboratory for Vascular Translational Science; UFR SMBH; Université Paris 13, Sorbonne Paris Cité; 74 avenue M. Cachin 93017 Bobigny France
- Service de Médecine Nucléaire; Hôpital Avicenne Assistance Publique-Hôpitaux de Paris; 93009 Bobigny France
| | - Erwann Guénin
- Inserm, U1148; Laboratory for Vascular Translational Science; UFR SMBH; Université Paris 13, Sorbonne Paris Cité; 74 avenue M. Cachin 93017 Bobigny France
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Comparison between the MDCT and the DXA scanners in the evaluation of BMD in the lumbar spine densitometry. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2016. [DOI: 10.1016/j.ejrnm.2016.04.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
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Nasiri M, Luo Y. Study of sex differences in the association between hip fracture risk and body parameters by DXA-based biomechanical modeling. Bone 2016; 90:90-8. [PMID: 27292653 DOI: 10.1016/j.bone.2016.06.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Revised: 05/25/2016] [Accepted: 06/07/2016] [Indexed: 11/17/2022]
Abstract
There is controversy about whether or not body parameters affect hip fracture in men and women in the same way. In addition, although bone mineral density (BMD) is currently the most important single discriminator of hip fracture, it is unclear if BMD alone is equally effective for men and women. The objective of this study was to quantify and compare the associations of hip fracture risk with BMD and body parameters in men and women using our recently developed two-level biomechanical model that combines a whole-body dynamics model with a proximal-femur finite element model. Sideways fall induced impact force of 130 Chinese clinical cases, including 50 males and 80 females, were determined by subject-specific dynamics modeling. Then, a DXA-based finite element model was used to simulate the femur bone under the fall-induced loading conditions and calculate the hip fracture risk. Body weight, body height, body mass index, trochanteric soft tissue thickness, and hip bone mineral density were determined for each subject and their associations with impact force and hip fracture risk were quantified. Results showed that the association between impact force and hip fracture risk was not strong enough in both men (r=-0.31,p<0.05) and women (r=0.42,p<0.001) to consider the force as a sole indicator of hip fracture risk. The correlation between hip BMD and hip fracture risk in men (r=-0.83,p<0.001) was notably stronger than that in women (r=-0.68,p<0.001). Increased body mass index was not a protective factor against hip fracture in men (r=-0.13,p>0.05), but it can be considered as a protective factor among women (r=-0.28,p<0.05). In contrast to men, trochanteric soft tissue thickness can be considered as a protective factor against hip fracture in women (r=-0.50,p<0.001). This study suggested that the biomechanical risk/protective factors for hip fracture are sex-specific. Therefore, the effect of body parameters should be considered differently for men and women in hip fracture risk assessment tools. These findings support further exploration of sex-specific preventive and protective measurements to reduce the incidence of hip fractures.
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Affiliation(s)
- Masoud Nasiri
- Department of Mechanical Engineering, Faculty of Engineering, University of Manitoba, Canada
| | - Yunhua Luo
- Department of Mechanical Engineering, Faculty of Engineering, University of Manitoba, Canada; Department of Biomedical Engineering, Faculty of Engineering, University of Manitoba, Canada.
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Ko H, Jeong K, Lee CH, Jun HY, Jeong C, Lee MS, Nam Y, Yoon KH, Lee J. Scattered image artifacts from cone beam computed tomography and its clinical potential in bone mineral density estimation. SPRINGERPLUS 2016; 5:1360. [PMID: 27588253 PMCID: PMC4990522 DOI: 10.1186/s40064-016-3032-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 08/09/2016] [Indexed: 12/31/2022]
Abstract
Background Image artifacts affect the quality of medical images and may obscure anatomic structure and pathology. Numerous methods for suppression and correction of scattered image artifacts have been suggested in the past three decades. In this paper, we assessed the feasibility of use of information on scattered artifacts for estimation of bone mineral density (BMD) without dual-energy X-ray absorptiometry (DXA) or quantitative computed tomographic imaging (QCT). Methods To investigate the relationship between scattered image artifacts and BMD, we first used a forearm phantom and cone-beam computed tomography. In the phantom, we considered two regions of interest—bone-equivalent solid material containing 50 mg HA per cm−3 and water—to represent low- and high-density trabecular bone, respectively. We compared the scattered image artifacts in the high-density material with those in the low-density material. The technique was then applied to osteoporosis patients and healthy subjects to assess its feasibility for BMD estimation. Results The high-density material produced a greater number of scattered image artifacts than the low-density material. Moreover, the radius and ulna of healthy subjects produced a greater number of scattered image artifacts than those from osteoporosis patients. Conclusions Although other parameters, such as bone thickness and X-ray incidence, should be considered, our technique facilitated BMD estimation directly without DXA or QCT. We believe that BMD estimation based on assessment of scattered image artifacts may benefit the prevention, early treatment and management of osteoporosis.
