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Rytky SJO, Tiulpin A, Finnilä MAJ, Karhula SS, Sipola A, Kurttila V, Valkealahti M, Lehenkari P, Joukainen A, Kröger H, Korhonen RK, Saarakkala S, Niinimäki J. Clinical Super-Resolution Computed Tomography of Bone Microstructure: Application in Musculoskeletal and Dental Imaging. Ann Biomed Eng 2024; 52:1255-1269. [PMID: 38361137 PMCID: PMC10995025 DOI: 10.1007/s10439-024-03450-y] [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: 08/17/2023] [Accepted: 01/09/2024] [Indexed: 02/17/2024]
Abstract
PURPOSE Clinical cone-beam computed tomography (CBCT) devices are limited to imaging features of half a millimeter in size and cannot quantify the tissue microstructure. We demonstrate a robust deep-learning method for enhancing clinical CT images, only requiring a limited set of easy-to-acquire training data. METHODS Knee tissue from five cadavers and six total knee replacement patients, and 14 teeth from eight patients were scanned using laboratory CT as training data for the developed super-resolution (SR) technique. The method was benchmarked against ex vivo test set, 52 osteochondral samples are imaged with clinical and laboratory CT. A quality assurance phantom was imaged with clinical CT to quantify the technical image quality. To visually assess the clinical image quality, musculoskeletal and maxillofacial CBCT studies were enhanced with SR and contrasted to interpolated images. A dental radiologist and surgeon reviewed the maxillofacial images. RESULTS The SR models predicted the bone morphological parameters on the ex vivo test set more accurately than conventional image processing. The phantom analysis confirmed higher spatial resolution on the SR images than interpolation, but image grayscales were modified. Musculoskeletal and maxillofacial CBCT images showed more details on SR than interpolation; however, artifacts were observed near the crown of the teeth. The readers assessed mediocre overall scores for both SR and interpolation. The source code and pretrained networks are publicly available. CONCLUSION Model training with laboratory modalities could push the resolution limit beyond state-of-the-art clinical musculoskeletal and dental CBCT. A larger maxillofacial training dataset is recommended for dental applications.
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Affiliation(s)
- Santeri J O Rytky
- Research Unit of Health Sciences and Technology, University of Oulu, POB 5000, 90014, Oulu, Finland.
| | - Aleksei Tiulpin
- Research Unit of Health Sciences and Technology, University of Oulu, POB 5000, 90014, Oulu, Finland
- Neurocenter Oulu, Oulu University Hospital, Oulu, Finland
| | - Mikko A J Finnilä
- Research Unit of Health Sciences and Technology, University of Oulu, POB 5000, 90014, Oulu, Finland
- Medical Research Center, University of Oulu, Oulu, Finland
| | - Sakari S Karhula
- Research Unit of Health Sciences and Technology, University of Oulu, POB 5000, 90014, Oulu, Finland
- Department of Radiotherapy, Oulu University Hospital, Oulu, Finland
| | - Annina Sipola
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - Väinö Kurttila
- Department of Oral and Maxillofacial Surgery, Oulu University Hospital, Oulu, Finland
| | - Maarit Valkealahti
- Department of Surgery and Intensive Care, Oulu University Hospital, Oulu, Finland
| | - Petri Lehenkari
- Department of Surgery and Intensive Care, Oulu University Hospital, Oulu, Finland
- Cancer and Translational Medical Research Unit, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Antti Joukainen
- Department of Orthopaedics, Traumatology and Hand Surgery, Kuopio University Hospital, Kuopio, Finland
| | - Heikki Kröger
- Department of Orthopaedics, Traumatology and Hand Surgery, Kuopio University Hospital, Kuopio, Finland
| | - Rami K Korhonen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Simo Saarakkala
- Research Unit of Health Sciences and Technology, University of Oulu, POB 5000, 90014, Oulu, Finland
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - Jaakko Niinimäki
- Research Unit of Health Sciences and Technology, University of Oulu, POB 5000, 90014, Oulu, Finland
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
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Cao X, Keyak JH, Sigurdsson S, Zhao C, Zhou W, Liu A, Lang TF, Deng HW, Gudnason V, Sha Q. A new hip fracture risk index derived from FEA-computed proximal femur fracture loads and energies-to-failure. Osteoporos Int 2024; 35:785-794. [PMID: 38246971 PMCID: PMC11069422 DOI: 10.1007/s00198-024-07015-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 01/02/2024] [Indexed: 01/23/2024]
Abstract
Hip fracture risk assessment is an important but challenging task. Quantitative CT-based patient-specific finite element (FE) analysis (FEA) incorporates bone geometry and bone density in the proximal femur. We developed a global FEA-computed fracture risk index to increase the prediction accuracy of hip fracture incidence. PURPOSE Quantitative CT-based patient-specific finite element (FE) analysis (FEA) incorporates bone geometry and bone density in the proximal femur to compute the force (fracture load) and energy necessary to break the proximal femur in a particular loading condition. The fracture loads and energies-to-failure are individually associated with incident hip fracture, and provide different structural information about the proximal femur. METHODS We used principal component analysis (PCA) to develop a global FEA-computed fracture risk index that incorporates the FEA-computed yield and ultimate failure loads and energies-to-failure in four loading conditions of 110 hip fracture subjects and 235 age- and sex-matched control subjects from the AGES-Reykjavik study. Using a logistic regression model, we compared the prediction performance for hip fracture based on the stratified resampling. RESULTS We referred the first principal component (PC1) of the FE parameters as the global FEA-computed fracture risk index, which was the significant predictor of hip fracture (p-value < 0.001). The area under the receiver operating characteristic curve (AUC) using PC1 (0.776) was higher than that using all FE parameters combined (0.737) in the males (p-value < 0.001). CONCLUSIONS The global FEA-computed fracture risk index increased hip fracture risk prediction accuracy in males.
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Affiliation(s)
- Xuewei Cao
- Department of Mathematical Sciences, Michigan Technological University, Houghton, MI, 49931, USA
| | - Joyce H Keyak
- Department of Radiological Sciences, Department of Biomedical Engineering, and Department of Mechanical and Aerospace Engineering, University of California, Irvine, CA, USA
| | | | - Chen Zhao
- Department of Applied Computing, Michigan Technological University, Houghton, MI, USA
| | - Weihua Zhou
- Department of Applied Computing, Michigan Technological University, Houghton, MI, USA
| | - Anqi Liu
- Center for Bioinformatics and Genomics, School of Medicine, Tulane University, New Orleans, LA, USA
| | - Thomas F Lang
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Hong-Wen Deng
- Center for Bioinformatics and Genomics, School of Medicine, Tulane University, New Orleans, LA, USA
| | - Vilmundur Gudnason
- Icelandic Heart Association Research Institute, Kopavogur, Iceland.
- University of Iceland, Reykjavik, Iceland.
| | - Qiuying Sha
- Department of Mathematical Sciences, Michigan Technological University, Houghton, MI, 49931, USA.
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Milara E, Gómez-Grande A, Sarandeses P, Seiffert AP, Gómez EJ, Sánchez-González P. Automatic Skeleton Segmentation in CT Images Based on U-Net. JOURNAL OF IMAGING INFORMATICS IN MEDICINE 2024:10.1007/s10278-024-01127-5. [PMID: 38689152 DOI: 10.1007/s10278-024-01127-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 04/19/2024] [Accepted: 04/19/2024] [Indexed: 05/02/2024]
Abstract
Bone metastasis, emerging oncological therapies, and osteoporosis represent some of the distinct clinical contexts which can result in morphological alterations in bone structure. The visual assessment of these changes through anatomical images is considered suboptimal, emphasizing the importance of precise skeletal segmentation as a valuable aid for its evaluation. In the present study, a neural network model for automatic skeleton segmentation from bidimensional computerized tomography (CT) slices is proposed. A total of 77 CT images and their semimanual skeleton segmentation from two acquisition protocols (whole-body and femur-to-head) are used to form a training group and a testing group. Preprocessing of the images includes four main steps: stretcher removal, thresholding, image clipping, and normalization (with two different techniques: interpatient and intrapatient). Subsequently, five different sets are created and arranged in a randomized order for the training phase. A neural network model based on U-Net architecture is implemented with different values of the number of channels in each feature map and number of epochs. The model with the best performance obtains a Jaccard index (IoU) of 0.959 and a Dice index of 0.979. The resultant model demonstrates the potential of deep learning applied in medical images and proving its utility in bone segmentation.
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Affiliation(s)
- Eva Milara
- Biomedical Engineering and Telemedicine Centre, Center for Biomedical Technology, ETSI Telecomunicación, Universidad Politécnica de Madrid, 28040, Madrid, Spain
| | - Adolfo Gómez-Grande
- Department of Nuclear Medicine, Hospital Universitario, 12 de Octubre, 28041, Madrid, Spain
- Facultad de Medicina, Universidad Complutense de Madrid, 28040, Madrid, Spain
| | - Pilar Sarandeses
- Department of Nuclear Medicine, Hospital Universitario, 12 de Octubre, 28041, Madrid, Spain
- Facultad de Medicina, Universidad Complutense de Madrid, 28040, Madrid, Spain
| | - Alexander P Seiffert
- Biomedical Engineering and Telemedicine Centre, Center for Biomedical Technology, ETSI Telecomunicación, Universidad Politécnica de Madrid, 28040, Madrid, Spain
| | - Enrique J Gómez
- Biomedical Engineering and Telemedicine Centre, Center for Biomedical Technology, ETSI Telecomunicación, Universidad Politécnica de Madrid, 28040, Madrid, Spain
- Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina, Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Patricia Sánchez-González
- Biomedical Engineering and Telemedicine Centre, Center for Biomedical Technology, ETSI Telecomunicación, Universidad Politécnica de Madrid, 28040, Madrid, Spain.
- Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina, Instituto de Salud Carlos III, 28029, Madrid, Spain.
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Adams GJ, Cook RB, Gibson M, Zioupos P. Predicting the Fracture Toughness of Human Cancellous Bone in Fractured Neck of Femur Patients Using Bone Volume and Micro-Architecture. Life (Basel) 2024; 14:467. [PMID: 38672738 PMCID: PMC11051296 DOI: 10.3390/life14040467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 03/20/2024] [Accepted: 03/29/2024] [Indexed: 04/28/2024] Open
Abstract
The current protocol used to determine if an individual is osteoporotic relies on assessment of the individual's bone mineral density (BMD), which allows clinicians to judge the condition of a patient with respect to their peers. This, in essence, evaluates a person's fracture risk, because BMD is a good surrogate measure for strength and stiffness. In recent studies, the authors were the first to produce fracture toughness (FT) data from osteoporotic (OP) and osteoarthritic (OA) patients, by using a testing technique which basically analyzes the prerequisite stress conditions for the onset of growth of a major crack through cancellous bone tissue. FT depends mainly on bone quantity (BV/TV, bone volume/tissue volume), but also on bone micro-architecture (mArch), the inner trabecular design of the bone. The working research hypothesis of the present study is that mArch offers added prediction power to BV/TV in determining FT parameters. Consequently, our aim was to investigate the use of predictive models for fracture toughness and also to investigate if there are any significant differences between the models produced from samples loaded across (AC, transverse to) the main trabecular orientation and along (AL, in parallel) the trabeculae. In multilinear regression analysis, we found that the strength of the relationships varied for a crack growing in these two orthogonal directions. Adding mArch variables in the Ac direction helped to increase the R2 to 0.798. However, in the AL direction, adding the mArch parameters did not add any predictive power to using BV/TV alone; BV/TV on its own could produce R2 = 0.730. The present results also imply that the anisotropic layout of the trabeculae makes it more difficult for a major crack to grow transversely across them. Cancellous bone models and remodels itself in a certain way to resist fracture in a specific direction, and thus, we should be mindful that architectural quality as well as bone quantity are needed to understand the resistance to fracture.
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Affiliation(s)
- George J. Adams
- Cranfield Forensic Institute, Cranfield University, Cranfield MK43 0AL, UK; (G.J.A.)
| | - Richard B. Cook
- nCATS, School of Engineering Science, University of Southampton, Southampton SO17 1BJ, UK;
| | - Michael Gibson
- Cranfield Forensic Institute, Cranfield University, Cranfield MK43 0AL, UK; (G.J.A.)
| | - Peter Zioupos
- Biomedical Engineering Research Group, School of Engineering, University of Hull, Kingston upon Hull HU6 7RX, UK
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Bisazza KT, Nelson BB, Sikes KJ, Nakamura L, Easley JT. Computed Tomography Provides Improved Quantification of Trabecular Lumbar Spine Bone Loss Compared to Dual-Energy X-Ray Absorptiometry in Ovariectomized Sheep. JBMR Plus 2023; 7:e10807. [PMID: 38130759 PMCID: PMC10731101 DOI: 10.1002/jbm4.10807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 07/26/2023] [Accepted: 08/01/2023] [Indexed: 12/23/2023] Open
Abstract
Early detection of osteoporosis using advanced imaging is imperative to the successful treatment and prevention of high morbidity fractures in aging patients. In this preclinical study, we aimed to compare dual-energy X-ray absorptiometry (DXA) and quantitative computed tomography (QCT) to quantify bone mineral density (BMD) changes in the sheep lumbar spine. We also aimed to determine the relationship of BMD to microarchitecture in the same animals as an estimate of imaging modality precision. Osteoporosis was induced in 10 ewes via laparoscopic ovariectomy and administration of high-dose corticosteroids. We performed DXA and QCT imaging to measure areal BMD (aBMD) and trabecular volumetric BMD (Tb.vBMD)/cortical vBMD (Ct.vBMD), respectively, at baseline (before ovariectomy) and at 3, 6, 9, and 12 months after ovariectomy. Iliac crest bone biopsies were collected at each time point for micro-computed tomography (microCT) analysis; bone volume fraction (BV/TV), trabecular number (Tb.N), thickness (Tb.Th), and spacing (Tb.Sp) were reported. aBMD and Tb.vBMD both decreased significantly by 3 and 6 months (p < 0.05) compared with baseline, whereas no changes to Ct.vBMD were observed. Combined (Tb. and Ct.) vBMD was significantly correlated with aBMD at all time points (all p < 0.05). Additionally, greater significant correlations were found between BV/TV and Tb.vBMD at all five time points (R 2 = 0.54, 0.57, 0.66, 0.46, and 0.56, respectively) than with aBMD values (R 2 = 0.23, 0.55, 0.41, 0.20, and 0.19, respectively). The higher correlation of microCT values with QCT than with DXA indicates that QCT provides additional detailed information regarding bone mineral density changes in preclinical settings. Because trabecular bone is susceptible to rapid density loss and structural changes during osteoporosis, QCT can capture these subtle changes more precisely than DXA in a large animal preclinical model. © 2023 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Katie T Bisazza
- Preclinical Surgical Research Laboratory, Department of Clinical SciencesColorado State UniversityFort CollinsCOUSA
| | - Brad B Nelson
- Preclinical Surgical Research Laboratory, Department of Clinical SciencesColorado State UniversityFort CollinsCOUSA
| | - Katie J Sikes
- Preclinical Surgical Research Laboratory, Department of Clinical SciencesColorado State UniversityFort CollinsCOUSA
| | - Lucas Nakamura
- Orthopaedic Bioengineering Research Laboratory, Department of Mechanical EngineeringColorado State UniversityFort CollinsCOUSA
| | - Jeremiah T Easley
- Preclinical Surgical Research Laboratory, Department of Clinical SciencesColorado State UniversityFort CollinsCOUSA
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Zhao C, Keyak JH, Cao X, Sha Q, Wu L, Luo Z, Zhao LJ, Tian Q, Serou M, Qiu C, Su KJ, Shen H, Deng HW, Zhou W. Multi-view information fusion using multi-view variational autoencoder to predict proximal femoral fracture load. Front Endocrinol (Lausanne) 2023; 14:1261088. [PMID: 38075049 PMCID: PMC10710145 DOI: 10.3389/fendo.2023.1261088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 10/30/2023] [Indexed: 12/18/2023] Open
Abstract
Background Hip fracture occurs when an applied force exceeds the force that the proximal femur can support (the fracture load or "strength") and can have devastating consequences with poor functional outcomes. Proximal femoral strengths for specific loading conditions can be computed by subject-specific finite element analysis (FEA) using quantitative computerized tomography (QCT) images. However, the radiation and availability of QCT limit its clinical usability. Alternative low-dose and widely available measurements, such as dual energy X-ray absorptiometry (DXA) and genetic factors, would be preferable for bone strength assessment. The aim of this paper is to design a deep learning-based model to predict proximal femoral strength using multi-view information fusion. Results We developed new models using multi-view variational autoencoder (MVAE) for feature representation learning and a product of expert (PoE) model for multi-view information fusion. We applied the proposed models to an in-house Louisiana Osteoporosis Study (LOS) cohort with 931 male subjects, including 345 African Americans and 586 Caucasians. We performed genome-wide association studies (GWAS) to select 256 genetic variants with the lowest p-values for each proximal femoral strength and integrated whole genome sequence (WGS) features and DXA-derived imaging features to predict proximal femoral strength. The best prediction model for fall fracture load was acquired by integrating WGS features and DXA-derived imaging features. The designed models achieved the mean absolute percentage error of 18.04%, 6.84% and 7.95% for predicting proximal femoral fracture loads using linear models of fall loading, nonlinear models of fall loading, and nonlinear models of stance loading, respectively. Conclusion The proposed models are capable of predicting proximal femoral strength using WGS features and DXA-derived imaging features. Though this tool is not a substitute for predicting FEA using QCT images, it would make improved assessment of hip fracture risk more widely available while avoiding the increased radiation exposure from QCT.
