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Bugbird AR, Klassen RE, Bruce OL, Burt LA, Edwards WB, Boyd SK. Fixed and Relative Positioning of Scans for High Resolution Peripheral Quantitative Computed Tomography. J Clin Densitom 2024; 27:101462. [PMID: 38104525 DOI: 10.1016/j.jocd.2023.101462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 12/07/2023] [Accepted: 12/07/2023] [Indexed: 12/19/2023]
Abstract
INTRODUCTION High resolution peripheral quantitative computed tomography (HR-pQCT) imaging protocol requires defining where to position the ∼1 cm thick scan along the bone length. Discrepancies between the use of two positioning methods, the relative and fixed offset, may be problematic in the comparison between studies and participants. This study investigated how bone landmarks scale linearly with length and how this scaling affects both positioning methods aimed at providing a consistent anatomical location for scan acquisition. METHODS Using CT images of the radius (N = 25) and tibia (N = 42), 10 anatomical landmarks were selected along the bone length. The location of these landmarks was converted to a percent length along the bone, and the variation in their location was evaluated across the dataset. The absolute location of the HR-pQCT scan position using both offset methods was identified for all bones and converted to a percent length position relative to the HR-pQCT reference line for comparison. A secondary analysis of the location of the scan region specifically within the metaphysis was explored at the tibia. RESULTS The location of landmarks deviated from a linear relationship across the dataset, with a range of 3.6 % at the radius sites, and 4.5 % at the tibia sites. The consequent variation of the position of the scan at the radius was 0.6 % and 0.3 %, and at the tibia 2.4 % and 0.5 %, for the fixed and relative offset, respectively. The position of the metaphyseal junction with the epiphysis relative to the scan position was poorly correlated to bone length, with R2 = 0.06 and 0.37, for the fixed and relative offset respectively. CONCLUSION The variation of the scan position by either method is negated by the intrinsic variation of the bone anatomy with respect both to total bone length as well as the metaphyseal region. Therefore, there is no clear benefit of either offset method. However, the lack of difference due to the inherent variation in the underlying anatomy implies that it is reasonable to compare studies even if they are using different positioning methods.
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Affiliation(s)
- Annabel R Bugbird
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary AB, Canada
| | - Rachel E Klassen
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary AB, Canada
| | - Olivia L Bruce
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary AB, Canada; Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary AB, Canada
| | - Lauren A Burt
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary AB, Canada
| | - W Brent Edwards
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary AB, Canada; Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary AB, Canada
| | - Steven K Boyd
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary AB, Canada.
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Mata-Mbemba D, Rohringer T, Ibrahim A, Adams-Webberc T, Moineddin R, Doria AS, Vali R. HR-pQCT imaging in children, adolescents and young adults: Systematic review and subgroup meta-analysis of normative data. PLoS One 2019; 14:e0225663. [PMID: 31834887 PMCID: PMC6910691 DOI: 10.1371/journal.pone.0225663] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 11/08/2019] [Indexed: 12/18/2022] Open
Abstract
We aimed to investigate the methodologies on image acquisition of normative data of high-resolution peripheral quantitative computed tomography (HR-pQCT) in children, adolescents and/or young adults (up to 25 years) and to determine their normative data based on available literature. A literature search was conducted in MEDLINE, EMBASE and Web of Science from 1947 to July 2019. Quality of articles was assessed using Standards for Reporting of Diagnostic Accuracy (STARD) scoring system and Modified Newcastle-Ottawa scale (NOS). Articles which fitted the following criteria were combined to meta-analysis: age range (15 to 22.6 years), references at tibia (22.5mm) and/or radius (9.0 to 9.5mm). Eight articles were ultimately included in the systematic review and 4 of them that filled the criteria were summarised in meta-analysis. The results of random effects model of HR-pQCT parameters of the 4 articles were as follows: 1)Radius: bone volume fraction (BT/BV) [estimate 0.17:0.1229(lower)-0.2115 (upper); trabecular number (Tb_N):2.08(2.03–2.12); trabecular thickness (Tb.Th):0.07 (0.07–0.0.08); trabecular separation (Tb.Sp):0.41 (0.38–0.42); cortical thickness (Ct.Th):0.85 (0.76–0.94); cortical porosity (Ct.Po):1.53 (0.63–2.44); total area (Tt.Ar):263.66(-385.3–912.6); total bone density (Tt-vBMD):280.5 (73.1–487.7); Trabecular density (Tb-vBMD):223.6 (47.1–400.09), and cortical density (CT.vBMD):765.9 (389.1–1142.8). 2)Tibia: BT/BV:0.18 (0.17–0.19); Tb_N:2.02 (1.83–2.2); Tb.Th:0.08 (0.80–0.09); Tb.Sp:0.40(0.36–0.44); Ct.Th:1.32(1.26–1.38); Ct.Po:3.15 (1.1–5.2); Tt.Ar:693.1(150.2–1235.8); Tt-vBMD:343.76 (335.5–352.1); Tb-vBMD:223.6 (213.37 (193.5–233.2), and CT.vBMD:894.3 (857.6–931.1). There is overall ‘fair’ evidence on reporting of results of normative data of HR-pQCT parameters in children, adolescents and/or young adults. However, data are scarce pointing out to the urgent need for standardization of acquisition parameters and guidelines on the use of HR-PQCT in these populations.