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Affiliation(s)
- Hoon Ko
- Department of Biomedical Engineering, Wonkwang University College of Medicine, Iksan Daero 460, Iksan, Jeonbuk 54538 Republic of Korea
| | - Kwanmoon Jeong
- Department of Biomedical Engineering, Wonkwang University College of Medicine, Iksan Daero 460, Iksan, Jeonbuk 54538 Republic of Korea
| | - Chang-Hoon Lee
- Department of Rheumatology Internal Medicine, Wonkwang University School of Medicine, Iksan, Jeonbuk 54538 Republic of Korea
| | - Hong Young Jun
- Imaging Science Based Lung and Bone Disease Research Center, Wonkwang University, 460 Iksandeaero, Iksan, Jeonbuk 54538 Republic of Korea
| | - Changwon Jeong
- Imaging Science Based Lung and Bone Disease Research Center, Wonkwang University, 460 Iksandeaero, Iksan, Jeonbuk 54538 Republic of Korea
| | - Myeung Su Lee
- Department of Rheumatology Internal Medicine, Wonkwang University School of Medicine, Iksan, Jeonbuk 54538 Republic of Korea
| | - Yunyoung Nam
- Department of Computer Science, Soonchunhyang University, Cheonan, Chungnam 31538 Republic of Korea
| | - Kwon-Ha Yoon
- Department of Radiology, Wonkwang University School of Medicine, Iksan Daero 460, Iksan, Jeonbuk 54538 Republic of Korea
| | - Jinseok Lee
- Department of Biomedical Engineering, Wonkwang University College of Medicine, Iksan Daero 460, Iksan, Jeonbuk 54538 Republic of Korea
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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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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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Rivas-Ruiz R, Méndez-Sánchez L, Castelán-Martínez OD, Clark P, Tamayo J, Talavera JO, Huitrón G, Salmerón-Castro J. Comparison of International Reference Values for Bone Speed of Sound in Pediatric Populations: Meta-analysis. J Clin Densitom 2016; 19:316-25. [PMID: 26088387 DOI: 10.1016/j.jocd.2015.04.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2015] [Revised: 04/07/2015] [Accepted: 04/23/2015] [Indexed: 10/23/2022]
Abstract
The aim of this study was to compare international reference values (RV) for tibial and radial speed of sound (SoS) assessed by quantitative ultrasound (QUS) in pediatric populations. These values were compared by age and country of origin in a systematic review with meta-analysis from studies published on QUS (Sunlight Omnisense). A search was carried out in electronic databases. Nine studies with 6963 patients were included in the meta-analysis. For the newborn populations, 3 studies (from Italy, Portugal, and Israel) were used. These studies included subjects with 27-42 wk gestational age. The mean difference (Portugal-Israel) was found to be 23.62 m/s [95% confidence interval [CI] 6.29, 40.95]. Additionally, no difference was found between Italy-Portugal (p = 0.69), or Italy-Israel (p = 0.28). In pediatric populations, we compared 8 studies from Canada, Mexico, Israel, Greece, Portugal, and Turkey. No significant differences found for SoS RV between Israel-Turkey, Israel-Greece, or Israel-Canada (p > 0.05). Significant differences were found in Mexico-Israel -105.29 m/s (95% CI -140.05, -70.54) (p < 0.001); Mexico-Portugal -115.14 m/s (95% CI -164.86, -65.42) (p < 0.001); Mexico-Greece: -239.14 m/s (95% CI -267.67, -210.62) (p < 0.001); Mexico-Turkey: -115.14 m/s (95% CI -164.86, -65.42) (p < 0.001); Mexico-Canada: -113.51 m/s (95% CI -140.25, -86.77) (p < 0.001).This study demonstrates that there are differences in SoS-RV obtained by tibial and radial QUS in pediatric populations between Mexico and other countries (Israel, Portugal, Greece, Turkey, and Canada).
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Affiliation(s)
- R Rivas-Ruiz
- Centro de Adiestramiento en Investigación Clínica, Coordinación de Investigación en Salud, Centro Médico Nacional S. XXI, IMSS, México, D.F.; Facultad de Medicina, Universidad Nacional Autónoma de México, México, D.F
| | - L Méndez-Sánchez
- Unidad de Epidemiología Clínica, Hospital Infantil de México Federico Gómez, México, D.F.; Facultad de Medicina, Universidad Nacional Autónoma de México, México, D.F..