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Affiliation(s)
- Chen Zhao
- Department of Applied Computing, Michigan Technological University, Houghton, MI, United States
| | - Joyce H. Keyak
- Department of Radiological Sciences, Department of Biomedical Engineering, Department of Mechanical and Aerospace Engineering, and Chao Family Comprehensive Cancer Center, University of California, Irvine, Irvine, CA, United States
| | - Xuewei Cao
- Department of Mathematical Sciences, Michigan Technological University, Houghton, MI, United States
| | - Qiuying Sha
- Department of Mathematical Sciences, Michigan Technological University, Houghton, MI, United States
| | - Li Wu
- Division of Biomedical Informatics and Genomics, Tulane Center of Biomedical Informatics and Genomics, Deming Department of Medicine, Tulane University, New Orleans, LA, United States
| | - Zhe Luo
- Division of Biomedical Informatics and Genomics, Tulane Center of Biomedical Informatics and Genomics, Deming Department of Medicine, Tulane University, New Orleans, LA, United States
| | - Lan-Juan Zhao
- Division of Biomedical Informatics and Genomics, Tulane Center of Biomedical Informatics and Genomics, Deming Department of Medicine, Tulane University, New Orleans, LA, United States
| | - Qing Tian
- Division of Biomedical Informatics and Genomics, Tulane Center of Biomedical Informatics and Genomics, Deming Department of Medicine, Tulane University, New Orleans, LA, United States
| | - Michael Serou
- Department of Radiology, Deming Department of Medicine, School of Medicine, Tulane University, New Orleans, LA, United States
| | - Chuan Qiu
- Division of Biomedical Informatics and Genomics, Tulane Center of Biomedical Informatics and Genomics, Deming Department of Medicine, Tulane University, New Orleans, LA, United States
| | - Kuan-Jui Su
- Division of Biomedical Informatics and Genomics, Tulane Center of Biomedical Informatics and Genomics, Deming Department of Medicine, Tulane University, New Orleans, LA, United States
| | - Hui Shen
- Division of Biomedical Informatics and Genomics, Tulane Center of Biomedical Informatics and Genomics, Deming Department of Medicine, Tulane University, New Orleans, LA, United States
| | - Hong-Wen Deng
- Division of Biomedical Informatics and Genomics, Tulane Center of Biomedical Informatics and Genomics, Deming Department of Medicine, Tulane University, New Orleans, LA, United States
| | - Weihua Zhou
- Department of Applied Computing, Michigan Technological University, Houghton, MI, United States
- Center for Biocomputing and Digital Health, Institute of Computing and Cybersystems, and Health Research Institute, Michigan Technological University, Houghton, MI, United States
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7
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Afzoon S, Ghorbani F, Hasani M. Evaluation of the mandibular condyles trabecular structure in patients with severe class III pattern: a computed tomography (CT) fractal analysis study. Sci Rep 2023; 13:18183. [PMID: 37875543 PMCID: PMC10598208 DOI: 10.1038/s41598-023-45407-6] [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: 05/26/2023] [Accepted: 10/19/2023] [Indexed: 10/26/2023] Open
Abstract
Class III malocclusion is a combination of dental and skeletal disorders that causes discrepancies in occlusion. Malocclusion can affect the structure of the Temporomandibular joint (TMJ) resulting in many problems, one of which is affecting the internal structure of the bone. This study aimed to examine the morphological features of class III patients' trabecular structure of the mandibular condyle in comparison with normal class I individuals using fractal analysis (FA). To study the internal structure of the mandibular condyle bone, Computed Tomography (CT) scans of 45 severe class III patients (age: 16-46) who were the candidates for orthognathic surgery were selected and matched by age and sex with 45 normal class I individuals. The trabecular bone structure of the left and right mandibular condyles in three CT planes of the study group and control group were evaluated employing the FA. The result of the present study indicated that the fractal dimensions (FD) values of class III patients were lower than those of the normal class I individuals in axial (class I: 1.31 ± 0.02, class III: 1.28 ± 0.02), sagittal (class I: 1.25 ± 0.03, class III: 1.19 ± 0.08), and coronal (class I: 1.5 ± 0.06, class III: 1.45 ± 0.07) planes (P < 0.001). There were no significant differences between the FD values of the males and females. The intra-group evaluation revealed that there was no correlation between age and FD values. No evidence of laterality was found regarding the FD values of the right and left condyles. Given the noticeable differences between the FD values, it can be implied that severe class III malocclusion may affect the trabecular pattern of the cancellous bone of the mandibular condyle compared to class I individuals. Therefore, due to the altered trabecular structure, clinicians should be cautious when planning treatments for these patients.
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Affiliation(s)
- Saeed Afzoon
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Farhad Ghorbani
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahvash Hasani
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.
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Dizbay Sak S, Sevim S, Buyuksungur A, Kayı Cangır A, Orhan K. The Value of Micro-CT in the Diagnosis of Lung Carcinoma: A Radio-Histopathological Perspective. Diagnostics (Basel) 2023; 13:3262. [PMID: 37892083 PMCID: PMC10606474 DOI: 10.3390/diagnostics13203262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/12/2023] [Accepted: 10/17/2023] [Indexed: 10/29/2023] Open
Abstract
Micro-computed tomography (micro-CT) is a relatively new imaging modality and the three-dimensional (3D) images obtained via micro-CT allow researchers to collect both quantitative and qualitative information on various types of samples. Micro-CT could potentially be used to examine human diseases and several studies have been published on this topic in the last decade. In this study, the potential uses of micro-CT in understanding and evaluating lung carcinoma and the relevant studies conducted on lung and other tumors are summarized. Currently, the resolution of benchtop laboratory micro-CT units has not reached the levels that can be obtained with light microscopy, and it is not possible to detect the histopathological features (e.g., tumor type, adenocarcinoma pattern, spread through air spaces) required for lung cancer management. However, its ability to provide 3D images in any plane of section, without disturbing the integrity of the specimen, suggests that it can be used as an auxiliary technique, especially in surgical margin examination, the evaluation of tumor invasion in the entire specimen, and calculation of primary and metastatic tumor volume. Along with future developments in micro-CT technology, it can be expected that the image resolution will gradually improve, the examination time will decrease, and the relevant software will be more user friendly. As a result of these developments, micro-CT may enter pathology laboratories as an auxiliary method in the pathological evaluation of lung tumors. However, the safety, performance, and cost effectiveness of micro-CT in the areas of possible clinical application should be investigated. If micro-CT passes all these tests, it may lead to the convergence of radiology and pathology applications performed independently in separate units today, and the birth of a new type of diagnostician who has equal knowledge of the histological and radiological features of tumors.
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Affiliation(s)
- Serpil Dizbay Sak
- Department of Pathology, Faculty of Medicine, Ankara University, Ankara 06230, Turkey
| | - Selim Sevim
- Department of Pathology, Faculty of Medicine, Ankara University, Ankara 06230, Turkey
| | - Arda Buyuksungur
- Department of Basic Medical Sciences, Faculty of Dentistry, Ankara University, Ankara 06560, Turkey
| | - Ayten Kayı Cangır
- Department of Thoracic Surgery Ankara, Faculty of Medicine, Ankara University, Ankara 06230, Turkey
| | - Kaan Orhan
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara 06560, Turkey
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Pothong W, Adulkasem N. Comparative evaluation of radiographic morphologic parameters for predicting subsequent contralateral fragility hip fracture. INTERNATIONAL ORTHOPAEDICS 2023:10.1007/s00264-023-05789-8. [PMID: 36991284 DOI: 10.1007/s00264-023-05789-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 03/21/2023] [Indexed: 03/31/2023]
Abstract
PURPOSE Subsequent contralateral fragility hip fracture (SCHF) is one of the most serious conditions in osteoporotic patients due to high morbidity and mortality. This study aimed to investigate the predictive ability of radiographic morphologic parameters for SCHF in patients diagnosed with unilateral fragility hip fractures. METHODS We conducted a retrospective observational study of unilateral fragility hip fracture patients between April 2016 and December 2021. Radiographic morphologic parameters, including canal-calcar ratio (CCR), cortical thickness index (CTI), canal-flare index (CFI), and morphological cortical index (MCI), were measured from patients' contralateral proximal femur anteroposterior radiographic study to evaluate the risk of SCHF. Multivariable logistic regression analysis was employed to determine the adjusted predictive ability of the radiographic morphologic parameters. RESULTS Of the included 459 patients, 49 (10.7%) experienced SCHF. All radiographic morphologic parameters demonstrated excellent performance in predicting SCHF. After being adjusted by patients' age, BMI, visual impairment status, and dementia, CTI revealed the greatest adjusted odds ratio for SCHF of 35.05 (95% CI 7.34 to 167.39, p < 0.001) followed by CFI (OR = 13.32; 95% CI 6.50 to 27.32, p < 0.001), MCI (OR = 5.60; 95% CI 2.84 to 11.04, p < 0.001), and CCR (OR = 4.50; 95% CI 2.32 to 8.72, p < 0.001). CONCLUSION CTI demonstrated the greatest odds ratio for SCHF, followed by CFI, MCI, and CCR. These radiographic morphologic parameters could provide a preliminary prediction for SCHF in elderly patients presenting with unilateral fragility hip fractures.
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Affiliation(s)
- Witit Pothong
- Orthopaedics Unit, Lamphun Hospital, Lamphun, Thailand
| | - Nath Adulkasem
- Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700, Thailand.
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Chin KY, Ng BN, Rostam MKI, Muhammad Fadzil NFD, Raman V, Mohamed Yunus F, Syed Hashim SA, Ekeuku SO. A Mini Review on Osteoporosis: From Biology to Pharmacological Management of Bone Loss. J Clin Med 2022; 11:6434. [PMID: 36362662 PMCID: PMC9657533 DOI: 10.3390/jcm11216434] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 10/27/2022] [Accepted: 10/28/2022] [Indexed: 07/25/2023] Open
Abstract
Osteoporosis refers to excessive bone loss as reflected by the deterioration of bone mass and microarchitecture, which compromises bone strength. It is a complex multifactorial endocrine disease. Its pathogenesis relies on the presence of several endogenous and exogenous risk factors, which skew the physiological bone remodelling to a more catabolic process that results in net bone loss. This review aims to provide an overview of osteoporosis from its biology, epidemiology and clinical aspects (detection and pharmacological management). The review will serve as an updated reference for readers to understand the basics of osteoporosis and take action to prevent and manage this disease.
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11
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Touban BM, Sayegh MJ, Galina J, Pavlesen S, Radwan T, Anders M. Computed Tomography Measured Psoas Cross Sectional Area Is Associated With Bone Mineral Density Measured by Dual Energy X-Ray Absorptiometry. J Clin Densitom 2022; 25:592-598. [PMID: 35606278 DOI: 10.1016/j.jocd.2022.04.001] [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: 06/30/2021] [Revised: 04/04/2022] [Accepted: 04/19/2022] [Indexed: 11/17/2022]
Abstract
Dual-energy X-ray absorptiometry (DEXA) is the gold standard for osteoporosis screening and diagnosis. However, abdominal conventional computed tomography (CT) scan is widely available and multiple studies validated its use as a screening tool for osteoporosis compared to DEXA. The aim of this study was to determine the reliability of measuring core muscle size at the L3-L4 intervertebral disk space and estimate the relationship between core muscle size and bone mineral density (BMD) measured by DEXA. Retrospective chart review was performed on patients who underwent a DEXA scan for osteoporosis and a conventional abdominal CT scan within one-year apart. Total cross-sectional area (CSA) and Hounsfield Unit (HU) density of core muscles (psoas, paraspinal, and abdominal wall muscles) were measured. The association between psoas, paraspinal, abdominal, and central muscle CSA and Bone Mineral density (BMD) at L3, L4, total Lumbar Spine (LS), and right (R) and left (L) hip was estimated in crude and adjusted for age and sex linear regression models. Sixty patients (37 females, 23 males) met the inclusion criteria. The average interval between DEXA and abdominal CT scans was 3.6 months (range 0.1-10.2). Psoas muscle density was significantly positively associated with R hip BMD in both crude and adjusted models (β = 20.2, p = 0.03; β = 18.5, p = 0.01). We found a significant positive linear association between psoas muscle CSA and HU density with BMD of LS, R, and L hip in both crude and adjusted models. The strongest significant positive linear association was observed between total abdominal CSA and R hip BMD in crude and age and sex adjusted (ß = 85.3, p = 0.01; ß = 63.9, p = 0.02, respectively). CT scans obtained for various clinical indications can provide valuable information regarding BMD. This is the first study investigating association between BMD with central muscle density and CSA, and it demonstrated their significant positive the association.
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Affiliation(s)
- Basel M Touban
- Department of Orthopaedics, Brooke Army Medical Center, F. Edward Hebert School of Medicine - Uniformed Services University JBSA-Fort Sam Houston, TX USA
| | - Michael J Sayegh
- Department of Orthopaedic Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell University, New Hyde Park, NY USA
| | - Jesse Galina
- Department of Orthopaedics, University at Buffalo, Jacobs School of Medicine and Biomedical Sciences, NY USA.
| | - Sonja Pavlesen
- Department of Orthopaedics, University at Buffalo, Jacobs School of Medicine and Biomedical Sciences, NY USA
| | - Tariq Radwan
- Department of Orthopaedics, University at Buffalo, Jacobs School of Medicine and Biomedical Sciences, NY USA
| | - Mark Anders
- Department of Orthopaedics, University at Buffalo, Jacobs School of Medicine and Biomedical Sciences, NY USA
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12
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Consoli FMA, Bernaldo de Quirós Y, Arbelo M, Fulle S, Marchisio M, Encinoso M, Fernandez A, Rivero MA. Cetaceans Humerus Radiodensity by CT: A Useful Technique Differentiating between Species, Ecophysiology, and Age. Animals (Basel) 2022; 12:ani12141793. [PMID: 35883340 PMCID: PMC9311750 DOI: 10.3390/ani12141793] [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: 05/09/2022] [Revised: 07/05/2022] [Accepted: 07/11/2022] [Indexed: 11/16/2022] Open
Abstract
Cetaceans are mammals that underwent a series of evolutionary adaptations to live in the aquatic environment, including morphological modifications of various anatomical structures of the skeleton and their bone mineral density (BMD); there are few studies on the latter. BMD is related to the radiodensity measured through computed tomography (CT) in Hounsfield units (HU). This work aimed to test and validate the usefulness of studying humeral bone radiodensity by CT of two cetacean species (the Atlantic spotted dolphin and the pygmy sperm whale) with different swimming and diving habits. The radiodensity was analysed at certain levels following a new protocol based on a review of previous studies. Humeral radiodensity values were related to four aspects: species, diving behaviour, swimming activity level, and age. We observed that the consistent differences in the radiodensity of the cortical bone of the distal epiphysis between animals of different life-history categories suggest that this bone portion could be particularly useful for future ontogenetic studies. Hence, this technique may be helpful in studying and comparing species with different ecophysiologies, particularly distinguishing between swimming and diving habits.
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Affiliation(s)
- Francesco Maria Achille Consoli
- Veterinary Histology and Pathology, Atlantic Center for Cetacean Research, Institute of Animal Health and Food Safety (IUSA), University of Las Palmas de Gran Canaria (ULPGC), 35400 Las Palmas, Spain; (F.M.A.C.); (M.A.); (A.F.); (M.A.R.)