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Affiliation(s)
- Daddy Mata-Mbemba
- Department of Diagnostic Imaging, IWK Health Centre, and Department of Diagnostic Radiology, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Diagnostic Imaging, Hospital for Sick Children and Department of Medical Imaging, University of Toronto, Toronto, Canada
- * E-mail:
| | | | - Ala Ibrahim
- Department of Diagnostic Imaging, Hospital for Sick Children and Department of Medical Imaging, University of Toronto, Toronto, Canada
| | | | - Rahim Moineddin
- Departments of Family and Community Medicine (R.M.), University of Toronto, Toronto, Canada
| | - Andrea S. Doria
- Department of Diagnostic Imaging, Hospital for Sick Children and Department of Medical Imaging, University of Toronto, Toronto, Canada
| | - Reza Vali
- Department of Diagnostic Imaging, Hospital for Sick Children and Department of Medical Imaging, University of Toronto, Toronto, Canada
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Cheuk KY, Wang XF, Wang J, Zhang Z, Yu FWP, Tam EMS, Hung VWY, Lee WYW, Ghasem-Zadeh A, Zebaze R, Zhu TY, Guo XE, Cheng JCY, Lam TP, Seeman E. Sexual Dimorphism in Cortical and Trabecular Bone Microstructure Appears During Puberty in Chinese Children. J Bone Miner Res 2018; 33:1948-1955. [PMID: 30001459 DOI: 10.1002/jbmr.3551] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 06/28/2018] [Accepted: 07/07/2018] [Indexed: 01/21/2023]
Abstract
Distal forearm fractures during growth are more common in males than females. Because metaphyseal cortical bone is formed by coalescence of trabeculae emerging from the periphery of the growth plate, we hypothesized that the later onset of puberty in males produces a longer delay in trabecular bone formation and coalescence, which leaves a transient phase of high cortical porosity, low matrix mineral density, and high trabecular density relative to females. We quantified the nondominant distal radial microstructure using high-resolution peripheral quantitative computed tomography in 214 healthy Chinese boys and 219 Chinese girls aged between 7 and 17 years living in Hong Kong. Measurements of 110 slices (9.02 mm) were acquired 5 mm proximal to the growth plate of the nondominant distal radius. Porosity was measured using StrAx1.0 (Straxcorp, Melbourne, VIC, Australia) and trabecular plate and rod structure were measured using individual trabecula segmentation (ITS). Mechanical properties were estimated using finite element analysis (FEA). Results were adjusted for age, total bone cross-sectional area (CSA), dietary calcium intake, and physical activity. In boys, total bone CSA was 17.2% to 22.9% larger throughout puberty, cortical/total bone CSA was 5.1% smaller in Tanner stage 2 only, cortical porosity was 9.4% to 17.5% higher, and matrix mineral density was 1.0% to 2.5% lower in Tanner stage 2 to 5, than girls. Boys had higher trabecular rod BV/TV in Tanner stage 3 and 4, but higher trabecular plate BV/TV and plate to rod ratio in Tanner stage 5, than girls. Boys had 17.0% lower apparent modulus than girls in Tanner stage 2. A transient phase of higher porosity due to dissociation between bone mineral accrual and linear growth may contribute to higher distal radial bone fragility in Chinese boys compared to girls. © 2018 American Society for Bone and Mineral Research.