| | - O D Castelán-Martínez
- Unidad de Epidemiología Clínica, Hospital Infantil de México Federico Gómez, México, D.F
| | - P Clark
- Unidad de Epidemiología Clínica, Hospital Infantil de México Federico Gómez, México, D.F.; Facultad de Medicina, Universidad Nacional Autónoma de México, México, D.F
| | - J Tamayo
- Comité Mexicano para la Prevención de la Osteoporosis, México, D.F
| | - J O Talavera
- Centro de Adiestramiento en Investigación Clínica, Coordinación de Investigación en Salud, Centro Médico Nacional S. XXI, IMSS, México, D.F.; Centro de Investigación en Ciencias Médicas, Universidad Autónoma del Estado de México, Toluca, México
| | - G Huitrón
- Centro de Investigación en Ciencias Médicas, Universidad Autónoma del Estado de México, Toluca, México
| | - J Salmerón-Castro
- Unidad de Investigación Epidemiológica y en Servicios de Salud, Instituto Mexicano del Seguro Social, Cuernavaca, México; Centro de Investigación de Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, México
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Ackerman KE, Cano Sokoloff N, DE Nardo Maffazioli G, Clarke HM, Lee H, Misra M. Fractures in Relation to Menstrual Status and Bone Parameters in Young Athletes. Med Sci Sports Exerc 2016; 47:1577-86. [PMID: 25397605 DOI: 10.1249/mss.0000000000000574] [Citation(s) in RCA: 96] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
INTRODUCTION This study was aimed to compare fracture prevalence in oligoamenorrheic athletes (AA), eumenorrheic athletes (EA), and nonathletes (NA) and determine relationships with bone density, structure, and strength estimates. METHODS One hundred seventy-five females (100 AA, 35 EA, and 40 NA) 14-25 yr old were studied. Lifetime fracture history was obtained through participant interviews. Areal bone mineral density (BMD) was assessed by DXA at the spine, hip, and whole body (WB). Bone structure was assessed by HRpQCT at the radius and tibia, and strength by finite element analysis. RESULTS AA, EA, and NA did not differ in age, sexual maturity, or height. AA had lower BMI, and older menarchal age than EA and NA (P ≤ 0.001). Bone mineral density Z-scores were lower in AA versus EA at the total hip, femoral neck, spine, and whole body (P ≤ 0.001). Lifetime fracture risk was higher in AA than EA and NA (47%, 25.7%, 12.5%; P ≤ 0.001), largely driven by stress fractures in AA versus EA and NA (32% vs 5.9% vs 0%). In AA, those who fractured had lower lumbar and WB BMD Z-scores, volumetric BMD (vBMD) of outer trabecular region in radius and tibia, and trabecular thickness of the radius (P ≤ 0.05). In AA, those who had two or more stress fractures had lower lumbar and WB BMD Z-scores, total cross-sectional area, trabecular vBMD, stiffness, and failure load at radius; and lower stiffness and failure load at tibia versus those with fewer than two stress fractures (P ≤ 0.05). CONCLUSION Weight-bearing athletic activity increases BMD but may increase stress fracture risk in those with menstrual dysfunction. Bone microarchitecture and strength differences are more pronounced in AA with multiple stress fractures. This is the first study to examine fractures in relation to bone structure in adolescent female athletes.
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Affiliation(s)
- Kathryn E Ackerman
- 1Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA; 2Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital and Harvard Medical School, Boston, MA; 3Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA; and 4Pediatric Endocrine Unit, Department of Pediatrics, Massachusetts General Hospital for Children and Harvard Medical School, Boston, MA
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Checefsky WA, Abidin AZ, Nagarajan MB, Bauer JS, Baum T, Wismüller A. Assessing vertebral fracture risk on volumetric quantitative computed tomography by geometric characterization of trabecular bone structure. PROCEEDINGS OF SPIE--THE INTERNATIONAL SOCIETY FOR OPTICAL ENGINEERING 2016; 9785:978508. [PMID: 29367797 PMCID: PMC5777337 DOI: 10.1117/12.2216898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The current clinical standard for measuring Bone Mineral Density (BMD) is dual X-ray absorptiometry, however more recently BMD derived from volumetric quantitative computed tomography has been shown to demonstrate a high association with spinal fracture susceptibility. In this study, we propose a method of fracture risk assessment using structural properties of trabecular bone in spinal vertebrae. Experimental data was acquired via axial multi-detector CT (MDCT) from 12 spinal vertebrae specimens using a whole-body 256-row CT scanner with a dedicated calibration phantom. Common image processing methods were used to annotate the trabecular compartment in the vertebral slices creating a circular region of interest (ROI) that excluded cortical bone for each slice. The pixels inside the ROI were converted to values indicative of BMD. High dimensional geometrical features were derived using the scaling index method (SIM) at different radii and scaling factors (SF). The mean BMD values within the ROI were then extracted and used in conjunction with a support vector machine to predict the failure load of the specimens. Prediction performance was measured using the root-mean-square error (RMSE) metric and determined that SIM combined with mean BMD features (RMSE = 0.82 ± 0.37) outperformed MDCT-measured mean BMD (RMSE = 1.11 ± 0.33) (p < 10-4). These results demonstrate that biomechanical strength prediction in vertebrae can be significantly improved through the use of SIM-derived texture features from trabecular bone.