- Department of Neuroscience Imaging and Clinical Sciences, University G. D’Annunzio, 66100 Chieti, Italy;
| | - Yara Bernaldo de Quirós
- Veterinary Histology and Pathology, Atlantic Center for Cetacean Research, Institute of Animal Health and Food Safety (IUSA), University of Las Palmas de Gran Canaria (ULPGC), 35400 Las Palmas, Spain; (F.M.A.C.); (M.A.); (A.F.); (M.A.R.)
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO 80303, USA
- Correspondence:
| | - Manuel Arbelo
- Veterinary Histology and Pathology, Atlantic Center for Cetacean Research, Institute of Animal Health and Food Safety (IUSA), University of Las Palmas de Gran Canaria (ULPGC), 35400 Las Palmas, Spain; (F.M.A.C.); (M.A.); (A.F.); (M.A.R.)
| | - Stefania Fulle
- Department of Neuroscience Imaging and Clinical Sciences, University G. D’Annunzio, 66100 Chieti, Italy;
| | - Marco Marchisio
- Department of Medicine and Aging Sciences, Center for Advanced Studies and Technology (CAST), University G. D’Annunzio, 66100 Chieti, Italy;
| | - Mario Encinoso
- Hospital Clínico Veterinario, Facultad de Veterinaria, Universidad de Las Palmas de Gran Canaria, 35413 Las Palmas, Spain;
| | - Antonio Fernandez
- Veterinary Histology and Pathology, Atlantic Center for Cetacean Research, Institute of Animal Health and Food Safety (IUSA), University of Las Palmas de Gran Canaria (ULPGC), 35400 Las Palmas, Spain; (F.M.A.C.); (M.A.); (A.F.); (M.A.R.)
| | - Miguel A. Rivero
- Veterinary Histology and Pathology, Atlantic Center for Cetacean Research, Institute of Animal Health and Food Safety (IUSA), University of Las Palmas de Gran Canaria (ULPGC), 35400 Las Palmas, Spain; (F.M.A.C.); (M.A.); (A.F.); (M.A.R.)
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13
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Modern Diagnostic Imaging Technique Applications and Risk Factors in the Medical Field: A Review. BIOMED RESEARCH INTERNATIONAL 2022; 2022:5164970. [PMID: 35707373 PMCID: PMC9192206 DOI: 10.1155/2022/5164970] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 05/25/2022] [Indexed: 11/18/2022]
Abstract
Medical imaging is the process of visual representation of different tissues and organs of the human body to monitor the normal and abnormal anatomy and physiology of the body. There are many medical imaging techniques used for this purpose such as X-ray, computed tomography (CT), positron emission tomography (PET), magnetic resonance imaging (MRI), single-photon emission computed tomography (SPECT), digital mammography, and diagnostic sonography. These advanced medical imaging techniques have many applications in the diagnosis of myocardial diseases, cancer of different tissues, neurological disorders, congenital heart disease, abdominal illnesses, complex bone fractures, and other serious medical conditions. There are benefits as well as some risks to every imaging technique. There are some steps for minimizing the radiation exposure risks from imaging techniques. Advance medical imaging modalities such as PET/CT hybrid, three-dimensional ultrasound computed tomography (3D USCT), and simultaneous PET/MRI give high resolution, better reliability, and safety to diagnose, treat, and manage complex patient abnormalities. These techniques ensure the production of new accurate imaging tools with improving resolution, sensitivity, and specificity. In the future, with mounting innovations and advancements in technology systems, the medical diagnostic field will become a field of regular measurement of various complex diseases and will provide healthcare solutions.
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Imamudeen N, Basheer A, Iqbal AM, Manjila N, Haroon NN, Manjila S. Management of Osteoporosis and Spinal Fractures: Contemporary Guidelines and Evolving Paradigms. Clin Med Res 2022; 20:95-106. [PMID: 35478096 PMCID: PMC9242734 DOI: 10.3121/cmr.2021.1612] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 11/17/2021] [Indexed: 01/24/2023]
Abstract
Physicians involved in treating spine fractures secondary to osteopenia and osteoporosis should know the pathogenesis and current guidelines on managing the underlying diminished bone mineral density, as worldwide fracture prevention campaigns are trailing behind in meeting their goals. This is a narrative review exploring the various imaging and laboratory tests used to diagnose osteoporotic fractures and a comprehensive compilation of contemporary medical and surgical management. We have incorporated salient recommendations from the Endocrine Society, the American Association of Clinical Endocrinology (AACE), and the American Society for Bone and Mineral Research (ASBMR). The use of modern scoring systems such as Fracture Risk Assessment Tool (FRAX®) for evaluating fracture risk in osteoporosis with a 10-year probability of hip fracture and major fractures in the spine, forearm, hip, or shoulder is highlighted. This osteoporosis risk assessment tool can be easily incorporated into the preoperative bone health optimization strategies, especially before elective spine surgery in osteoporotic patients. The role of primary surgical intervention for vertebral compression fracture and secondary fracture prevention with pharmacological therapy is described, with randomized clinical trial-based wisdom on its timing and dosage, drug holiday, adverse effects, and relevant evidence-based literature. We also aim to present an evidence-based clinical management algorithm for treating osteoporotic vertebral body compression fractures, tumor-induced osteoporosis, or hardware stabilization in elderly trauma patients in the setting of their impaired bone health. The recent guidelines and recommendations on surgical intervention by various medical societies are covered, along with outcome studies that reveal the efficacy of cement augmentation of vertebral compression fractures via vertebroplasty and balloon kyphoplasty versus conservative medical management in the elderly population.
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Affiliation(s)
- Nasvin Imamudeen
- Department of Medicine, Marshfield Medical Center, Marshfield, Wisconsin, USA
| | - Amjad Basheer
- Department of Medicine, University of Connecticut, CT, USA
| | - Anoop Mohamed Iqbal
- Division of Pediatric Endocrinology, Marshfield Medical Center, Marshfield, Wisconsin, USA
| | - Nihal Manjila
- Department of History and Biology, Case Western Reserve University, Cleveland, Ohio, USA
| | - Nisha Nigil Haroon
- Department of Neurosurgery, Ayer Neuroscience Institute, The Hospital of Central Connecticut, New Britain, Connecticut, USA
| | - Sunil Manjila
- Division of Pediatric Endocrinology, Marshfield Medical Center, Marshfield, Wisconsin, USA
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15
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Gullberg J, Sundh D, Johansson L, Isberg PE, Lorentzon M, Lindh C. The outcome of an automated assessment of trabecular pattern in intraoral radiographs as a fracture risk predictor. Dentomaxillofac Radiol 2022; 51:20210483. [PMID: 35348365 PMCID: PMC10043615 DOI: 10.1259/dmfr.20210483] [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: 11/05/2022] Open
Abstract
OBJECTIVES This study aims to investigate if automated analyses of the trabecular pattern in intraoral radiographs independently contribute to fracture risk assessment when other risk factors incorporated in the Fracture Risk Assessment Tool (FRAX) are taken into account. A secondary aim is to explore the correlation between the automated trabecular pattern assessment in intraoral radiographs and Trabecular Bone Score (TBS). METHODS A total of 567 intraoral radiographs from older females participating in a large population-based study (SUPERB) based in Gothenburg, Sweden, were selected to analyse trabecular pattern using semi-automated and fully automated software. Associations between trabecular pattern analysis and incident fractures were studied using Cox proportional hazard model, unadjusted and adjusted for FRAX risk factors (previous fracture, family history of hip fracture, smoking, corticosteroids, rheumatoid arthritis, without and with bone mineral density (BMD) of the femoral neck). In addition, the correlation between trabecular pattern analysis and TBS of the lumbar spine was investigated using Pearson correlation analysis. RESULTS Neither the unadjusted nor the adjusted trabecular pattern analysis in intraoral radiographs was significantly associated with any fracture or major osteoporotic fracture (MOF). A weak correlation was found between semi-automated trabecular pattern analysis and TBS. No correlation was found between the fully automated trabecular pattern analysis and TBS. CONCLUSIONS The present study shows that semi-automated and fully automated digital analyses of the trabecular pattern in intraoral radiographs do not contribute to fracture risk prediction. Furthermore, the study shows a weak correlation between semi-automated trabecular pattern analysis and TBS.
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Affiliation(s)
| | - Daniel Sundh
- Sahlgrenska Osteoporosis Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Region Västra Götaland, Department of Orthopaedics, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Lisa Johansson
- Department of Statistics, Lund University School of Economics and Management, Lunds University, Lund, Sweden
| | - Per-Erik Isberg
- Sahlgrenska Osteoporosis Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia.,Region Västra Götaland, Geriatric Medicine, Sahlgrenska University Hospital, Mölndal, Sweden
| | | | - Christina Lindh
- Region Västra Götaland, Geriatric Medicine, Sahlgrenska University Hospital, Mölndal, Sweden
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16
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Aging Alters Cervical Vertebral Bone Density Distribution: A Cross-Sectional Study. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12063143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Osteoporosis reduces bone mineral density (BMD) with aging. The incidence of cervical vertebral injuries for the elderly has increased in the last decade. Thus, the objective of the current study was to examine whether dental cone beam computed tomography (CBCT) can identify age and sex effects on volumetric BMD and morphology of human cervical vertebrae. A total of 136 clinical CBCT images were obtained from 63 male and 73 female patients (20 to 69 years of age). Three-dimensional images of cervical vertebral bodies (C2 and C3) were digitally isolated. A gray level, which is proportional to BMD, was obtained and its distribution was analyzed in each image. Morphology, including volume, heights, widths, and concavities, was also measured. Most of the gray level parameters had significantly higher values of C2 and C3 in females than in males for all age groups (p < 0.039). The female 60-age group had significant lower values of Mean and Low5 of C2 and C3 than both female 40- and 50-age groups (p < 0.03). The reduced BMD of the female 60-age group likely resulted from postmenopausal demineralization of bone. Current findings suggest that dental CBCT can detect age-dependent changes of cervical vertebral BMD, providing baseline information to develop an alternative tool to diagnose osteoporosis.
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17
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Leuliet T, Maxim V, Peyrin F, Sixou B. Impact of the training loss in deep learning based CT reconstruction of bone microarchitecture. Med Phys 2022; 49:2952-2964. [PMID: 35218039 DOI: 10.1002/mp.15577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 12/23/2021] [Accepted: 02/13/2022] [Indexed: 11/07/2022] Open
Abstract
PURPOSE Computed tomography (CT) is a technique of choice to image bone structure at different scales. Methods to enhance the quality of degraded reconstructions obtained from low-dose CT data have shown impressive results recently, especially in the realm of supervised deep learning. As the choice of the loss function affects the reconstruction quality, it is necessary to focus on the way neural networks evaluate the correspondence between predicted and target images during the training stage. This is even more true in the case of bone microarchitecture imaging at high spatial resolution where both the quantitative analysis of Bone Mineral Density (BMD) and bone microstructure are essential for assessing diseases such as osteoporosis. Our aim is thus to evaluate the quality of reconstruction on key metrics for diagnosis depending on the loss function that has been used for training the neural network. METHODS We compare and analyze volumes that are reconstructed with neural networks trained with pixelwise, structural and adversarial loss functions or with a combination of them. We perform realistic simulations of various low-dose acquisitions of bone microarchitecture. Our comparative study is performed with metrics that have an interest regarding the diagnosis of bone diseases. We therefore focus on bone-specific metrics such as BV/TV, resolution, connectivity assessed with the Euler number and quantitative analysis of BMD to evaluate the quality of reconstruction obtained with networks trained with the different loss functions. RESULTS We find that using L1 norm as the pixelwise loss is the best choice compared to L2 or no pixelwise loss since it improves resolution without deteriorating other metrics. VGG perceptual loss, especially when combined with an adversarial loss, allows to better retrieve topological and morphological parameters of bone microarchitecture compared to SSIM. This however leads to a decreased resolution performance. The adversarial loss enchances the reconstruction performance in terms of BMD distribution accuracy. CONCLUSIONS In order to retrieve the quantitative and structural characteristics of bone microarchitecture that are essential for post-reconstruction diagnosis, our results suggest to use L1 norm as part of the loss function. Then, trade-offs should be made depending on the application: VGG perceptual loss improves accuracy in terms of connectivity at the cost of a deteriorated resolution, and adversarial losses help better retrieve BMD distribution while significantly increasing the training time. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Théo Leuliet
- Univ Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, LYON, F-69621, France
| | - Voichiţa Maxim
- Univ Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, LYON, F-69621, France
| | - Françoise Peyrin
- Univ Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, LYON, F-69621, France
| | - Bruno Sixou
- Univ Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, LYON, F-69621, France
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18
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Lee S, Kim M, Hong S, Kim EJ, Kim JH, Sohn Y, Jung HS. Effects of Sparganii Rhizoma on Osteoclast Formation and Osteoblast Differentiation and on an OVX-Induced Bone Loss Model. Front Pharmacol 2022; 12:797892. [PMID: 35058781 PMCID: PMC8764242 DOI: 10.3389/fphar.2021.797892] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 12/06/2021] [Indexed: 12/31/2022] Open
Abstract
Postmenopausal osteoporosis is caused by an imbalance between osteoclasts and osteoblasts and causes severe bone loss. Osteoporotic medicines are classified into bone resorption inhibitors and bone formation promoters according to the mechanism of action. Long-term use of bisphosphonate and selective estrogen receptor modulators (SERMs) can cause severe side effects in postmenopausal osteoporosis patients. Therefore, it is important to find alternative natural products that reduce osteoclast activity and increase osteoblast formation. Sparganii Rhizoma (SR) is the dried tuberous rhizome of Sparganium stoloniferum Buchanan-Hamilton and is called “samreung” in Korea. However, to date, the effect of SR on osteoclast differentiation and the ovariectomized (OVX)-induced bone loss model has not been reported. In vitro, tartrate-resistant acid phosphatase (TRAP) staining, western blots, RT-PCR and other methods were used to examine the effect of SR on osteoclast differentiation and osteoblasts. In vivo, we confirmed the effect of SR in a model of OVX-induced postmenopausal osteoporosis. SR inhibited osteoclast differentiation and decreased the expression of TNF receptor-associated factor 6 (TRAF6), nuclear factor of activated T cells 1 (NFATc1) and c-Fos pathway. In addition, SR stimulates osteoblast differentiation and increased protein expression of the bone morphogenetic protein 2 (BMP-2)/SMAD signaling pathway. Moreover, SR protected against bone loss in OVX-induced rats. Our results appear to advance our knowledge of SR and successfully demonstrate its potential role as a osteoclastogenesis-inhibiting and osteogenesis-promoting herbal medicine for the treatment of postmenopausal osteoporosis.
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Affiliation(s)
- Sungyub Lee
- Department of Anatomy, College of Korean Medicine, Kyung Hee University, Seoul, South Korea
| | - Minsun Kim
- Department of Anatomy, College of Korean Medicine, Kyung Hee University, Seoul, South Korea
| | - Sooyeon Hong
- Department of Anatomy, College of Korean Medicine, Kyung Hee University, Seoul, South Korea
| | - Eom Ji Kim
- Department of Anatomy, College of Korean Medicine, Kyung Hee University, Seoul, South Korea
| | - Jae-Hyun Kim
- Department of Anatomy, College of Korean Medicine, Kyung Hee University, Seoul, South Korea
| | - Youngjoo Sohn
- Department of Anatomy, College of Korean Medicine, Kyung Hee University, Seoul, South Korea
| | - Hyuk-Sang Jung
- Department of Anatomy, College of Korean Medicine, Kyung Hee University, Seoul, South Korea
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19
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Beltran-Bless A, Murshed M, Zakikhani M, Kuchuk I, Bouganim N, Robertson S, Kekre N, Vandermeer L, Li J, Addison C, Rauch F, Clemons M, Kremer R. Histomorphometric and microarchitectural analysis of bone in metastatic breast cancer patients. Bone Rep 2021; 15:101145. [PMID: 34841014 PMCID: PMC8605385 DOI: 10.1016/j.bonr.2021.101145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 09/09/2021] [Accepted: 10/16/2021] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Despite widespread use of repeated doses of potent bone-targeting agents (BTA) in oncology patients, relatively little is known about their in vivo effects on bone homeostasis, bone quality, and bone architecture. Traditionally bone quality has been assessed using a trans-iliac bone biopsy with a 7 mm "Bordier" core needle. We examined the feasibility of using a 2 mm "Jamshidi™" core needle as a more practical and less invasive technique. METHODS Patients with metastatic breast cancer on BTAs were divided according to the extent of bone metastases. They were given 2 courses of tetracycline labeling and then underwent a posterior trans-iliac trephine biopsy and bone marrow aspirate. Samples were analyzed for the extent of tumor invasion and parameters of bone turnover and bone formation by histomorphometry. RESULTS Twelve patients were accrued, 1 had no bone metastases, 3 had limited bone metastases (LSM) (<3 lesions) and 7 had extensive bone metastases (ESM) (>3 lesions). Most of the primary tumors were estrogen receptor (ER)/progesterone receptor (PR) positive. The procedure was well tolerated. The sample quality was sufficient to analyze bone trabecular structure and bone turnover by histomorphometry in 11 out of 12 patients. There was a good correlation between imaging data and morphometric analysis of tumor invasion. Patients with no evidence or minimal bone metastases had no evidence of tumor invasion. Most had suppressed bone turnover and no detectable bone formation when treated with BTA. In contrast, 6 out of 7 patients with extensive bone invasion by imaging and evidence of tumor cells in the marrow had intense osteoclastic activity as measured by the number of osteoclasts. Of these 7 patients with ESM, 6 were treated with BTA with 5 showing resistance to BTA as demonstrated by the high number of osteoclasts present. 3 of these 6 patients had active bone formation. Based on osteoblast activity and bone formation, 3 out of 6 patients with ESM responded to BTA compared to all 3 with LSM. Compared to untreated patients, all patients treated with BTA showed a trend towards suppression of bone formation, as measured by tetracycline labelling. There was also a trend towards a significant difference between ESM and LSM treated with BTA, highly suggestive of resistance although limited by the small sample size. DISCUSSION Our results indicate that trans-iliac bone biopsy using a 2 mm trephine shows excellent correlation between imaging assessment of tumor invasion and tumor burden by morphometric analysis of bone tissues. In addition, our approach provides additional mechanistic information on therapeutic response to BTA supporting the current clinical understanding that the majority of patients with extensive bone involvement eventually fail to suppress bone turnover (Petrut B, et al. 2008). This suggests that antiresorptive therapies become less effective as disease progresses.