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Affiliation(s)
- Ka Yee Cheuk
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China.,SH Ho Scoliosis Research Laboratory, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.,Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, The Chinese University of Hong Kong, Hong Kong, China
| | - Xiao-Fang Wang
- Department of Endocrinology, Austin Health, University of Melbourne, Heidelberg, VIC, Australia.,Department of Medicine, Austin Health, University of Melbourne, Heidelberg, VIC, Australia
| | - Ji Wang
- Bone Bioengineering Laboratory, Department of Biomedical Engineering, Columbia University, New York, NY, USA
| | - Zhendong Zhang
- Bone Bioengineering Laboratory, Department of Biomedical Engineering, Columbia University, New York, NY, USA
| | - Fiona Wai Ping Yu
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China.,SH Ho Scoliosis Research Laboratory, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.,Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, The Chinese University of Hong Kong, Hong Kong, China.,Bone Quality and Health Centre, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China
| | - Elisa Man Shan Tam
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China.,SH Ho Scoliosis Research Laboratory, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.,Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, The Chinese University of Hong Kong, Hong Kong, China
| | - Vivian Wing Yin Hung
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China.,SH Ho Scoliosis Research Laboratory, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.,Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, The Chinese University of Hong Kong, Hong Kong, China.,Bone Quality and Health Centre, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China
| | - Wayne Yuk Wai Lee
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China.,SH Ho Scoliosis Research Laboratory, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.,Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, The Chinese University of Hong Kong, Hong Kong, China
| | - Ali Ghasem-Zadeh
- Department of Endocrinology, Austin Health, University of Melbourne, Heidelberg, VIC, Australia.,Department of Medicine, Austin Health, University of Melbourne, Heidelberg, VIC, Australia
| | - Roger Zebaze
- Department of Endocrinology, Austin Health, University of Melbourne, Heidelberg, VIC, Australia.,Department of Medicine, Austin Health, University of Melbourne, Heidelberg, VIC, Australia
| | - Tracy Y Zhu
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China.,SH Ho Scoliosis Research Laboratory, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.,Bone Quality and Health Centre, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China
| | - X Edward Guo
- Bone Bioengineering Laboratory, Department of Biomedical Engineering, Columbia University, New York, NY, USA
| | - Jack Chun Yiu Cheng
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China.,SH Ho Scoliosis Research Laboratory, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.,Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, The Chinese University of Hong Kong, Hong Kong, China.,Bone Quality and Health Centre, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China
| | - Tsz Ping Lam
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China.,SH Ho Scoliosis Research Laboratory, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.,Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, The Chinese University of Hong Kong, Hong Kong, China.,Bone Quality and Health Centre, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China
| | - Ego Seeman
- Department of Endocrinology, Austin Health, University of Melbourne, Heidelberg, VIC, Australia.,Department of Medicine, Austin Health, University of Melbourne, Heidelberg, VIC, Australia.,Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
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Ghasem-Zadeh A, Burghardt A, Wang XF, Iuliano S, Bonaretti S, Bui M, Zebaze R, Seeman E. Quantifying sex, race, and age specific differences in bone microstructure requires measurement of anatomically equivalent regions. Bone 2017; 101:206-213. [PMID: 28502884 DOI: 10.1016/j.bone.2017.05.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 04/29/2017] [Accepted: 05/10/2017] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Individuals differ in forearm length. As microstructure differs along the radius, we hypothesized that errors may occur when sexual and racial dimorphisms are quantified at a fixed distance from the radio-carpal joint. METHODS Microstructure was quantified ex vivo in 18 cadaveric radii using high resolution peripheral quantitative computed tomography and in vivo in 158 Asian and Caucasian women and men at a fixed region of interest (ROI), a corrected ROI positioned at 4.5-6% of forearm length and using the fixed ROI adjusted for cross sectional area (CSA), forearm length or height. Secular effects of age were assessed by comparing 38 younger and 33 older women. RESULTS Ex vivo, similar amounts of bone mass fashioned adjacent cross sections. Larger distal cross sections had thinner porous cortices of lower matrix mineral density (MMD), a larger medullary CSA and higher trabecular density. Smaller proximal cross-sections had thicker less porous cortices of higher MMD, a small medullary canal with little trabecular bone. Taller persons had more distally positioned fixed ROIs which moved proximally when corrected. Shorter persons had more proximally positioned fixed ROIs which moved distally when corrected, so dimorphisms lessened. In the corrected ROIs, in Caucasians, women had 0.6 SD higher porosity and 0.6 SD lower trabecular density than men (p<0.01). In Asians, women had 0.25 SD higher porosity (NS) and 0.5 SD lower trabecular density than men (p<0.05). In women, Asians had 0.8 SD lower porosity and 0.3 SD higher trabecular density than Caucasians (p<0.01). In men, Asians and Caucasians had similar porosity and trabecular density. Results were similar using an adjusted fixed ROI. Adjusting for secular effects of age on forearm length resulted in the age-related increment in porosity increasing from 2.08 SD to 2.48 SD (p<0.05). CONCLUSION Assessment of sex, race and age related differences in microstructure requires measurement of anatomically equivalent regions.
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Affiliation(s)
- Ali Ghasem-Zadeh
- Department of Endocrinology and Medicine, Austin Health, University of Melbourne, Melbourne, Australia.
| | - Andrew Burghardt
- Musculoskeletal Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Xiao-Fang Wang
- Department of Endocrinology and Medicine, Austin Health, University of Melbourne, Melbourne, Australia
| | - Sandra Iuliano
- Department of Endocrinology and Medicine, Austin Health, University of Melbourne, Melbourne, Australia
| | - Serena Bonaretti
- Musculoskeletal Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA; Department of Radiology, Stanford University, Stanford, CA, USA
| | - Minh Bui
- Centre for Epidemiology and Biostatistics, University of Melbourne, Melbourne, Australia
| | - Roger Zebaze
- Department of Endocrinology and Medicine, Austin Health, University of Melbourne, Melbourne, Australia
| | - Ego Seeman
- Department of Endocrinology and Medicine, Austin Health, University of Melbourne, Melbourne, Australia; Institute for Health and Aging, Australian Catholic University, Melbourne, Australia
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