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Affiliation(s)
- Walter A Checefsky
- Department of Electrical and Computer Engineering, University of Rochester, New York, United States
| | - Anas Z Abidin
- Departments of Imaging Sciences and Biomedical Engineering, University of Rochester, New York, United States
| | - Mahesh B Nagarajan
- Departments of Imaging Sciences and Biomedical Engineering, University of Rochester, New York, United States
| | - Jan S Bauer
- Institute for Diagnostic and Interventional Radiology, Technical University of Munich, Germany
| | - Thomas Baum
- Institute for Diagnostic and Interventional Radiology, Technical University of Munich, Germany
| | - Axel Wismüller
- Department of Electrical and Computer Engineering, University of Rochester, New York, United States
- Departments of Imaging Sciences and Biomedical Engineering, University of Rochester, New York, United States
- Faculty of Medicine and Institute of Clinical Radiology, Ludwig Maximilian University, Munich, Germany
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Morin SN, Wall M, Belzile EL, Godbout B, Moser TP, Michou L, Ste-Marie LG, de Guise JA, Rahme E, Brown JP. Assessment of femur geometrical parameters using EOS™ imaging technology in patients with atypical femur fractures; preliminary results. Bone 2016; 83:184-189. [PMID: 26541215 DOI: 10.1016/j.bone.2015.10.016] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 10/26/2015] [Accepted: 10/29/2015] [Indexed: 12/12/2022]
Abstract
Atypical femur fractures (AFF) arise in the subtrochanteric and diaphyseal regions. Because of this unique distribution, we hypothesized that patients with AFF demonstrate specific geometrical variations of their lower limb whereby baseline tensile forces applied to the lateral cortex are higher and might favor the appearance of these rare stress fractures, when exposed to bisphosphonates. Using the low irradiation 2D-3D X-ray scanner EOS™ imaging technology we aimed to characterize and compare femur geometric parameters between women who sustained bisphosphonate-associated AFF and those who had experienced similar duration of exposure to bisphosphonates but did not sustain fractures. Conditional logistic regression models were constructed to estimate the association between selected geometric parameters and the occurrence of AFF. We identified 16 Caucasian women with AFF and recruited 16 ethnicity-, sex-, age-, height- and cumulative bisphosphonate exposure-matched controls from local osteoporosis clinics. Compared to controls, those with AFF had more lateral femur bowing (-3.2° SD [3.4] versus -0.8° SD [1.9] p=0.02). In regression analysis, lateral femur bowing was associated with the risk of AFF (aOR 1.54; 95% CI 1.04-2.28, p=0.03). Women who sustained a subtrochanteric AFF demonstrated a lesser femoral neck shaft angle (varus geometry) than those with a fracture at a diaphyseal site (121.9 [3.6]° versus 127.6 [7.2]°, p=0.07), whereas femur bowing was more prominent in those with a diaphyseal fracture compared to those with a subtrochanteric fracture (-4.3 [3.2]° versus -0.9 [2.7]°, p=0.07). Our analyses support that subjects with AFF exhibit femoral geometry parameters that result in higher tensile mechanical load on the lateral femur. This may play a critical role in the pathogenesis of AFF and requires further evaluation in a larger size population.
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Affiliation(s)
- Suzanne N Morin
- McGill University, Montreal, Canada; McGill University Health Center Research Institute, Montreal, Canada.
| | - Michelle Wall
- McGill University Health Center Research Institute, Montreal, Canada
| | - Etienne L Belzile
- Laval University, Quebec City, Canada; CHU de Québec Research Centre, Quebec City, Canada
| | - Benoit Godbout
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Canada
| | - Thomas P Moser
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Canada; Université de Montréal, Montreal, Canada
| | - Laëtitia Michou
- Laval University, Quebec City, Canada; CHU de Québec Research Centre, Quebec City, Canada
| | - Louis-Georges Ste-Marie
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Canada; Université de Montréal, Montreal, Canada
| | - Jacques A de Guise
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Canada; Université de Montréal, Montreal, Canada
| | - Elham Rahme
- McGill University, Montreal, Canada; McGill University Health Center Research Institute, Montreal, Canada
| | - Jacques P Brown
- Laval University, Quebec City, Canada; CHU de Québec Research Centre, Quebec City, Canada
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Wang Y, Videman T, Boyd SK, Battié MC. The distribution of bone mass in the lumbar vertebrae: are we measuring the right target? Spine J 2015; 15:2412-6. [PMID: 26133256 DOI: 10.1016/j.spinee.2015.06.059] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 05/22/2015] [Accepted: 06/22/2015] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT The ideal target of bone mineral density (BMD) measurements of the spine is the trabecula-rich vertebral body. Yet, spine BMD measurements routinely obtained with dual-energy X-ray absorptiometry also include the posterior elements of the vertebra, which are mainly cortical bone and insensitive to bone loss. PURPOSE We compared the bone mass of the vertebral body and posterior elements to determine the contributions of vertebral components to vertebral BMD measurements. STUDY DESIGN A micro-computed tomography study of lumbar vertebral bone. METHODS From a spine archive, 144 cadaveric lumbar vertebrae (L1-L5) from 48 male human spines (mean age, 50 years) were scanned in air using micro-computed tomography to measure bone volume, bone mineral content (BMC) and BMD of the vertebral body, posterior elements, and entire vertebra. The contributions of the vertebral components to the total vertebral BMC and volume were compared, and the correlations between the BMC and BMD of the vertebrae and their components were examined. RESULTS Overall, the vertebral body contributed about one-third of the total vertebral BMC and two-thirds of the total vertebral volume, and the posterior elements contributed the remainder. The vertebral body BMC and BMD were poorly correlated to those of the posterior elements (r=0.39 for BMC and r=0.34 for BMD, p<.0001) and moderately correlated to the whole vertebra (r=0.77 and 0.75, respectively, p<.0001). The BMC and BMD of the posterior elements and whole vertebra were more strongly correlated (r=0.89 and 0.84, respectively, p<.0001). CONCLUSIONS The posterior elements are the primary contributor to vertebral BMC and BMD measurements. Dual-energy X-ray absorptiometry spine BMD measurements are likely to be more representative of the posterior elements than the targeted vertebral body. The findings elucidate the extent of the limitation of dual-energy X-ray absorptiometry spine BMD measurements.
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Affiliation(s)
- Yue Wang
- Spine Laboratory, Department of Orthopedic Surgery, The First Affiliated Hospital of Zhejiang University, 79#, Qingchun Road, Hangzhou, China, 310003; Faculty of Rehabilitation Medicine, University of Alberta, 3-44, 8205 114 St, Edmonton, Alberta, Canada T6G 2G4
| | - Tapio Videman
- Faculty of Rehabilitation Medicine, University of Alberta, 3-44, 8205 114 St, Edmonton, Alberta, Canada T6G 2G4
| | - Steven K Boyd
- Schulich School of Engineering, University of Calgary, 3280 Hospital Drive NW, Calgary, Alberta, Canada T2N 4Z6
| | - Michele C Battié
- Faculty of Rehabilitation Medicine, University of Alberta, 3-44, 8205 114 St, Edmonton, Alberta, Canada T6G 2G4.