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Key Words
- BM, Bone met
- BPs, Bisphosphonates
- BTAs, Bone targeting agents
- Bone biopsy
- Bone microarchitecture
- Bone turnover
- Bone-targeted agents
- Breast cancer
- CK, Cytokeratin staining
- CM, Collagen material
- DEXA, Dual-energy X-ray absorptiometry
- ER, Estrogen receptor
- ESM, Extensive skeletal metastases
- HE, Haematoxylin and Eosin
- HER2, Human Epidermal growth factor Receptor 2
- Histomorphometry
- IDC, Invasive ductal carcinoma
- IHC, Immunohistochemistry staining
- LSM, Limited skeletal metastases
- MB, Mineralized bone
- OB, Osteoblasts
- OC, Osteoclasts
- OS, Osteoid surface
- PAM, Pamidronate
- PFA/PBS, Paraformaldehyde/phosphate buffer solution
- PR, Progesterone receptor
- QCT, Quantitative CT
- SREs, Skeletal related events
- TRAP, Tartrate-resistant acid phosphatase staining
- VKVG, von Kossa and van Gieson
- Zol, Zoledronic acid
- astasis AI, Aromatase inhibitors
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Affiliation(s)
- A. Beltran-Bless
- Division of Medical Oncology, Department of Medicine, The Ottawa Hospital, The University of Ottawa, Ottawa, Canada
| | - M. Murshed
- Department of Medicine, Faculty of Dentistry, Shriners Hospital for Children, McGill University, Montreal, Canada
| | - M. Zakikhani
- Department of Medicine, Research Institute of the McGill University Health Center, Montreal, Canada
| | - I. Kuchuk
- Division of Medical Oncology, Department of Medicine, The Ottawa Hospital, The University of Ottawa, Ottawa, Canada
| | - N. Bouganim
- Division of Medical Oncology, Department of Medicine, The Ottawa Hospital, The University of Ottawa, Ottawa, Canada
| | - S. Robertson
- Department of Pathology, The Ottawa Hospital and the University of Ottawa, Ottawa, Canada
| | - N. Kekre
- Division of Medical Oncology, Department of Medicine, The Ottawa Hospital, The University of Ottawa, Ottawa, Canada
| | - L. Vandermeer
- Division of Medical Oncology, Department of Medicine, The Ottawa Hospital, The University of Ottawa, Ottawa, Canada
| | - J. Li
- Department of Medicine, Research Institute of the McGill University Health Center, Montreal, Canada
| | - C.L. Addison
- Centre for Cancer Therapeutics, Ottawa Hospital Research Institute, Ottawa, Canada
| | - F. Rauch
- Department of Pediatric Surgery, McGill University Health Center, Montreal, Canada
| | - M. Clemons
- Division of Medical Oncology, Department of Medicine, The Ottawa Hospital, The University of Ottawa, Ottawa, Canada
- Centre for Cancer Therapeutics, Ottawa Hospital Research Institute, Ottawa, Canada
| | - R. Kremer
- Department of Medicine, Research Institute of the McGill University Health Center, Montreal, Canada
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20
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Pekedis M, Ozan F, Yildiz H. Biomechanics of the Femoral Head Cartilage and Subchondral Trabecular Bone in Osteoporotic and Osteopenic Fractures. Ann Biomed Eng 2021; 49:3388-3400. [PMID: 34472001 DOI: 10.1007/s10439-021-02861-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 08/23/2021] [Indexed: 11/28/2022]
Abstract
This study aimed to investigate the relationship between the micro structural properties of the subchondral trabecular bone (STB) and the macro mechanical properties of the articular cartilage (AC) in patients with osteoporotic (OP) and osteopenic (OPE) fractures. Sixteen femoral head samples (OP;OPE, n = 8 each) were obtained from female patients who underwent hip hemiarthroplasty. STB and AC specimens were harvested from those heads. Bone specimens were scanned using µ-CT to determine the micro structural properties. In-situ nondestructive compressive tests were performed for the cartilages to obtain elastic properties. The finite element technique was implemented on STB models created from µ-CT data to compute apparent elastic modulus. In addition, dynamic cyclic destructive tests were performed on STB and AC specimens to assess failure cycles. The results demonstrated that STB specimens in OPE group have more interconnected structure and higher cyclic dynamic strength than those in OP group. Furthermore, bone mineral density, failure cycle, and trabecular number of STB were positively correlated with the cartilage failure cycle, which indicates that STB alteration may affect the macroscopic mechanical properties of AC. The findings suggest that STB loss correlates with a decrease in cartilage strength and that improving of bone quality may prevent cartilage weakness.
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Affiliation(s)
- Mahmut Pekedis
- Department of Mechanical Engineering, Faculty of Engineering, Ege University, Bornova, 35100, Izmir, Turkey.
| | - Firat Ozan
- Department of Orthopedics and Traumatology, Kayseri City Hospital, 38080, Kayseri, Turkey
| | - Hasan Yildiz
- Department of Mechanical Engineering, Faculty of Engineering, Ege University, Bornova, 35100, Izmir, Turkey
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21
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Yuan T, Zhang H, Liu H, Du J, Yu H, Wang Y, Xu Y. Watertight 2-manifold 3D bone surface model reconstruction from CT images based on visual hyper-spherical mapping. MATHEMATICAL BIOSCIENCES AND ENGINEERING : MBE 2021; 18:1280-1313. [PMID: 33757186 DOI: 10.3934/mbe.2021068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
This paper proposes a general algorithm to reconstruct watertight 2-manifold 3D bone surface model from CT images based on visual hyper-spherical mapping. The reconstruction algorithm includes three main steps: two-step thresholding, initial watertight surface reconstruction and shape optimization. Firstly, volume sampling points of the target bone with given narrower threshold range are extracted by thresholding with combination of 3D morphology operation. Secondly, visible points near the bone's outer surface are extracted from its corresponding volume sampling points by hyper-spherical projection mapping method. Thirdly, implicit surface reconstruction algorithm is employed on the extracted visible surface points to obtain an initial watertight 3D bone surface model which is used as the deformation model in the following accurate bone surface model generation stage. Finally, the initial surface model is deformed according to the segmentation data with wider threshold range under given constraints in order to achieve an accurate watertight 3D bone surface model. Experiment and comparison results show that the proposed algorithm can reconstruct watertight 3D bone surface model from CT images, and local details of the bone surface can be restored accurately for the cases used in this paper.
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Affiliation(s)
- Tianran Yuan
- School of Mechanical and Material Engineering, Huaiyin Institute of Technology, Huaian, Jiangsu 223003, China
| | - Hongsheng Zhang
- School of Mechanical and Material Engineering, Huaiyin Institute of Technology, Huaian, Jiangsu 223003, China
| | - Hao Liu
- College of Mechanical and Electrical Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, Jiangsu 210016, China
| | - Juan Du
- School of Medical Technology, Jiangsu College of Nursing, Huaian, Jiangsu 223005, China
| | - Huiming Yu
- Department of Oral and Maxillofacial Surgery, Huaian First People's Hospital, Huaian, Jiangsu 223300, China
| | - Yimin Wang
- School of Mechanical and Material Engineering, Huaiyin Institute of Technology, Huaian, Jiangsu 223003, China
| | - Yabin Xu
- College of Mechanical and Electrical Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, Jiangsu 210016, China
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22
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Romero-Díaz C, Duarte-Montero D, Gutiérrez-Romero SA, Mendivil CO. Diabetes and Bone Fragility. Diabetes Ther 2021; 12:71-86. [PMID: 33185853 PMCID: PMC7843783 DOI: 10.1007/s13300-020-00964-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 10/29/2020] [Indexed: 02/08/2023] Open
Abstract
Diabetes is a highly prevalent disease with complications that impact most bodily systems. However, the impact of diabetes on bone health is frequently ignored or underestimated. Both type 1 (T1D) and type 2 diabetes (T2D) are associated with a higher risk of fractures, albeit through different mechanisms. T1D is characterized by near total insulinopenia, which affects the anabolic tone of bone and results in reduced bone mineral density (BMD). Meanwhile, patients with T2D have normal or high BMD, but carry an increased risk of fractures due to alterations of bone microarchitecture and a local humoral environment that stimulates osteoclast activity. Chronic hyperglycemia induces non-enzymatic glycation of collagen in both types of diabetes. Epidemiological evidence confirms a largely increased fracture risk in T1D and T2D, but also that it can be substantially reduced by opportune monitoring of fracture risk and appropriate treatment of both diabetes itself and osteopenia or osteoporosis if they are present. In this review, we summarize the mechanistic, epidemiological, and clinical evidence that links diabetes and bone fragility, and describe the impact of available diabetes treatments on bone health.
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Affiliation(s)
| | | | | | - Carlos O Mendivil
- School of Medicine, Universidad de los Andes, Bogotá, Colombia.
- Department of Internal Medicine, Endocrinology Section, Fundación Santa Fe de Bogotá, Bogotá, Colombia.
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23
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Bennacef I, Rubins D, Riffel K, Williams M, Posavec DJ, Holahan MA, Purcell ML, Haley HD, Wolf M, Stachel SJ, Lubbers LS, Wesolowski GA, Duong LT, Hamill TG, Evelhoch JL, Hostetler ED. Preclinical evaluation of [ 11 C]L-235 as a radioligand for Positron Emission Tomography cathepsin K imaging in bone. J Labelled Comp Radiopharm 2020; 64:159-167. [PMID: 33226657 DOI: 10.1002/jlcr.3896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 06/23/2020] [Accepted: 07/30/2020] [Indexed: 11/06/2022]
Abstract
The cathepsin K (CatK) enzyme is abundantly expressed in osteoclasts, and CatK inhibitors have been developed for the treatment of osteoporosis. In our effort to support discovery and clinical evaluations of a CatK inhibitor, we sought to discover a radioligand to determine target engagement of the enzyme by therapeutic candidates using positron emission tomography (PET). L-235, a potent and selective CatK inhibitor, was labeled with carbon-11. PET imaging studies recording baseline distribution of [11 C]L-235, and chase and blocking studies using the selective CatK inhibitor MK-0674 were performed in juvenile and adult nonhuman primates (NHP) and ovariectomized rabbits. Retention of the PET tracer in regions expected to be osteoclast-rich compared with osteoclast-poor regions was examined. Increased retention of the radioligand was observed in osteoclast-rich regions of juvenile rabbits and NHP but not in the adult monkey or adult ovariectomized rabbit. Target engagement of CatK was observed in blocking studies with MK-0674, and the radioligand retention was shown to be sensitive to the level of MK-0674 exposure. [11 C]L-235 can assess target engagement of CatK in bone only in juvenile animals. [11 C]L-235 may be a useful tool for guiding the discovery of CatK inhibitors.
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Affiliation(s)
- Idriss Bennacef
- Translational Biomarkers-Imaging, Merck & Co., Inc., Kenilworth, NJ, USA
| | - Daniel Rubins
- Translational Biomarkers-Imaging, Merck & Co., Inc., Kenilworth, NJ, USA
| | - Kerry Riffel
- Translational Biomarkers-Imaging, Merck & Co., Inc., Kenilworth, NJ, USA
| | - Mangay Williams
- Translational Biomarkers-Imaging, Merck & Co., Inc., Kenilworth, NJ, USA
| | - Diane J Posavec
- Translational Biomarkers-Imaging, Merck & Co., Inc., Kenilworth, NJ, USA
| | - Marie A Holahan
- Translational Biomarkers-Imaging, Merck & Co., Inc., Kenilworth, NJ, USA
| | - Mona L Purcell
- Translational Biomarkers-Imaging, Merck & Co., Inc., Kenilworth, NJ, USA
| | - Hyking D Haley
- Translational Biomarkers-Imaging, Merck & Co., Inc., Kenilworth, NJ, USA
| | - Mary Wolf
- Translational Biomarkers-Imaging, Merck & Co., Inc., Kenilworth, NJ, USA
| | | | - Laura S Lubbers
- In Vitro Pharmacology, Merck & Co., Inc., Kenilworth, NJ, USA
| | | | - Le T Duong
- Bone Biology, Merck & Co., Inc., Kenilworth, NJ, USA
| | - Terence G Hamill
- Translational Biomarkers-Imaging, Merck & Co., Inc., Kenilworth, NJ, USA
| | - Jeffrey L Evelhoch
- Translational Biomarkers-Imaging, Merck & Co., Inc., Kenilworth, NJ, USA
| | - Eric D Hostetler
- Translational Biomarkers-Imaging, Merck & Co., Inc., Kenilworth, NJ, USA
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24
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Cardona CI, Tinoco HA, Marín-Berrio MLF, García-Grisales J, Gomez JP, Roldan-Restrepo SI, Ortiz-Jimenez J. Electromechanical impedance measurements for bone health monitoring through teeth used as probes of a Piezo-device. Biomed Phys Eng Express 2020; 7. [PMID: 34037537 DOI: 10.1088/2057-1976/abc099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 10/13/2020] [Indexed: 11/11/2022]
Abstract
Bone is a dynamic biological tissue that acts as the primary rigid support of the body. Several systemic factors are responsible for pathologies that negatively affect its structural attributes. Although the bone is in continuous renewal by osteogenesis, metabolic diseases are the most common affectations that alter its natural equilibrium. Different techniques based on ionizing radiation are used for the bone diagnosis restrictively. However, if these are not used adequately, the application could present risks for human health. In this paper, it is proposed and explored a new technique to apply an early-stage diagnosis of bone variations. The technique evaluates bone structural conditions from the teeth (used as probes) by applying a structural health monitoring (SHM) methodology. An experimental procedure is described to identify the stiffness variations produced by mechanical drillings done in prepared bone samples. The identification is carried out applying the electromechanical impedance technique (EMI) through a piezo-actuated device in the frequency spectrum 5-20kHz. Three bone samples with incorporated teeth (three teeth, two teeth, and one tooth) were prepared to emulate a mandibular portion of alveolar bone-PDL (periodontal ligament)-tooth system. Piezo-device was attached to the crown of the tooth with an orthodontic bracket allowing the teeth to act as probes. The electrical resistance measurements were computed with an electrical decoupling approach that improved the detection of the drillings; it was due to the increment of the sensitivity of the signals. The results showed that the bone mass reduction is correlated with statistical indices obtained in specific frequency intervals of the electrical resistance. This work suggests the possibility of a future application addressed to a bone diagnosis in a non-invasive way.