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Assessment of Hip Fracture Risk Using Cross-Section Strain Energy Determined by QCT-Based Finite Element Modeling. BIOMED RESEARCH INTERNATIONAL 2015; 2015:413839. [PMID: 26601105 PMCID: PMC4637043 DOI: 10.1155/2015/413839] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Revised: 06/28/2015] [Accepted: 06/29/2015] [Indexed: 01/25/2023]
Abstract
Accurate assessment of hip fracture risk is very important to prevent hip fracture and to monitor the effect of a treatment. A subject-specific QCT-based finite element model was constructed to assess hip fracture risk at the critical locations of femur during the single-leg stance and the sideways fall. The aim of this study was to improve the prediction of hip fracture risk by introducing a novel failure criterion to more accurately describe bone failure mechanism. Hip fracture risk index was defined using cross-section strain energy, which is able to integrate information of stresses, strains, and material properties affecting bone failure. It was found that the femoral neck and the intertrochanteric region have higher fracture risk than other parts of the femur, probably owing to the larger content of cancellous bone in these regions. The study results also suggested that women are more prone to hip fracture than men. The findings in this study have a good agreement with those clinical observations reported in the literature. The proposed hip fracture risk index based on strain energy has the potential of more accurate assessment of hip fracture risk. However, experimental validation should be conducted before its clinical applications.
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Sarvi MN, Luo Y. A two-level subject-specific biomechanical model for improving prediction of hip fracture risk. Clin Biomech (Bristol, Avon) 2015; 30:881-7. [PMID: 26126498 DOI: 10.1016/j.clinbiomech.2015.05.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 05/23/2015] [Accepted: 05/25/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND Sideways fall-induced hip fracture is a major worldwide health problem among the elderly population. However, all existing biomechanical models for predicting hip fracture mainly consider the femur related parameters. Their accuracy is limited as hip fracture is significantly affected by loading conditions as well. The objective of this study was to develop a biomechanical model for improving assessment of hip fracture risk by subject-specific prediction of fall-induced loading conditions. METHOD All information required to construct the models was extracted from the subject's whole-body and hip medical image in order to make the models subject-specific. Fall-induced hip fracture risk for eighty clinical cases was calculated under two sets of loading conditions: subject-specific determined by the proposed model, and non-subject-specific obtained from empirical functions. The predicted hip fracture risk indices were then compared with clinical observations. FINDINGS It was found that the subject-specific prediction of fall-induced loading conditions significantly improves the hip fracture risk assessment. Consistent to the clinical observations, the fracture risk predicted by the proposed model suggested that obesity is a protective factor for hip fracture and underweight subjects are more likely to experience a hip fracture. INTERPRETATIONS This study shows that hip fracture risk is affected by a number of factors, including body weight, body height, impact force, body mass index, hip soft tissue thickness, and bone quality. The proposed model provides a comprehensive, fast, accurate, and non-expensive method for prediction of hip fracture risk which should lead to more effective prevention of hip fractures.
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Affiliation(s)
- Masoud Nasiri Sarvi
- Department of Mechanical Engineering, Faculty of Engineering, University of Manitoba, 75A Chancellors Circle, Winnipeg, Manitoba R3T 2N2, Canada
| | - Yunhua Luo
- Department of Mechanical Engineering, Faculty of Engineering, University of Manitoba, 75A Chancellors Circle, Winnipeg, Manitoba R3T 2N2, Canada.
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Barngkgei I, Al Haffar I, Shaarani E, Khattab R, Mashlah A. Assessment of jawbone trabecular bone structure amongst osteoporotic women by cone-beam computed tomography: the OSTEOSYR project. ACTA ACUST UNITED AC 2015; 7:332-340. [DOI: 10.1111/jicd.12170] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Accepted: 05/19/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Imad Barngkgei
- Department of Oral Medicine; Faculty of Dentistry; Damascus University; Damascus Syria
| | - Iyad Al Haffar
- Department of Oral Medicine; Faculty of Dentistry; Damascus University; Damascus Syria
| | - Eyad Shaarani
- Department of Removable Prosthodontics; Faculty of Dentistry; Damascus University; Damascus Syria
| | - Razan Khattab
- Department of Periodontology; Faculty of Dentistry; Damascus University; Damascus Syria
| | - Ammar Mashlah
- Department of Oral Medicine; Faculty of Dentistry; Damascus University; Damascus Syria
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Nagarajan MB, Checefsky WA, Abidin AZ, Tsai H, Wang X, Hobbs SK, Bauer JS, Baum T, Wismüller A. Characterizing Trabecular Bone structure for Assessing Vertebral Fracture Risk on Volumetric Quantitative Computed Tomography. PROCEEDINGS OF SPIE--THE INTERNATIONAL SOCIETY FOR OPTICAL ENGINEERING 2015; 9417. [PMID: 29200590 DOI: 10.1117/12.2082059] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
While the proximal femur is preferred for measuring bone mineral density (BMD) in fracture risk estimation, the introduction of volumetric quantitative computed tomography has revealed stronger associations between BMD and spinal fracture status. In this study, we propose to capture properties of trabecular bone structure in spinal vertebrae with advanced second-order statistical features for purposes of fracture risk assessment. For this purpose, axial multi-detector CT (MDCT) images were acquired from 28 spinal vertebrae specimens using a whole-body 256-row CT scanner with a dedicated calibration phantom. A semi-automated method was used to annotate the trabecular compartment in the central vertebral slice with a circular region of interest (ROI) to exclude cortical bone; pixels within were converted to values indicative of BMD. Six second-order statistical features derived from gray-level co-occurrence matrices (GLCM) and the mean BMD within the ROI were then extracted and used in conjunction with a generalized radial basis functions (GRBF) neural network to predict the failure load of the specimens; true failure load was measured through biomechanical testing. Prediction performance was evaluated with a root-mean-square error (RMSE) metric. The best prediction performance was observed with GLCM feature 'correlation' (RMSE = 1.02 ± 0.18), which significantly outperformed all other GLCM features (p < 0.01). GLCM feature correlation also significantly outperformed MDCT-measured mean BMD (RMSE = 1.11 ± 0.17) (p < 10-4). These results suggest that biomechanical strength prediction in spinal vertebrae can be significantly improved through characterization of trabecular bone structure with GLCM-derived texture features.
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Affiliation(s)
- Mahesh B Nagarajan
- Departments of Imaging Sciences and Biomedical Engineering, University of Rochester, New York, United States
| | - Walter A Checefsky
- Departments of Imaging Sciences and Biomedical Engineering, University of Rochester, New York, United States
| | - Anas Z Abidin
- Departments of Imaging Sciences and Biomedical Engineering, University of Rochester, New York, United States
| | - Halley Tsai
- Departments of Imaging Sciences and Biomedical Engineering, University of Rochester, New York, United States
| | - Xixi Wang
- Departments of Imaging Sciences and Biomedical Engineering, University of Rochester, New York, United States
| | - Susan K Hobbs
- Departments of Imaging Sciences and Biomedical Engineering, University of Rochester, New York, United States
| | - Jan S Bauer
- Institute for Diagnostic Radiology, Technical University of Munich, Munich, Germany
| | - Thomas Baum
- Institute for Diagnostic Radiology, Technical University of Munich, Munich, Germany
| | - Axel Wismüller
- Departments of Imaging Sciences and Biomedical Engineering, University of Rochester, New York, United States.,Institute for Clinical Radiology, Ludwig Maximilian University, Munich, Germany
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Focus on diffusion MR investigations of musculoskeletal tissue to improve osteoporosis diagnosis: a brief practical review. BIOMED RESEARCH INTERNATIONAL 2015; 2015:948610. [PMID: 25861652 PMCID: PMC4377366 DOI: 10.1155/2015/948610] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Accepted: 02/18/2015] [Indexed: 01/13/2023]
Abstract
Nowadays, a huge number of papers have documented the ability of diffusion magnetic resonance imaging (D-MRI) to highlight normal and pathological conditions in a variety of cerebral, abdominal, and cardiovascular applications. To date, however, the role of D-MRI to investigate musculoskeletal tissue, specifically the cancellous bone, has not been extensively explored. In order to determine potentially useful applications of diffusion techniques in musculoskeletal investigation, D-MRI applications to detect osteoporosis disease were reviewed and further explained.
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Impact of Obesity on Osteoporosis: Limitations of the Current Modalities of Assessing Osteoporosis in Obese Subjects. Clin Rev Bone Miner Metab 2015. [DOI: 10.1007/s12018-015-9179-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Ebeling PR, Daly RM, Kerr DA, Kimlin MG. Building healthy bones throughout life: an evidence-informed strategy to prevent osteoporosis in Australia. Med J Aust 2015; 199:S1-S46. [PMID: 25370432 DOI: 10.5694/j.1326-5377.2013.tb04225.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2012] [Accepted: 12/02/2012] [Indexed: 12/14/2022]
Abstract
Osteoporosis imposes a tremendous burden on Australia: 1.2 million Australians have osteoporosis and 6.3 million have osteopenia. In the 2007–08 financial year, 82 000 Australians suffered fragility fractures, of which > 17 000 were hip fractures. In the 2000–01 financial year, direct costs were estimated at $1.9 billion per year and an additional $5.6 billion on indirect costs. Osteoporosis was designated a National Health Priority Area in 2002; however, implementation of national plans has not yet matched the rhetoric in terms of urgency. Building healthy bones throughout life, the Osteoporosis Australia strategy to prevent osteoporosis throughout the life cycle, presents an evidence-informed set of recommendations for consumers, health care professionals and policymakers. The strategy was adopted by consensus at the Osteoporosis Australia Summit in Sydney, 20 October 2011. Primary objectives throughout the life cycle are: to maximise peak bone mass during childhood and adolescence to prevent premature bone loss and improve or maintain muscle mass, strength and functional capacity in healthy adults to prevent and treat osteoporosis in order to minimise the risk of suffering fragility fractures, and reduce falls risk, in older people. The recommendations focus on three affordable and important interventions — to ensure people have adequate calcium intake, vitamin D levels and appropriate physical activity throughout their lives. Recommendations relevant to all stages of life include: daily dietary calcium intakes should be consistent with Australian and New Zealand guidelines serum levels of vitamin D in the general population should be above 50nmol/L in winter or early spring for optimal bone health regular weight-bearing physical activity, muscle strengthening exercises and challenging balance/mobility activities should be conducted in a safe environment.