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Affiliation(s)
- Carlos I Cardona
- Experimental and Computational Mechanics Laboratory, Universidad Autónoma de Manizales. Antigua Estación del Ferrocarril, Edificio Fundadores, P.C. 170001. Manizales, Colombia
| | - Hector A Tinoco
- Experimental and Computational Mechanics Laboratory, Universidad Autónoma de Manizales. Antigua Estación del Ferrocarril, Edificio Fundadores, P.C. 170001. Manizales, Colombia.,Institute of Physics of Materials, Sciences Academy of Czech Republic, Žižkova 22, 616 62 Brno, Czech Republic.,Central European Institute of Technology - Brno University of Technology, Technická 3058/10, 61600 Brno, Czech Republic
| | - Maribel L F Marín-Berrio
- Department of Health, Universidad Autónoma de Manizales, Antigua Estación del Ferrocarril, Edificio Sacatín P.C. 170001. Manizales, Colombia
| | - Juliana García-Grisales
- Department of Health, Universidad Autónoma de Manizales, Antigua Estación del Ferrocarril, Edificio Sacatín P.C. 170001. Manizales, Colombia
| | - Juan P Gomez
- Department of Health, Universidad Autónoma de Manizales, Antigua Estación del Ferrocarril, Edificio Sacatín P.C. 170001. Manizales, Colombia
| | | | - Juliana Ortiz-Jimenez
- Experimental and Computational Mechanics Laboratory, Universidad Autónoma de Manizales. Antigua Estación del Ferrocarril, Edificio Fundadores, P.C. 170001. Manizales, Colombia
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25
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Hanusch BC, Tuck SP, Mekkayil B, Shawgi M, McNally RJQ, Walker J, Francis RM, Datta HK. Quantitative Computed Tomography (QCT) of the Distal Forearm in Men Using a Spiral Whole-Body CT Scanner - Description of a Method and Reliability Assessment of the QCT Pro Software. J Clin Densitom 2020; 23:418-425. [PMID: 31160147 DOI: 10.1016/j.jocd.2019.05.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 05/15/2019] [Accepted: 05/15/2019] [Indexed: 11/18/2022]
Abstract
The Mr F study investigates the pathogenesis of low trauma distal forearm fractures in men and includes volumetric bone mineral density (vBMD) measurements at the ultradistal forearm as there are no current data. A standard 64 slice CT scanner was used to determine if it was possible to adapt the existing Mindways quantitative computed tomography Pro software for measuring vBMD values at the hip and spine sites. For calculation of intra- and interobserver reliability 40 forearm scans out of the 300 available were chosen randomly. The images were analyzed using the Slice Pick module and Bone Investigational Toolkit. The 4% length of the radius was chosen by measuring the length of the radius from the scaphoid fossa distally to the radial head. The acquired image then underwent extraction, isolation, rotation, and selection of region of interest in order to generate a report on vBMD. A cross-sectional image was created to allow the generation of data on the cortical and trabecular components separately. Repeat analyses were undertaken by 3 independent observers who were blinded as to whether the image was from a participant with or without fracture. The images were presented in random order at each time point. The following parameters were recorded: cortical cross sectional area, total vBMD, trabecular vBMD, and cortical vBMD (CvBMD). Data were analyzed by calculating intraclass correlation coefficients for intra- and interobserver reliability. The lowest values occurred at the CvBMD with intraobserver reliability of 0.92 (95% confidence interval [CI] of 0.86-0.96) and interobserver reliability of 0.92 (95% CI 0.89-0.96). All other parameters had reliability values between 0.97 and 0.99 with tighter 95% CI than for CvBMD. The method of adapting the Mindways Pro software using a standard CT to produce vBMD and structural data at the ultradistal radius is reliable.
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Affiliation(s)
- Birgit C Hanusch
- The James Cook University Hospital, Middlesbrough, United Kingdom
| | - Stephen P Tuck
- The James Cook University Hospital, Middlesbrough, United Kingdom; Musculoskeletal Research Group, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom.
| | - Babitha Mekkayil
- The James Cook University Hospital, Middlesbrough, United Kingdom
| | - Mohamed Shawgi
- The James Cook University Hospital, Middlesbrough, United Kingdom
| | - Richard J Q McNally
- Institute of Health and Society, Newcastle University, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom
| | - Julie Walker
- The James Cook University Hospital, Middlesbrough, United Kingdom
| | - Roger M Francis
- Musculoskeletal Research Group, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Harish K Datta
- The James Cook University Hospital, Middlesbrough, United Kingdom; Musculoskeletal Research Group, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
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26
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Molino G, Dalpozzi A, Ciapetti G, Lorusso M, Novara C, Cavallo M, Baldini N, Giorgis F, Fiorilli S, Vitale-Brovarone C. Osteoporosis-related variations of trabecular bone properties of proximal human humeral heads at different scale lengths. J Mech Behav Biomed Mater 2019; 100:103373. [DOI: 10.1016/j.jmbbm.2019.103373] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 04/01/2019] [Accepted: 07/25/2019] [Indexed: 11/30/2022]
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27
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Narayanan A, Cai A, Xi Y, Maalouf NM, Rubin C, Chhabra A. CT bone density analysis of low-impact proximal femur fractures using Hounsfield units. Clin Imaging 2019; 57:15-20. [PMID: 31102777 DOI: 10.1016/j.clinimag.2019.04.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 03/12/2019] [Accepted: 04/17/2019] [Indexed: 10/26/2022]
Abstract
AIM To quantify and compare changes in bone mineral density (BMD) via CT analysis in patients with and without spontaneous femoral fractures. MATERIALS AND METHODS Consecutive series of patients with CT imaging for spontaneous femoral fractures were compared to the age and gender matched controls. Bone density fixed region of interest measurements were obtained at the site of the fracture, proximally at the femoral head, and distally at the lesser trochanter in fracture patients and controls. Inter- and intrapatient comparisons were performed, including Chi-square and t-test analyses. RESULTS 24 spontaneous fractures and 25 controls were analyzed with no significant differences in mean age, gender, or body mass index. There were differences in the bone density between the fracture and contralateral non-fracture sides at (p = 0.0001) and distal (p < 0.0001) to the fracture. Proximal and distal bone density differences existed between case fracture and control non-fracture sites (p < 0.0001, p = 0.0001), and between the case non-fracture and control non-fracture sites (p < 0.0001, p < 0.0001). The reliability for measurements was good to excellent proximally (ICC = 0.63-0.87), moderate to excellent at the fracture site (ICC = 0.43-0.78), and fair to good distal (ICC = 0.24-0.68) to the fracture site. CONCLUSION Patients with spontaneous femoral fractures exhibit lower bone density than the asymptomatic controls. Bone insufficiency is best demonstrated proximal or distal to, rather than at the fracture site.
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Affiliation(s)
- Anish Narayanan
- Radiology Department, UT Southwestern Medical Center, Dallas, TX, USA.
| | - Anthony Cai
- Radiology Department, UT Southwestern Medical Center, Dallas, TX, USA
| | - Yin Xi
- Radiology Department, UT Southwestern Medical Center, Dallas, TX, USA
| | - Naim M Maalouf
- Division of Mineral Metabolism, Internal Medicine Department, UT Southwestern Medical Center, Dallas, TX, USA
| | - Craig Rubin
- Geriatrics, Internal Medicine Department, UT Southwestern Medical Center, Dallas, TX, USA
| | - Avneesh Chhabra
- Radiology Department, UT Southwestern Medical Center, Dallas, TX, USA; Orthopedics Department, UT Southwestern Medical Center, Dallas, TX, USA
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28
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Gehweiler D, Teunis T, Varjas V, Kerstan D, Gueorguiev B, Kamer L, Noser H. Computerized anatomy of the distal radius and its relevance to volar plating, research, and teaching. Clin Anat 2018; 32:361-368. [PMID: 30521090 PMCID: PMC7379250 DOI: 10.1002/ca.23320] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 11/26/2018] [Accepted: 12/02/2018] [Indexed: 11/09/2022]
Abstract
Distal radius fractures are common and fracture patterns and fixation can be complex. Computerized anatomy evaluation (CAE) might offer non-invasive and enhanced anatomy assessment that might help with implant selection and placement and screw length determination. Our goal was to test the accuracy of two CAE methods for anatomical volar plate positioning and screw lengths measurement of the distal radius. We included 56 high-resolution peripheral quantitative computed tomography scans of intact, human distal radii. Plates were placed manually onto 3D printed models (method 1), which was compared with automated computerized plate placement onto the 3D computer models (method 2). Subsequently, screw lengths were determined digitally for both methods. Screw lengths evaluations were compared via Bland-Altman plots. Both CAE methods resulted in identical volar plate selection and in anatomical plate positioning. For screw length the concordance correlation coefficient was ≥0.91, the location shift ≤0.22 mm, and the scale shift ≤0.16. The differences were smaller than ±1 mm in all samples. Both CAE methods allow for comparable plate positioning and subsequent screw length measurement in distal radius volar plating. Both can be used as a non-invasive teaching environment for volar plate fixation. Method 2 even offers fully computerized assessments. Future studies could compare our models to other anatomical areas, post-operative volar plate positioning, and model performance in actual distal radius fracture instead of intact radii. Clin. Anat. 32:361-368, 2019. © 2018 The Authors. Clinical Anatomy published by Wiley Periodicals, Inc. on behalf of American Association of Clinical Anatomists.
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Affiliation(s)
| | - Teun Teunis
- Plastic Surgery Department, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | | | | | - Lukas Kamer
- AO Research Institute Davos, Davos, Switzerland
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29
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Guerri S, Mercatelli D, Aparisi Gómez MP, Napoli A, Battista G, Guglielmi G, Bazzocchi A. Quantitative imaging techniques for the assessment of osteoporosis and sarcopenia. Quant Imaging Med Surg 2018. [PMID: 29541624 DOI: 10.21037/qims.2018.01.05] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Bone and muscle are two deeply interconnected organs and a strong relationship between them exists in their development and maintenance. The peak of both bone and muscle mass is achieved in early adulthood, followed by a progressive decline after the age of 40. The increase in life expectancy in developed countries resulted in an increase of degenerative diseases affecting the musculoskeletal system. Osteoporosis and sarcopenia represent a major cause of morbidity and mortality in the elderly population and are associated with a significant increase in healthcare costs. Several imaging techniques are currently available for the non-invasive investigation of bone and muscle mass and quality. Conventional radiology, dual energy X-ray absorptiometry (DXA), computed tomography (CT), magnetic resonance imaging (MRI) and ultrasound often play a complementary role in the study of osteoporosis and sarcopenia, depicting different aspects of the same pathology. This paper presents the different imaging modalities currently used for the investigation of bone and muscle mass and quality in osteoporosis and sarcopenia with special emphasis on the clinical applications and limitations of each technique and with the intent to provide interesting insights into recent advances in the field of conventional imaging, novel high-resolution techniques and fracture risk.
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Affiliation(s)
- Sara Guerri
- The Unit of Diagnostic and Interventional Radiology, The "Rizzoli" Orthopaedic Institute, Bologna, Italy.,Department of Experimental, Diagnostic and Specialty Medicine, Division of Radiology, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Daniele Mercatelli
- The Unit of Diagnostic and Interventional Radiology, The "Rizzoli" Orthopaedic Institute, Bologna, Italy
| | - Maria Pilar Aparisi Gómez
- Department of Radiology, Auckland City Hospital, Grafton, Auckland, New Zealand.,Department of Radiology, Hospital Nueve de Octubre, Valencia, Spain
| | - Alessandro Napoli
- Radiology Section, Department of Radiological, Oncological and Anatomopathological Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Giuseppe Battista
- Department of Experimental, Diagnostic and Specialty Medicine, Division of Radiology, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Giuseppe Guglielmi
- Department of Radiology, University of Foggia, Foggia, Italy.,Department of Radiology, Scientific Institute "Casa Sollievo della Sofferenza" Hospital, San Giovanni Rotondo, Foggia, Italy
| | - Alberto Bazzocchi
- The Unit of Diagnostic and Interventional Radiology, The "Rizzoli" Orthopaedic Institute, Bologna, Italy
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30
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Kazakia GJ, Carballido-Gamio J, Lai A, Nardo L, Facchetti L, Pasco C, Zhang CA, Han M, Parrott AH, Tien P, Krug R. Trabecular bone microstructure is impaired in the proximal femur of human immunodeficiency virus-infected men with normal bone mineral density. Quant Imaging Med Surg 2018. [PMID: 29541618 DOI: 10.21037/qims.2017.10.10] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Background There is evidence that human immunodeficiency virus (HIV) infection and antiretroviral therapy (ART) are independent risk factors for osteoporosis and fracture which is not solely explained by changes in bone mineral density. Thus, we hypothesized that the assessment of trabecular microstructure might play an important role for bone quality in this population and might explain the increased fracture risk. In this study, we have assessed bone microstructure in the proximal femur using high-resolution magnetic resonance imaging (MRI) as well as in the extremities using high resolution peripheral quantitative computed tomography (HR-pQCT) in HIV-infected men and healthy controls and compared these findings to those based on areal bone mineral density (aBMD) derived from dual X-ray absorptiometry (DXA) which is the standard clinical parameter for the diagnosis of osteoporosis. Methods Eight HIV-infected men and 11 healthy age-matched controls were recruited and informed consent was obtained before each scan. High-resolution MRI of the proximal femur was performed using fully balanced steady state free precession (bSSFP) on a 3T system. Three volumes of interest at corresponding anatomic locations across all subjects were defined based on registrations of a common template. Four MR-based trabecular microstructural parameters were analyzed at each region: fuzzy bone volume fraction (f-BVF), trabecular number (Tb.N), thickness (Tb.Th), and spacing (Tb.Sp). In addition, the distal radius and distal tibia were imaged with HR-pQCT. Four HR-pQCT-based microstructural parameters were analyzed: trabecular bone volume fraction (BV/TV), Tb.N, Tb.Th, and Tb.Sp. Total hip and spine aBMD were determined from DXA. Results Microstructural bone parameters derived from MRI at the proximal femur and from HR-pQCT at the distal tibia showed significantly lower bone quality in HIV-infected patients compared to healthy controls. In contrast, DXA aBMD data showed no significant differences between HIV-infected patients and healthy controls. Conclusions Our results suggest that high-resolution imaging is a powerful tool to assess trabecular bone microstructure and can be used to assess bone health in HIV-infected men who show no differences to healthy males by DXA aBMD. Advances in MRI technology have made microstructural imaging at the proximal femur possible. Further studies in larger patient cohorts are clearly warranted.
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Affiliation(s)
- Galateia J Kazakia
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | | | - Andrew Lai
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Lorenzo Nardo
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Luca Facchetti
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Courtney Pasco
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Chiyuan A Zhang
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Misung Han
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Amanda Hutton Parrott
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Phyllis Tien
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Roland Krug
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
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Sano H, Kondo N, Shimakura T, Fujisawa J, Kijima Y, Kanai T, Poole KES, Yamamoto N, Takahashi HE, Endo N. Evidence for Ongoing Modeling-Based Bone Formation in Human Femoral Head Trabeculae via Forming Minimodeling Structures: A Study in Patients with Fractures and Arthritis. Front Endocrinol (Lausanne) 2018; 9:88. [PMID: 29615973 PMCID: PMC5868326 DOI: 10.3389/fendo.2018.00088] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2017] [Accepted: 02/23/2018] [Indexed: 12/21/2022] Open
Abstract
Bone modeling is a biological process of bone formation that adapts bone size and shape to mechanical loads, especially during childhood and adolescence. Bone modeling in cortical bone can be easily detected using sequential radiographic images, while its assessment in trabecular bone is challenging. Here, we performed histomorphometric analysis in 21 bone specimens from biopsies collected during hip arthroplasty, and we proposed the criteria for histologically identifying an active modeling-based bone formation, which we call a "forming minimodeling structure" (FMiS). Evidence of FMiSs was found in 9 of 20 specimens (45%). In histomorphometric analysis, bone volume was significant higher in specimens displaying FMiSs compared with the specimens without these structures (BV/TV, 31.7 ± 10.2 vs. 23.1 ± 3.9%; p < 0.05). Osteoid parameters were raised in FMiS-containing bone specimens (OV/BV, 2.1 ± 1.6 vs. 0.6 ± 0.3%; p < 0.001, OS/BS, 23.6 ± 15.5 vs. 7.6 ± 4.2%; p < 0.001, and O.Th, 7.4 µm ± 2.0 vs. 5.2 ± 1.0; p < 0.05). Our results showed that the modeling-based bone formation on trabecular bone surfaces occurs even during adulthood. As FMiSs can represent histological evidence of modeling-based bone formation, understanding of this physiology in relation to bone homeostasis is crucial.
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Affiliation(s)
- Hiroshige Sano
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
- Niigata Bone Science Institute, Niigata, Japan
- Department of Medicine, University of Cambridge, Cambridge, United Kingdom
- *Correspondence: Hiroshige Sano,
| | - Naoki Kondo
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | | | - Junichi Fujisawa
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yasufumi Kijima
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Tomotake Kanai
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | | | - Noriaki Yamamoto
- Niigata Bone Science Institute, Niigata, Japan
- Department of Orthopedic Surgery, Niigata Rehabilitation Hospital, Niigata, Japan
| | - Hideaki E. Takahashi
- Niigata Bone Science Institute, Niigata, Japan
- Department of Orthopedic Surgery, Niigata Rehabilitation Hospital, Niigata, Japan
| | - Naoto Endo
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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Shapiro G, Bez M, Tawackoli W, Gazit Z, Gazit D, Pelled G. Semiautomated Longitudinal Microcomputed Tomography-based Quantitative Structural Analysis of a Nude Rat Osteoporosis-related Vertebral Fracture Model. J Vis Exp 2017. [PMID: 28994771 DOI: 10.3791/55928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Osteoporosis-related vertebral compression fractures (OVCFs) are a common and clinically unmet need with increasing prevalence as the world population ages. Animal OVCF models are essential to the preclinical development of translational tissue engineering strategies. While a number of models currently exist, this protocol describes an optimized method for inducing multiple highly reproducible vertebral defects in a single nude rat. A novel longitudinal semiautomated microcomputed tomography (µCT)-based quantitative structural analysis of the vertebral defects is also detailed. Briefly, rats were imaged at multiple time points post-op. The day 1 scan was reoriented to a standard position, and a standard volume of interest was defined. Subsequent µCT scans of each rat were automatically registered to the day 1 scan so the same volume of interest was then analyzed to assess for new bone formation. This versatile approach can be adapted to a variety of other models where longitudinal imaging-based analysis could benefit from precise 3D semiautomated alignment. Taken together, this protocol describes a readily quantifiable and easily reproducible system for osteoporosis and bone research. The suggested protocol takes 4 months to induce osteoporosis in nude ovariectomized rats and between 2.7 and 4 h to generate, image, and analyze two vertebral defects, depending on tissue size and equipment.
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Affiliation(s)
- Galina Shapiro
- Skeletal Biotech Laboratory, Hebrew University-Hadassah Faculty of Dental Medicine
| | - Maxim Bez
- Skeletal Biotech Laboratory, Hebrew University-Hadassah Faculty of Dental Medicine
| | - Wafa Tawackoli
- Department of Surgery, Cedars-Sinai Medical Center; Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center; Biomedical Imaging Research Institute, Cedars-Sinai Medical Center
| | - Zulma Gazit
- Skeletal Biotech Laboratory, Hebrew University-Hadassah Faculty of Dental Medicine; Department of Surgery, Cedars-Sinai Medical Center; Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center; Department of Orthopedics, Cedars-Sinai Medical Center
| | - Dan Gazit
- Skeletal Biotech Laboratory, Hebrew University-Hadassah Faculty of Dental Medicine; Department of Surgery, Cedars-Sinai Medical Center; Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center; Biomedical Imaging Research Institute, Cedars-Sinai Medical Center; Department of Orthopedics, Cedars-Sinai Medical Center
| | - Gadi Pelled
- Skeletal Biotech Laboratory, Hebrew University-Hadassah Faculty of Dental Medicine; Department of Surgery, Cedars-Sinai Medical Center; Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center; Biomedical Imaging Research Institute, Cedars-Sinai Medical Center;
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Jeong JH, An JH, Yang H, Kim DK, Lee NS, Jeong YG, Na CS, Na DS, Dong MS, Han SY. Protective effect of Rhus verniciflua Stokes extract in an experimental model of post-menopausal osteoporosis. Anat Cell Biol 2017; 50:219-229. [PMID: 29043101 PMCID: PMC5639177 DOI: 10.5115/acb.2017.50.3.219] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 06/22/2017] [Accepted: 06/24/2017] [Indexed: 12/20/2022] Open
Abstract
Post-menopausal osteoporosis (PMO) is a major global human health concern. Owing to the need for therapeutic drugs without side effects, natural extracts containing various polyphenolic compounds that may exert estrogenic effects have been studied in depth. Rhus verniciflua Stokes (RVS), which has been used as a traditional herbal medicine for centuries in Korea, was recently revealed to exert estrogenic effects attributable to its bioactive ingredients sulfuretin and butein, which have strong estrogen receptor–binding affinities. In this study, the protective potential of RVS in PMO was evaluated by using an experimental animal model of PMO, which was established by ovariectomy (OVX) of female Sprague Dawley rats. The oral administration of RVS at 20 mg/kg or 100 mg/kg for 8 weeks markedly protected against OVX-induced atrophy of the uterine tube and reversed the elevation in the ratio of serum receptor activator of nuclear factor-κB ligand to osteoprotegerin, which is a marker of disease severity. In addition, RVS inhibited OVX-induced tibia bone loss, activated osteogenic activity, and suppressed osteoclastic activity in the tibial epiphyseal plate, a region of bone remodeling. Collectively, these factors indicated that the oral intake of RVS might be beneficial for the prevention of PMO.
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Affiliation(s)
- Ji Heun Jeong
- Department of Anatomy, Konyang University College of Medicine, Daejeon, Korea
| | - Jong Hoon An
- Department of Anatomy, Konyang University College of Medicine, Daejeon, Korea
| | - Hui Yang
- Department of Microbiology, Konyang University College of Medicine, Daejeon, Korea
| | - Do-Kyung Kim
- Department of Anatomy, Konyang University College of Medicine, Daejeon, Korea
| | - Nam-Seob Lee
- Department of Anatomy, Konyang University College of Medicine, Daejeon, Korea
| | - Young-Gil Jeong
- Department of Anatomy, Konyang University College of Medicine, Daejeon, Korea
| | | | | | - Mi-Sook Dong
- School of Life Sciences & Biotechnology, Korea University, Seoul, Korea
| | - Seung Yun Han
- Department of Anatomy, Konyang University College of Medicine, Daejeon, Korea.,Myunggok Research Institute, Konyang University College of Medicine, Daejeon, Korea
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Mussmann B, Overgaard S, Torfing T, Traise P, Gerke O, Andersen PE. Agreement and precision of periprosthetic bone density measurements in micro-CT, single and dual energy CT. J Orthop Res 2017; 35:1470-1477. [PMID: 27600874 DOI: 10.1002/jor.23417] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 09/06/2016] [Indexed: 02/04/2023]
Abstract
The objective of this study was to test the precision and agreement between bone mineral density measurements performed in micro CT, single and dual energy computed tomography, to determine how the keV level influences density measurements and to assess the usefulness of quantitative dual energy computed tomography as a research tool for longitudinal studies aiming to measure bone loss adjacent to total hip replacements. Samples from 10 fresh-frozen porcine femoral heads were placed in a Perspex phantom and computed tomography was performed with two acquisition modes. Bone mineral density was calculated and compared with measurements derived from micro CT. Repeated scans and dual measurements were performed in order to measure between- and within-scan precision. Mean density difference between micro CT and single energy computed tomography was 72 mg HA/cm3 . For dual energy CT, the mean difference at 100 keV was 128 mg HA/cm3 while the mean difference at 110-140 keV ranged from -84 to -67 mg HA/cm3 compared with micro CT. Rescanning the samples resulted in a non-significant overall between-scan difference of 13 mg HA/cm3 . Bland-Altman limits of agreement were wide and intraclass correlation coefficients ranged from 0.29 to 0.72, while 95% confidence intervals covered almost the full possible range. Repeating the density measurements for within-scan precision resulted in ICCs >0.99 and narrow limits of agreement. Single and dual energy quantitative CT showed excellent within-scan precision, but poor between-scan precision. No significant density differences were found in dual energy quantitative CT at keV-levels above 110 keV. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1470-1477, 2017.
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Affiliation(s)
- Bo Mussmann
- Department of Radiology, Odense University Hospital, Sdr. Boulevard 29, 5000, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Søren Overgaard
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Department of Orthopedic Surgery and Traumatology, Odense University Hospital, Sdr. Boulevard 29, 5000, Odense, Denmark
| | - Trine Torfing
- Department of Radiology, Odense University Hospital, Sdr. Boulevard 29, 5000, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Peter Traise
- Hunter New England Imaging, Armidale Hospital, Armidale, New South Wales, Australia
| | - Oke Gerke
- Department of Nuclear Medicine, Odense University Hospital, Sdr. Boulevard 29, 5000, Odense, Denmark.,Centre of Health Economics Research, University of Southern Denmark, Odense, Denmark
| | - Poul Erik Andersen
- Department of Radiology, Odense University Hospital, Sdr. Boulevard 29, 5000, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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Wang CY, Hsu YJ, Peng YJ, Lee HS, Chang YC, Chang CS, Chiang SW, Hsu YC, Lin MH, Huang GS. Knee subchondral bone perfusion and its relationship to marrow fat and trabeculation on multi-parametric MRI and micro-CT in experimental CKD. Sci Rep 2017; 7:3073. [PMID: 28596576 PMCID: PMC5465086 DOI: 10.1038/s41598-017-03059-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 04/21/2017] [Indexed: 12/16/2022] Open
Abstract
The pathogenesis of chronic kidney disease (CKD) is multifactorial. In the progression of CKD arthropathy, arteriosclerosis may alter the knee subchondral bone marrow by altering blood flow through the bone vasculature. Herein, multi-parametric MRI assessment, including dynamic contrast enhanced magnetic resonance imaging (DCE-MRI), magnetic resonance spectroscopy (MRS), MRI T2*, contrast enhanced MR angiography (CE-MRA), and micro-CT were applied in a rodent nephrectomy model to: 1) investigate the blood perfusion of subchondral bone marrow and its relationship to fat water content and trabeculation pattern in CKD and 2) demonstrate the feasibility of using multi-parametric MRI parameters as imaging biomarkers to evaluate the disease’s progression. Two groups of rats in our study underwent either 1) no intervention or 2) 5/6 nephrectomy. We found that in the CKD group, perfusion amplitude A and elimination constant kel values were significantly decreased, and vascular permeability kep was significantly increased. MRS showed that fat fraction (FF) was significantly lower, water fraction (WF) was significantly higher in the CKD group. Micro-CT showed a significant loss of trabecular bone. Knee subchondral bone marrow perfusion deficiency in experimental CKD may be associated with decreased fat content, increased water content, and sparse trabeculation.
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Affiliation(s)
- Chao-Ying Wang
- Department and Graduate Institute of Biology and Anatomy, National Defense Medical Center, Taipei, Taiwan.,Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yu-Juei Hsu
- Division of Nephrology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yi-Jen Peng
- Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Herng-Sheng Lee
- Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Department of Pathology and Laboratory Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Yue-Cune Chang
- Department of Mathematics, Tamkang University, New Taipei, Taiwan
| | - Chih-Shan Chang
- Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Shih-Wei Chiang
- Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan
| | - Yi-Chih Hsu
- Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Ming-Huang Lin
- Institute of Biomedical Sciences, Academic Sinica, Taipei, Taiwan
| | - Guo-Shu Huang
- Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan. .,Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
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36
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Z Movassagh E, Kontulainen S, Baxter-Jones ADG, Whiting S, Szafron M, Papadimitropoulos M, Vatanparast H. Are milk and alternatives and fruit and vegetable intakes during adolescence associated with cortical and trabecular bone structure, density, and strength in adulthood? Osteoporos Int 2017; 28:609-619. [PMID: 27699440 DOI: 10.1007/s00198-016-3775-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 09/12/2016] [Indexed: 01/11/2023]
Abstract
UNLABELLED We investigated the impact of food group intake during adolescence on bone structure and strength during adulthood. In females, we found a beneficial effect of adolescent milk and alternatives and fruit and vegetable intake on adult radius shaft and distal tibia bone structure, respectively. No association was observed in males. INTRODUCTION The purpose of this study was to investigate whether adolescents with high intake of milk and alternatives (M&A) or fruit and vegetables (F&V) had better adult bone structure and strength compared to those with low intake levels. METHODS We analyzed data from 47 males and 69 females enrolled in the Pediatric Bone Mineral Accrual Study (PBMAS 1991-2011), who had one peripheral quantitative computed tomography scan at age 29 ± 2 years. We measured radius and tibia shaft total area (ToA), cortical area (CoA), cortical content (CoC), cortical density, bone strength (SSIp), and muscle area, as well as distal radius and tibia ToA, total density, trabecular area, trabecular content, trabecular density, and bone strength (BSIc). Sequential 24-h recalls were used to assess M&A and F&V intake; participants were grouped for their mean intake during adolescence (low = bottom quartile, moderate = middle quartiles, high = top quartile) and were compared using multivariate analysis of covariance while adjusting for adult height, muscle area, physical activity, energy and calcium intake and adolescent energy intake, and physical activity. RESULTS Females with high M&A intake compared to low M&A intake group (mean 3.8 vs. 1.3 servings/day, respectively) had greater adult ToA (14 %, p < 0.05), CoA (15 %, p < 0.01), and CoC (16 %, p < 0.01) at radius shaft. Females with moderate F&V intake compared to low F&V intake group (mean 3.7 vs. 2.1 servings/day, respectively) had greater adult ToA (8.5 %, p < 0.05) at distal tibia. CONCLUSION Higher intake of M&A or F&V during adolescence had a long-term beneficial effect on bone structure in females, an association not observed in males.
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Affiliation(s)
- E Z Movassagh
- College of Pharmacy and Nutrition, University of Saskatchewan, 104 Clinic place, Saskatoon, SK, S7N 2Z4, Canada
| | - S Kontulainen
- College of Kinesiology, University of Saskatchewan, 87 Campus Drive, Saskatoon, SK, S7N5B2, Canada
| | - A D G Baxter-Jones
- College of Kinesiology, University of Saskatchewan, 87 Campus Drive, Saskatoon, SK, S7N5B2, Canada
- College of Graduate Studies and Research, University of Saskatchewan, 105 Administration place, Saskatoon, SK, S7N 5A2, Canada
| | - S Whiting
- College of Pharmacy and Nutrition, University of Saskatchewan, 104 Clinic place, Saskatoon, SK, S7N 2Z4, Canada
| | - M Szafron
- School of Public Health, University of Saskatchewan, 104 Clinic place, Saskatoon, SK, S7N 5E5, Canada
| | - M Papadimitropoulos
- College of Pharmacy and Nutrition, University of Saskatchewan, 104 Clinic place, Saskatoon, SK, S7N 2Z4, Canada
| | - H Vatanparast
- College of Pharmacy and Nutrition, University of Saskatchewan, 104 Clinic place, Saskatoon, SK, S7N 2Z4, Canada.
- School of Public Health, University of Saskatchewan, 104 Clinic place, Saskatoon, SK, S7N 5E5, Canada.
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María RS, Marta PM, Sonia S, Natalia GG, Tamara M, Ignasi T, Maria MG, Jaime RM, Adolfo DP, Joan A, Xavier N. TBS and BMD at the end of AI-therapy: A prospective study of the B-ABLE cohort. Bone 2016; 92:1-8. [PMID: 27519968 DOI: 10.1016/j.bone.2016.08.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 07/27/2016] [Accepted: 08/08/2016] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Patients with breast cancer under aromatase inhibitor (AI) treatment often develop osteoporosis and their average bone loss rate is twice that of natural reduction during menopause, increasing fracture risk. As the current diagnostic technique based on bone mineral density (BMD) provides no information on bone quality, the Trabecular Bone Score (TBS) has been proposed to reflect bone microarchitecture status. The present study was designed to assess prospective changes in TBS and lumbar spine (LS) BMD in postmenopausal women with breast cancer at completion of AI treatment. METHODS B-ABLE is a prospective cohort of 735 women with breast cancer treated with AIs according to American Society of Clinical Oncology recommendations: 5years of AI starting within 6weeks post-surgery or 1month after the last cycle of chemotherapy (5y-AI group), or switching to an AI to complete 5-year therapy after 2-3years of tamoxifen (pTMX-AI group). Patients with osteoporosis were treated with oral bisphosphonates (BP). TBS and LS-BMD changes at completion of AI therapy were evaluated by Student t-test for paired samples. Pearson correlation coefficients were computed for correlations between LS-BMD and TBS. RESULTS AI treatment was completed by 277 women. Of these, 70 (25.3%) were allocated to BP therapy. The non-BP-treated patients (74.7%) showed significant decreases in TBS (-2.94% in pTMX-AI and -2.93% in 5y-AI groups) and in LS-BMD (-4.14% in pTMX-AI and -2.28% in 5y-AI groups) at the end of AI treatment. In BP-treated patients, TBS remained stable at the end of AI treatment, whereas LS-BMD showed significant increases (+2.30% in pTMX-AI and +5.33% in 5y-AI groups). Moderate associations between TBS and LS-BMD values at baseline and at the end of AI treatment (r=0.4; P<0.001) were observed. At the end of treatment, changes in spine BMD and TBS were weakly correlated (r=0.1, P<0.01). CONCLUSIONS AI therapy induces significant decreases in TBS, comparable to BMD loss. BP-treated patients maintained TBS values, whereas BMD increased. AI treatment leads to deterioration of bone microarchitecture, which seems to be attenuated by BP therapy.