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Affiliation(s)
- Peter R Ebeling
- NorthWest Academic Centre, University of Melbourne, and Western Health, Melbourne, VIC, Australia.
| | - Robin M Daly
- Centre for Physical Activity and Nutrition Research, Deakin University, Melbourne, VIC, Australia
| | - Deborah A Kerr
- Curtin Health Innovation Research Institute and School of Public Health, Curtin University, Perth, WA, Australia
| | - Michael G Kimlin
- Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
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Marinova M, Edon B, Wolter K, Katsimbari B, Schild HH, Strunk HM. Use of routine thoracic and abdominal computed tomography scans for assessing bone mineral density and detecting osteoporosis. Curr Med Res Opin 2015; 31:1871-81. [PMID: 26308674 DOI: 10.1185/03007995.2015.1074892] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Evaluation of computed tomography (CT) attenuation measurements for assessing bone mineral density (BMD) and predicting osteoporosis in thoracic and abdominal CT scans for various clinical indications using dual-energy X-ray absorptiometry (DXA) as reference standard. RESEARCH DESIGN AND METHODS A total of 234 patients (147 women, 87 men) undergoing DXA and CT were examined retrospectively. Mean time between both studies was 0.5 years. CT-attenuation values in Hounsfield units (HU) were measured at the thoracic and lumbar spine (T1, T6, T12, L1-L5), at the femoral neck, and then assigned to their corresponding DXA scores. RESULTS Patients with DXA-defined osteoporosis or osteopenia showed significantly lower HU values of trabecular bone at all measured levels compared to healthy subjects (p < 0.001). HU values were highest at T1 and T6, lowest at L1-L3 and the femoral neck. There were no significant intraindividual differences between HU values in the sagittal, coronal or transversal plane. Significant differences between normal and abnormal BMD categories were verified for three CT scanners. More than half of all fractures were detected in patients with non-osteoporotic DXA T-scores. CONCLUSIONS Abdominal and particularly thoracic CT scans obtained for other clinical indications can sensibly be applied toward determining low BMD, detecting osteoporosis and identifying persons at increased fracture risk. Osteoporotic morbidity and mortality might be minimized. Superiorly to DXA, fragility fractures can be found without additional imaging or radiation exposure which can initiate early adequate treatment. LIMITATIONS Key limitations of the study were as following: a retrospective, single-center study; small patient cohort - larger cohorts are needed to evaluate the sensitivity and specificity of diagnostic performance measurements; more complex CT evaluation of the hip for BMD assessment; DXA measurements were used as a reference standard, however, patients with unsuspected compression fractures but showing osteopenic or even normal BMD outline the limitations of DXA.
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Affiliation(s)
- Milka Marinova
- a a Department of Radiology , Hospital & Medical School, University of Bonn , Bonn , Germany
| | - Bob Edon
- a a Department of Radiology , Hospital & Medical School, University of Bonn , Bonn , Germany
- b b Klinikum Mutterhaus der Borromäerinnen , Trier , Germany
| | - Karsten Wolter
- a a Department of Radiology , Hospital & Medical School, University of Bonn , Bonn , Germany
| | - Barbara Katsimbari
- a a Department of Radiology , Hospital & Medical School, University of Bonn , Bonn , Germany
| | - Hans H Schild
- a a Department of Radiology , Hospital & Medical School, University of Bonn , Bonn , Germany
| | - Holger M Strunk
- a a Department of Radiology , Hospital & Medical School, University of Bonn , Bonn , Germany
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46
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Evaluation of perfusion-related and true diffusion in vertebral bone marrow: a preliminary study. Radiol Phys Technol 2014; 8:135-40. [DOI: 10.1007/s12194-014-0301-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Revised: 10/30/2014] [Accepted: 11/04/2014] [Indexed: 01/20/2023]
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Intravenous contrast injection significantly affects bone mineral density measured on CT. Eur Radiol 2014; 25:283-9. [PMID: 25187384 DOI: 10.1007/s00330-014-3408-2] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Revised: 08/12/2014] [Accepted: 08/21/2014] [Indexed: 01/22/2023]
Abstract
OBJECTIVE The objective is to evaluate the effect of intravenous contrast media on bone mineral density (BMD) assessment by comparing unenhanced and contrast-enhanced computed tomography (CT) examinations performed for other indications. METHODS One hundred and fifty-two patients (99 without and 53 with malignant neoplasm) who underwent both unenhanced and two contrast-enhanced (arterial and portal venous phase) abdominal CT examinations in a single session between June 2011 and July 2013 were included. BMD was evaluated on the three examinations as CT-attenuation values in Hounsfield Units (HU) in the first lumbar vertebra (L1). RESULTS CT-attenuation values were significantly higher in both contrast-enhanced phases, compared to the unenhanced phase (p < 0.01). In patients without malignancies, mean ± standard deviation (SD) HU-values increased from 128.8 ± 48.6 HU for the unenhanced phase to 142.3 ± 47.2 HU for the arterial phase and 147.0 ± 47.4 HU for the portal phase (p < 0.01). In patients with malignancies, HU-values increased from 112.1 ± 38.1 HU to 126.2 ± 38.4 HU and 130.1 ± 37.3 HU (p < 0.02), respectively. With different thresholds to define osteoporosis, measurements in the arterial and portal phase resulted in 7-25% false negatives. CONCLUSIONS Our study showed that intravenous contrast injection substantially affects BMD-assessment on CT and taking this into account may improve routine assessment of low BMD in nonquantitative CT. KEY POINTS • Routine CT may gain a role in bone attenuation measurements for osteoporosis • Contrast media injection has substantial influence on CT-derived bone density • Contrast-enhanced CT leads to underestimation of osteoporosis compared to unenhanced CT • Adjusting for contrast injection phase may improve CT screening protocols for osteoporosis.
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Klintström E, Smedby O, Klintström B, Brismar TB, Moreno R. Trabecular bone histomorphometric measurements and contrast-to-noise ratio in CBCT. Dentomaxillofac Radiol 2014; 43:20140196. [PMID: 25168811 DOI: 10.1259/dmfr.20140196] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The aim of this study was to evaluate how imaging parameters at clinical dental CBCT affect the accuracy in quantifying trabecular bone structures, contrast-to-noise ratio (CNR) and radiation dose. METHODS 15 radius samples were examined using CBCT (Accuitomo FPD; J. Morita Mfg., Kyoto, Japan). Nine imaging protocols were used, differing in current, voltage, rotation degree, voxel size, imaging area and rotation time. Radiation doses were measured using a kerma area product-meter. After segmentation, six bone structure parameters and CNRs were quantified. Micro-CT (μCT) images with an isotropic resolution of 20 μm were used as a gold standard. RESULTS Structure parameters obtained by CBCT were strongly correlated to those by μCT, with correlation coefficients >0.90 for all studied parameters. Bone volume and trabecular thickness were not affected by changes in imaging parameters. Increased tube current from 5 to 8 mA, decreased isotropic voxel size from 125 to 80 μm and decreased rotation angle from 360° to 180° affected correlations for trabecular termini negatively. Decreasing rotation degree also weakened correlations for trabecular separation and trabecular number at 80 μm voxel size. Changes in the rotation degree and tube current affected CNR significantly. The radiation dose varied between 269 and 1153 mGy cm(2). CONCLUSIONS Trabecular bone structure can be accurately quantified by clinical dental CBCT in vitro, and the obtained structure parameters are strongly related to those obtained by μCT. A fair CNR and strong correlations can be obtained with a low radiation dose, indicating the possibility for monitoring trabecular bone structure also in vivo.
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Affiliation(s)
- E Klintström
- 1 Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
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Cheung AM, Majumdar S, Brixen K, Chapurlat R, Fuerst T, Engelke K, Dardzinski B, Cabal A, Verbruggen N, Ather S, Rosenberg E, de Papp AE. Effects of odanacatib on the radius and tibia of postmenopausal women: improvements in bone geometry, microarchitecture, and estimated bone strength. J Bone Miner Res 2014; 29:1786-94. [PMID: 24643905 DOI: 10.1002/jbmr.2194] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Revised: 01/24/2014] [Accepted: 02/01/2014] [Indexed: 11/08/2022]
Abstract
The cathepsin K inhibitor odanacatib (ODN), currently in phase 3 development for postmenopausal osteoporosis, has a novel mechanism of action that reduces bone resorption while maintaining bone formation. In phase 2 studies, odanacatib increased areal bone mineral density (aBMD) at the lumbar spine and total hip progressively over 5 years. To determine the effects of ODN on cortical and trabecular bone and estimate changes in bone strength, we conducted a randomized, double-blind, placebo-controlled trial, using both quantitative computed tomography (QCT) and high-resolution peripheral (HR-p)QCT. In previously published results, odanacatib was superior to placebo with respect to increases in trabecular volumetric BMD (vBMD) and estimated compressive strength at the spine, and integral and trabecular vBMD and estimated strength at the hip. Here, we report the results of HR-pQCT assessment. A total of 214 postmenopausal women (mean age 64.0 ± 6.8 years and baseline lumbar spine T-score -1.81 ± 0.83) were randomized to oral ODN 50 mg or placebo, weekly for 2 years. With ODN, significant increases from baseline in total vBMD occurred at the distal radius and tibia. Treatment differences from placebo were also significant (3.84% and 2.63% for radius and tibia, respectively). At both sites, significant differences from placebo were also found in trabecular vBMD, cortical vBMD, cortical thickness, cortical area, and strength (failure load) estimated using finite element analysis of HR-pQCT scans (treatment differences at radius and tibia = 2.64% and 2.66%). At the distal radius, odanacatib significantly improved trabecular thickness and bone volume/total volume (BV/TV) versus placebo. At a more proximal radial site, odanacatib attenuated the increase in cortical porosity found with placebo (treatment difference = -7.7%, p = 0.066). At the distal tibia, odanacatib significantly improved trabecular number, separation, and BV/TV versus placebo. Safety and tolerability were similar between treatment groups. In conclusion, odanacatib increased cortical and trabecular density, cortical thickness, aspects of trabecular microarchitecture, and estimated strength at the distal radius and distal tibia compared with placebo.
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Alghamdi HS, van den Beucken JJ, Jansen JA. Osteoporotic Rat Models for Evaluation of Osseointegration of Bone Implants. Tissue Eng Part C Methods 2014; 20:493-505. [DOI: 10.1089/ten.tec.2013.0327] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Affiliation(s)
- Hamdan S. Alghamdi
- Department of Biomaterials, Radboud University 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 Medical Center, Nijmegen, The Netherlands
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