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Affiliation(s)
- Rodríguez-Sanz María
- IMIM (Hospital del Mar Research Institute), Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad (RETICEF), Barcelona, Spain
| | - Pineda-Moncusí Marta
- IMIM (Hospital del Mar Research Institute), Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad (RETICEF), Barcelona, Spain
| | - Servitja Sonia
- Cancer Research Program, IMIM (Hospital del Mar Research Institute), Medical Oncology Department, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Garcia-Giralt Natalia
- IMIM (Hospital del Mar Research Institute), Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad (RETICEF), Barcelona, Spain.
| | - Martos Tamara
- Cancer Research Program, IMIM (Hospital del Mar Research Institute), Medical Oncology Department, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Tusquets Ignasi
- Cancer Research Program, IMIM (Hospital del Mar Research Institute), Medical Oncology Department, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Martínez-García Maria
- Cancer Research Program, IMIM (Hospital del Mar Research Institute), Medical Oncology Department, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Rodriguez-Morera Jaime
- Internal Medicine Department, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Diez-Perez Adolfo
- IMIM (Hospital del Mar Research Institute), Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad (RETICEF), Barcelona, Spain; Internal Medicine Department, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Albanell Joan
- Cancer Research Program, IMIM (Hospital del Mar Research Institute), Medical Oncology Department, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Nogués Xavier
- IMIM (Hospital del Mar Research Institute), Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad (RETICEF), Barcelona, Spain; Internal Medicine Department, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain
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Bone quality assessment techniques: geometric, compositional, and mechanical characterization from macroscale to nanoscale. Clin Rev Bone Miner Metab 2016; 14:133-149. [PMID: 28936129 DOI: 10.1007/s12018-016-9222-4] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
This review presents an overview of the characterization techniques available to experimentally evaluate bone quality, defined as the geometric and material factors that contribute to fracture resistance independently of areal bone mineral density (aBMD) assessed by dual energy x-ray absorptiometry. The methods available for characterization of the geometric, compositional, and mechanical properties of bone across multiple length scales are summarized, along with their outcomes and their advantages and disadvantages. Examples of how each technique is used are discussed, as well as practical concerns such as sample preparation and whether or not each testing method is destructive. Techniques that can be used in vivo and those that have been recently improved or developed are emphasized, including high resolution peripheral quantitative computed tomography to evaluate geometric properties and reference point indentation to evaluate material properties. Because no single method can completely characterize bone quality, we provide a framework for how multiple characterization methods can be used together to generate a more comprehensive analysis of bone quality to complement aBMD in fracture risk assessment.
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Marques EA, Gudnason V, Sigurdsson G, Lang T, Johannesdottir F, Siggeirsdottir K, Launer L, Eiriksdottir G, Harris TB. Are bone turnover markers associated with volumetric bone density, size, and strength in older men and women? The AGES-Reykjavik study. Osteoporos Int 2016; 27:1765-76. [PMID: 26630978 PMCID: PMC5560050 DOI: 10.1007/s00198-015-3442-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Accepted: 11/23/2015] [Indexed: 12/23/2022]
Abstract
UNLABELLED Association between serum bone formation and resorption markers and bone mineral, structural, and strength variables derived from quantitative computed tomography (QCT) in a population-based cohort of 1745 older adults was assessed. The association was weak for lumbar spine and femoral neck areal and volumetric bone mineral density. INTRODUCTION The aim of this study was to examine the relationship between levels of bone turnover markers (BTMs; osteocalcin (OC), C-terminal cross-linking telopeptide of type I collagen (CTX), and procollagen type 1N propeptide (P1NP)) and quantitative computed tomography (QCT)-derived bone density, geometry, and strength indices in the lumbar spine and femoral neck (FN). METHODS A total of 1745 older individuals (773 men and 972 women, aged 66-92 years) from the Age, Gene/Environment Susceptibility (AGES)-Reykjavik cohort were studied. QCT was performed in the lumbar spine and hip to estimate volumetric trabecular, cortical, and integral bone mineral density (BMD), areal BMD, bone geometry, and bone strength indices. Association between BTMs and QCT variables were explored using multivariable linear regression. RESULTS Major findings showed that all BMD measures, FN cortical index, and compressive strength had a low negative correlation with the BTM levels in both men and women. Correlations between BTMs and bone size parameters were minimal or not significant. No associations were found between BTMs and vertebral cross-sectional area in women. BTMs alone accounted for only a relatively small percentage of the bone parameter variance (1-10 %). CONCLUSION Serum CTX, OC, and P1NP were weakly correlated with lumbar spine and FN areal and volumetric BMD and strength measures. Most of the bone size indices were not associated with BTMs; thus, the selected bone remodeling markers do not reflect periosteal bone formation. These results confirmed the limited ability of the most sensitive established BTMs to predict bone structural integrity in older adults.
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Affiliation(s)
- E A Marques
- Laboratory of Epidemiology and Population Science, Intramural Research Program, National Institute on Aging, National Institutes of Health, 7201 Wisconsin Ave, 3C-309 Gateway Building, Bethesda, MD, 20814, USA.
| | - V Gudnason
- Icelandic Heart Association Research Institute, Kópavogur, Iceland
- University of Iceland, Reykjavik, Iceland
| | - G Sigurdsson
- Icelandic Heart Association Research Institute, Kópavogur, Iceland
- University of Iceland, Reykjavik, Iceland
- Landspitalinn University Hospital, Reykjavik, Iceland
| | - T Lang
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | | | - K Siggeirsdottir
- Icelandic Heart Association Research Institute, Kópavogur, Iceland
| | - L Launer
- Laboratory of Epidemiology and Population Science, Intramural Research Program, National Institute on Aging, National Institutes of Health, 7201 Wisconsin Ave, 3C-309 Gateway Building, Bethesda, MD, 20814, USA
| | - G Eiriksdottir
- Icelandic Heart Association Research Institute, Kópavogur, Iceland
| | - T B Harris
- Laboratory of Epidemiology and Population Science, Intramural Research Program, National Institute on Aging, National Institutes of Health, 7201 Wisconsin Ave, 3C-309 Gateway Building, Bethesda, MD, 20814, USA
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Giannotti S, Bottai V, Panetta D, De Paola G, Tripodi M, Citarelli C, Dell'Osso G, Lazzerini I, Salvadori PA, Guido G. Three-dimensional parametric mapping in quantitative micro-CT imaging of post-surgery femoral head-neck samples: preliminary results. CLINICAL CASES IN MINERAL AND BONE METABOLISM 2016; 12:243-6. [PMID: 26811703 DOI: 10.11138/ccmbm/2015.12.3.243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Osteoporosis and pathological increased occurrence of fractures are an important public health problem. They may affect patients' quality of life and even increase mortality of osteoporotic patients, and consequently represent a heavy economic burden for national healthcare systems. The adoption of simple and inexpensive methods for mass screening of population at risk may be the key for an effective prevention. The current clinical standards of diagnosing osteoporosis and assessing the risk of an osteoporotic bone fracture include dual-energy X-ray absorptiometry (DXA) and quantitative computed tomography (QCT) for the measurement of bone mineral density (BMD). Micro-computed tomography (micro-CT) is a tomographic imaging technique with very high resolution allowing direct quantification of cancellous bone microarchitecture. The Authors performed micro-CT analysis of the femoral heads harvested from 8 patients who have undergone surgery for hip replacement for primary and secondary degenerative disease to identify possible new morphometric parameters based on the analysis of the distribution of intra-subject microarchitectural parameters through the creation of parametric images. Our results show that the micro-architectural metrics commonly used may not be sufficient for the realistic assessment of bone microarchitecture of the femoral head in patients with hip osteoarthritis. The innovative micro-CT approach considers the entire femoral head in its physiological shape with all its components like cartilage, cortical layer and trabecular region. The future use of these methods for a more detailed study of the reaction of trabecular bone for the internal fixation or prostheses would be desirable.
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Affiliation(s)
- Stefano Giannotti
- II Orthopaedic and Traumatologic Clinic, University of Pisa, Pisa, Italy
| | - Vanna Bottai
- II Orthopaedic and Traumatologic Clinic, University of Pisa, Pisa, Italy
| | | | - Gaia De Paola
- II Orthopaedic and Traumatologic Clinic, University of Pisa, Pisa, Italy
| | - Maria Tripodi
- Institute of Clinical Physiology, IFC-CNR, Pisa, Italy
| | - Carmine Citarelli
- II Orthopaedic and Traumatologic Clinic, University of Pisa, Pisa, Italy
| | - Giacomo Dell'Osso
- II Orthopaedic and Traumatologic Clinic, University of Pisa, Pisa, Italy
| | - Ilaria Lazzerini
- II Orthopaedic and Traumatologic Clinic, University of Pisa, Pisa, Italy
| | | | - Giulio Guido
- II Orthopaedic and Traumatologic Clinic, University of Pisa, Pisa, Italy
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Hoff BA, Toole M, Yablon C, Ross BD, Luker GD, VanPoznak C, Galbán CJ. Potential for Early Fracture Risk Assessment in Patients with Metastatic Bone Disease using Parametric Response Mapping of CT Images. ACTA ACUST UNITED AC 2015; 1:98-104. [PMID: 26771006 PMCID: PMC4710140 DOI: 10.18383/j.tom.2015.00154] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Pathologic vertebral compression fractures (PVCFs) cause significant morbidity in patients with metastatic bone disease. Limitations in existing clinical biomarkers leave clinicians without reliable metrics for predicting PVCF, thus impeding efforts to prevent this severe complication. To establish the feasibility of a new method for defining the risk of a PVCF, we retrospectively analyzed serial computed tomography (CT) scans from 5 breast cancer patients using parametric response mapping (PRM) to quantify dynamic bone miniral density (BMD) changes that preceded an event. Vertebrae segmented from each scan were registered to the same spatial frame and voxel classification was accomplished using a predetermined threshold of change in Hounsfield units (HU), resulting in relative volumes of increased (PRMHU+), decreased (PRMHU−), or unchanged (PRMHU0) attenuation. A total of 7 PVCFs were compared to undiseased vertebrae in each patient serving as controls. A receiver operator curve (ROC) analysis identified optimal imaging times for group stratification. BMD changes were apparent by an elevated PRMHU+ as early as 1 year before fracture. ROC analysis showed poor performance of PRMHU− in stratifying PVCFs versus controls. As early as 6 months before PVCF, PRMHU+ was significantly larger (12.9 ± 11.6%) than control vertebrae (2.3 ± 2.5%), with an area under the curve of 0.918 from an ROC analysis. Mean HU changes were also significant between PVCF (26.8 ± 26.9%) and control (−2.2 ± 22.0%) over the same period. A PRM analysis of BMD changes using standard CT imaging was sensitive for spatially resolving changes that preceded structural failure in these patients.
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Affiliation(s)
- Benjamin A Hoff
- Department of Radiology, University of Michigan, Center for Molecular Imaging, Ann Arbor, MI 48109, USA
| | - Michael Toole
- Department of Internal Medicine, University of Michigan, Center for Molecular Imaging, Ann Arbor, MI 48109, USA
| | - Corrie Yablon
- Department of Radiology, University of Michigan, Center for Molecular Imaging, Ann Arbor, MI 48109, USA
| | - Brian D Ross
- Department of Radiology, University of Michigan, Center for Molecular Imaging, Ann Arbor, MI 48109, USA
| | - Gary D Luker
- Department of Radiology, University of Michigan, Center for Molecular Imaging, Ann Arbor, MI 48109, USA
| | - Catherine VanPoznak
- Department of Internal Medicine, University of Michigan, Center for Molecular Imaging, Ann Arbor, MI 48109, USA
| | - Craig J Galbán
- Department of Radiology, University of Michigan, Center for Molecular Imaging, Ann Arbor, MI 48109, USA
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van der Hoorn MMC, Tett SE, de Vries OJ, Dobson AJ, Peeters GMEEG. The effect of dose and type of proton pump inhibitor use on risk of fractures and osteoporosis treatment in older Australian women: A prospective cohort study. Bone 2015; 81:675-682. [PMID: 26319499 DOI: 10.1016/j.bone.2015.08.024] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 08/24/2015] [Accepted: 08/25/2015] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Proton pump inhibitors (PPIs) are among the most prescribed medications worldwide, however, there is growing concern regarding potential negative effects on bone health. The aim was to examine the effect of dose and type of PPI use on subsequent use of osteoporosis medication and fractures in older Australian women. METHODS Data were included from 4432 participants (born 1921-26) in the 2002 survey of the Australian Longitudinal Study on Women's Health. Medication data were from the national pharmaceutical administrative database (2003-2012, inclusive). Fractures were sourced from linked hospital datasets available for four major States of Australia. Competing risk regression models used PPI exposure as a time-dependent covariate and either time to first osteoporosis medication prescription or fracture as the outcome, with death as a competing risk. RESULTS Of the 2328 PPI users and 2104 PPI non-users, 827 (36%) and 550 (26%) became users of osteoporosis medication, respectively. PPI use was associated with an increased risk of subsequent use of osteoporosis medication (adjusted sub-hazard ratio [SHR]=1.28; 95% confidence interval [CI]=1.13-1.44) and subsequent fracture (SHR=1.29, CI=1.08-1.55). Analysis with PPI categorized according to defined daily dose (DDD), showed some evidence for a dose-response effect (osteoporosis medication: <400 DDD: SHR=1.23, CI=1.06-1.42 and ≥400 DDD: SHR=1.39, CI=1.17-1.65, compared with non-users; SHRs were in the same range for fractures). Esomeprazole was the most common PPI prescribed (22.9%). Analysis by type of PPI use showed an increased subsequent risk for: (1) use of osteoporosis medication for rabeprazole (SHR=1.51, CI=1.08-2.10) and esomeprazole (SHR=1.48, CI=1.17-1.88); and (2) fractures for rabeprazole (SHR=2.06, CI=1.37-3.10). Users of multiple types of PPI also had increased risks for use of osteoporosis medication and fractures. CONCLUSION An appropriate benefit/risk assessment should be made when prescribing PPIs, especially for esomeprazole and rabeprazole, as osteoporosis and fracture risks were increased in this cohort of elderly females subsequent to PPI prescription.
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Affiliation(s)
- Mariëlle M C van der Hoorn
- The University of Queensland, School of Public Health, Brisbane, QLD 4006, Australia; VU University Amsterdam, Faculty of Medicine, Amsterdam 1081 BT, Netherlands
| | - Susan E Tett
- The University of Queensland, School of Pharmacy, Brisbane, QLD 4072, Australia
| | - Oscar J de Vries
- VU University Medical Center, Department of Internal Medicine, Amsterdam 1007 MB, Netherlands
| | - Annette J Dobson
- The University of Queensland, School of Public Health, Brisbane, QLD 4006, Australia
| | - G M E E Geeske Peeters
- The University of Queensland, School of Public Health, Brisbane, QLD 4006, Australia; The University of Queensland, School of Human Movement and Nutrition Sciences, Brisbane, QLD 4072, Australia.
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Parmar BJ, Yang X, Chaudhry A, Shajudeen PS, Nair SP, Weiner BK, Tasciotti E, Krouskop TA, Righetti R. Ultrasound elastography assessment of bone/soft tissue interface. Phys Med Biol 2015; 61:131-50. [PMID: 26611328 DOI: 10.1088/0031-9155/61/1/131] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
We report on the use of elastographic imaging techniques to assess the bone/soft tissue interface, a region that has not been previously investigated but may provide important information about fracture and bone healing. The performance of axial strain elastograms and axial shear strain elastograms at the bone/soft tissue interface was studied ex vivo on intact and fractured canine and ovine tibias. Selected ex vivo results were corroborated on intact sheep tibias in vivo. The elastography results were statistically analyzed using elastographic image quality tools. The results of this study demonstrate distinct patterns in the distribution of the normalized local axial strains and axial shear strains at the bone/soft tissue interface with respect to the background soft tissue. They also show that the relative strength and distribution of the elastographic parameters change in the presence of a fracture and depend on the degree of misalignment between the fracture fragments. Thus, elastographic imaging modalities might be used in the future to obtain information regarding the integrity of bones and to assess the severity of fractures, alignment of bone fragments as well as to follow bone healing.
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Affiliation(s)
- Biren J Parmar
- Department of Electrical and Computer Engineering, Texas A&M University, College Station, TX 77840, USA
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Wilson HCP, Abel PD, Shah SIA. Repeated vertebral augmentation for new vertebral compression fractures of postvertebral augmentation patients: a nationwide cohort study--how useful is the current clinical gold standard for fracture risk? Clin Interv Aging 2015; 10:1653-4. [PMID: 26527866 PMCID: PMC4621176 DOI: 10.2147/cia.s96526] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Affiliation(s)
- Hannah C P Wilson
- Department of Post-graduate Students, Imperial College London, Charing Cross Hospital, London, UK
| | - Paul D Abel
- Department of surgery and cancer, Imperial College London, Hammersmith Hospital, London, UK
| | - S Imran A Shah
- Department of surgery and cancer, Imperial College London, Hammersmith Hospital, London, UK
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45
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Carballido-Gamio J, Bonaretti S, Saeed I, Harnish R, Recker R, Burghardt AJ, Keyak JH, Harris T, Khosla S, Lang TF. Automatic multi-parametric quantification of the proximal femur with quantitative computed tomography. Quant Imaging Med Surg 2015; 5:552-68. [PMID: 26435919 DOI: 10.3978/j.issn.2223-4292.2015.08.02] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Quantitative computed tomography (QCT) imaging is the basis for multiple assessments of bone quality in the proximal femur, including volumetric bone mineral density (vBMD), tissue volume, estimation of bone strength using finite element modeling (FEM), cortical bone thickness, and computational-anatomy-based morphometry assessments. METHODS Here, we present an automatic framework to perform a multi-parametric QCT quantification of the proximal femur. In this framework, the proximal femur is cropped from the bilateral hip scans, segmented using a multi-atlas based segmentation approach, and then assigned volumes of interest through the registration of a proximal femoral template. The proximal femur is then subjected to compartmental vBMD, compartmental tissue volume, FEM bone strength, compartmental surface-based cortical bone thickness, compartmental surface-based vBMD, local surface-based cortical bone thickness, and local surface-based cortical vBMD computations. Consequently, the template registrations together with vBMD and surface-based cortical bone parametric maps enable computational anatomy studies. The accuracy of the segmentation was validated against manual segmentations of 80 scans from two clinical facilities, while the multi-parametric reproducibility was evaluated using repeat scans with repositioning from 22 subjects obtained on CT imaging systems from two manufacturers. RESULTS Accuracy results yielded a mean dice similarity coefficient of 0.976±0.006, and a modified Haussdorf distance of 0.219±0.071 mm. Reproducibility of QCT-derived parameters yielded root mean square coefficients of variation (CVRMS) between 0.89-1.66% for compartmental vBMD; 0.20-1.82% for compartmental tissue volume; 3.51-3.59% for FEM bone strength; 1.89-2.69% for compartmental surface-based cortical bone thickness; and 1.08-2.19% for compartmental surface-based cortical vBMD. For local surface-based assessments, mean CVRMS were between 3.45-3.91% and 2.74-3.15% for cortical bone thickness and vBMD, respectively. CONCLUSIONS The automatic framework presented here enables accurate and reproducible QCT multi-parametric analyses of the proximal femur. Our subjects were elderly, with scans obtained across multiple clinical sites and manufacturers, thus documenting its value for clinical trials and other multi-site studies.
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Affiliation(s)
- Julio Carballido-Gamio
- 1 Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA ; 2 Department of Endocrinology, Creighton University, Omaha, NE, USA ; 3 Department of Radiological Sciences, Department of Mechanical and Aerospace Engineering, Department of Biomedical Engineering, and Chao Family Comprehensive Cancer Center, University of California, Irvine, Irvine, CA, USA ; 4 Intramural Research Program, National Institute on Aging, Bethesda, Maryland, USA ; 5 Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Internal Medicine, College of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Serena Bonaretti
- 1 Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA ; 2 Department of Endocrinology, Creighton University, Omaha, NE, USA ; 3 Department of Radiological Sciences, Department of Mechanical and Aerospace Engineering, Department of Biomedical Engineering, and Chao Family Comprehensive Cancer Center, University of California, Irvine, Irvine, CA, USA ; 4 Intramural Research Program, National Institute on Aging, Bethesda, Maryland, USA ; 5 Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Internal Medicine, College of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Isra Saeed
- 1 Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA ; 2 Department of Endocrinology, Creighton University, Omaha, NE, USA ; 3 Department of Radiological Sciences, Department of Mechanical and Aerospace Engineering, Department of Biomedical Engineering, and Chao Family Comprehensive Cancer Center, University of California, Irvine, Irvine, CA, USA ; 4 Intramural Research Program, National Institute on Aging, Bethesda, Maryland, USA ; 5 Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Internal Medicine, College of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Roy Harnish
- 1 Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA ; 2 Department of Endocrinology, Creighton University, Omaha, NE, USA ; 3 Department of Radiological Sciences, Department of Mechanical and Aerospace Engineering, Department of Biomedical Engineering, and Chao Family Comprehensive Cancer Center, University of California, Irvine, Irvine, CA, USA ; 4 Intramural Research Program, National Institute on Aging, Bethesda, Maryland, USA ; 5 Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Internal Medicine, College of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Robert Recker
- 1 Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA ; 2 Department of Endocrinology, Creighton University, Omaha, NE, USA ; 3 Department of Radiological Sciences, Department of Mechanical and Aerospace Engineering, Department of Biomedical Engineering, and Chao Family Comprehensive Cancer Center, University of California, Irvine, Irvine, CA, USA ; 4 Intramural Research Program, National Institute on Aging, Bethesda, Maryland, USA ; 5 Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Internal Medicine, College of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Andrew J Burghardt
- 1 Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA ; 2 Department of Endocrinology, Creighton University, Omaha, NE, USA ; 3 Department of Radiological Sciences, Department of Mechanical and Aerospace Engineering, Department of Biomedical Engineering, and Chao Family Comprehensive Cancer Center, University of California, Irvine, Irvine, CA, USA ; 4 Intramural Research Program, National Institute on Aging, Bethesda, Maryland, USA ; 5 Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Internal Medicine, College of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Joyce H Keyak
- 1 Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA ; 2 Department of Endocrinology, Creighton University, Omaha, NE, USA ; 3 Department of Radiological Sciences, Department of Mechanical and Aerospace Engineering, Department of Biomedical Engineering, and Chao Family Comprehensive Cancer Center, University of California, Irvine, Irvine, CA, USA ; 4 Intramural Research Program, National Institute on Aging, Bethesda, Maryland, USA ; 5 Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Internal Medicine, College of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Tamara Harris
- 1 Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA ; 2 Department of Endocrinology, Creighton University, Omaha, NE, USA ; 3 Department of Radiological Sciences, Department of Mechanical and Aerospace Engineering, Department of Biomedical Engineering, and Chao Family Comprehensive Cancer Center, University of California, Irvine, Irvine, CA, USA ; 4 Intramural Research Program, National Institute on Aging, Bethesda, Maryland, USA ; 5 Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Internal Medicine, College of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Sundeep Khosla
- 1 Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA ; 2 Department of Endocrinology, Creighton University, Omaha, NE, USA ; 3 Department of Radiological Sciences, Department of Mechanical and Aerospace Engineering, Department of Biomedical Engineering, and Chao Family Comprehensive Cancer Center, University of California, Irvine, Irvine, CA, USA ; 4 Intramural Research Program, National Institute on Aging, Bethesda, Maryland, USA ; 5 Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Internal Medicine, College of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Thomas F Lang
- 1 Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA ; 2 Department of Endocrinology, Creighton University, Omaha, NE, USA ; 3 Department of Radiological Sciences, Department of Mechanical and Aerospace Engineering, Department of Biomedical Engineering, and Chao Family Comprehensive Cancer Center, University of California, Irvine, Irvine, CA, USA ; 4 Intramural Research Program, National Institute on Aging, Bethesda, Maryland, USA ; 5 Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Internal Medicine, College of Medicine, Mayo Clinic, Rochester, MN, USA
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Barngkgei I, Joury E, Jawad A. An innovative approach in osteoporosis opportunistic screening by the dental practitioner: the use of cervical vertebrae and cone beam computed tomography with its viewer program. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 120:651-9. [PMID: 26453386 DOI: 10.1016/j.oooo.2015.08.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Revised: 08/06/2015] [Accepted: 08/12/2015] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To investigate the use of cone beam computed tomography (CBCT) for predicting osteoporosis based on the cervical vertebrae CBCT-derived radiographic density (RD) using the CBCT-viewer program. STUDY DESIGN CBCT scans (WhiteFox, de Gotzen S.r.l device, distributed by Satelec-Acteon Group, Italy) and dual-energy X-ray absorptiometry examinations of 38 women who participated in an earlier investigation were examined. A coronal slice, subjectively determined from the cervical vertebrae, was selected and the RD as gray values for the first and second vertebrae, and the dens was calculated by using CBCT-viewer software (WhiteFox imaging). RESULTS The CBCT-derived RD values of the dens and the left part of the first cervical vertebra showed the strongest correlation coefficients (r=0.7, 0.6; P<.001) and the highest sensitivity (76.9%, 70%), specificity (92%, 92.9%), and accuracy (90.8%, 86.4%) in predicting osteoporosis in the lumbar vertebrae and the femoral neck, respectively. CONCLUSIONS CBCT-derived RD of cervical vertebrae can predict osteoporosis status using a CBCT-viewer program. This finding should be confirmed on other CBCT devices.
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Affiliation(s)
- Imad Barngkgei
- Oral Medicine Department, Faculty of Dentistry, Damascus University, Damascus, Syria.
| | - Easter Joury
- Assistant Professor of Dental Public Health and Oral Epidemiology, Oral Medicine Department, Faculty of Dentistry, Damascus University, Damascus, Syria; Centre for Oral Growth and Development, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Ali Jawad
- William Harvey Research Institute, Queen Mary University of London, London, United Kingdom; Royal London Hospital, London, United Kingdom
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Effendy NM, Ibrahim NI, Mohamed N, Shuid AN. An Evidence-Based Review of Micro-CT Assessments of the Postmenopausal Osteoporosis Rat Model. INT J PHARMACOL 2015. [DOI: 10.3923/ijp.2015.177.200] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Khobragade P, Jain A, Setlur Nagesh SV, Andreana S, Dziak R, Sunkara SK, Sunkara S, Bednarek DR, Rudin S, Ionita CN. Micro-Computed tomography (CT) based assessment of dental regenerative therapy in the canine mandible model. PROCEEDINGS OF SPIE--THE INTERNATIONAL SOCIETY FOR OPTICAL ENGINEERING 2015; 9417. [PMID: 26869742 DOI: 10.1117/12.2082173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
High-resolution 3D bone-tissue structure measurements may provide information critical to the understanding of the bone regeneration processes and to the bone strength assessment. Tissue engineering studies rely on such nondestructive measurements to monitor bone graft regeneration area. In this study, we measured bone yield, fractal dimension and trabecular thickness through micro-CT slices for different grafts and controls. Eight canines underwent surgery to remove a bone volume (defect) in the canine's jaw at a total of 44 different locations. We kept 11 defects empty for control and filled the remaining ones with three regenerative materials; NanoGen (NG), a FDA-approved material (n=11), a novel NanoCalcium Sulfate (NCS) material (n=11) and NCS alginate (NCS+alg) material (n=11). After a minimum of four and eight weeks, the canines were sacrificed and the jaw samples were extracted. We used a custom-built micro-CT system to acquire the data volume and developed software to measure the bone yield, fractal dimension and trabecular thickness. The software used a segmentation algorithm based on histograms derived from volumes of interest indicated by the operator. Using bone yield and fractal dimension as indices we are able to differentiate between the control and regenerative material (p<0.005). Regenerative material NCS showed an average 63.15% bone yield improvement over the control sample, NCS+alg showed 55.55% and NanoGen showed 37.5%. The bone regeneration process and quality of bone were dependent upon the position of defect and time period of healing. This study presents one of the first quantitative comparisons using non-destructive Micro-CT analysis for bone regenerative material in a large animal with a critical defect model. Our results indicate that Micro-CT measurement could be used to monitor in-vivo bone regeneration studies for greater regenerative process understanding.
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Affiliation(s)
- P Khobragade
- Department of Biomedical Engineering, State University of New York at Buffalo; Toshiba Stroke and Vascular Research Center, State University of New York at Buffalo
| | - A Jain
- Toshiba Stroke and Vascular Research Center, State University of New York at Buffalo
| | - S V Setlur Nagesh
- Toshiba Stroke and Vascular Research Center, State University of New York at Buffalo
| | - S Andreana
- Department of Restorative Dentistry, State University of New York at Buffalo
| | - R Dziak
- Department of Oral Biology, State University of New York at Buffalo
| | - S K Sunkara
- Department of Oral Biology, State University of New York at Buffalo
| | - S Sunkara
- Department of Oral Biology, State University of New York at Buffalo
| | - D R Bednarek
- Toshiba Stroke and Vascular Research Center, State University of New York at Buffalo
| | - S Rudin
- Department of Biomedical Engineering, State University of New York at Buffalo; Toshiba Stroke and Vascular Research Center, State University of New York at Buffalo
| | - C N Ionita
- Department of Biomedical Engineering, State University of New York at Buffalo; Toshiba Stroke and Vascular Research Center, State University of New York at Buffalo
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Liu Z, Yan C, kang C, Zhang B, Li Y. Distributional variations in trabecular architecture of the mandibular bone: an in vivo micro-CT analysis in rats. PLoS One 2015; 10:e0116194. [PMID: 25625431 PMCID: PMC4307973 DOI: 10.1371/journal.pone.0116194] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Accepted: 12/07/2014] [Indexed: 12/03/2022] Open
Abstract
Purpose To evaluate the effect of trabecular thickness and trabecular separation on modulating the trabecular architecture of the mandibular bone in ovariectomized rats. Materials and Methods Fourteen 12-week-old adult female Wistar rats were divided into an ovariectomy group (OVX) and a sham-ovariectomy group (sham). Five months after the surgery, the mandibles from 14 rats (seven OVX and seven sham) were analyzed by micro-CT. Images of inter-radicular alveolar bone of the mandibular first molars underwent three-dimensional reconstruction and were analyzed. Results Compared to the sham group, trabecular thickness in OVX alveolar bone decreased by 27% (P = 0.012), but trabecular separation in OVX alveolar bone increased by 59% (P = 0.005). A thickness and separation map showed that trabeculae of less than 100μm increased by 46%, whereas trabeculae of more than 200μm decreased by more than 40% in the OVX group compared to those in the sham group. Furthermore, the OVX separation of those trabecular of more than 200μm was 65% higher compared to the sham group. Bone mineral density (P = 0.028) and bone volume fraction (p = 0.001) were also significantly decreased in the OVX group compared to the sham group. Conclusions Ovariectomy-induced bone loss in mandibular bone may be related to the distributional variations in trabecular thickness and separation which profoundly impact the modulation of the trabecular architecture.
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Affiliation(s)
- Zhongshuang Liu
- Sino-Russian Institute of Hard Tissue Development and Regeneration, the Second Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang, China
| | - Chengwei Yan
- Department of Pediatric Dentistry, the First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang, China
| | - Chen kang
- Sino-Russian Institute of Hard Tissue Development and Regeneration, the Second Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang, China
| | - Bin Zhang
- Sino-Russian Institute of Hard Tissue Development and Regeneration, the Second Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang, China
- Heilongjiang Academy of Medical Sciences, Harbin 150001, Heilongjiang, China
- * E-mail: (BZ); (YL)
| | - Ying Li
- Sino-Russian Institute of Hard Tissue Development and Regeneration, the Second Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang, China
- Heilongjiang Academy of Medical Sciences, Harbin 150001, Heilongjiang, China
- * E-mail: (BZ); (YL)
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Ventura M, Boerman OC, de Korte C, Rijpkema M, Heerschap A, Oosterwijk E, Jansen JA, Walboomers XF. Preclinical Imaging in Bone Tissue Engineering. TISSUE ENGINEERING PART B-REVIEWS 2014; 20:578-95. [DOI: 10.1089/ten.teb.2013.0635] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- Manuela Ventura
- Department of Biomaterials, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Otto C. Boerman
- Department of Nuclear Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Chris de Korte
- Department of Radiology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Mark Rijpkema
- Department of Nuclear Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Arend Heerschap
- Department of Radiology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Egbert Oosterwijk
- Department of Urology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - John A. Jansen
- Department of Biomaterials, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - X. Frank Walboomers
- Department of Biomaterials, Radboud University Medical Centre, Nijmegen, The Netherlands
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