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Yang Y, Liao F, Xing X, Liao N, Wang D, Yin X, Liu Y, Guo J, Li L, Wang H, Li C, Zheng Y. The reduced cortical bone density in vertebral bodies: risk for osteoporotic fractures? Insights from CT analysis. J Orthop Surg Res 2024; 19:486. [PMID: 39152470 PMCID: PMC11329995 DOI: 10.1186/s13018-024-04896-5] [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: 03/08/2024] [Accepted: 07/03/2024] [Indexed: 08/19/2024] Open
Abstract
BACKGROUND There is a corresponding increase in the prevalence of osteoporosis and related fractures with the aging population on the rise. Furthermore, osteoporotic vertebral compression fractures (OVCF) may contribute to higher patient mortality rates. It is essential to conduct research on risk factors for OVCF and provide a theoretical basis for preventing such fractures. METHODS We retrospectively recruited patients who had spine CT for OVCF or back pain. Demographic and CT data were collected. Quantitative computed tomography (QCT) software analyzed the CT data, using subcutaneous fat and paraspinal muscles as reference standards for BMD processing. BMD of cortical and cancellous bones in each patient's vertebral body was determined. RESULTS In this study, 144 patients were divided into non-OVCF (96) and OVCF (48) groups. Non-OVCF patients had higher cortical BMD of 382.5 ± 52.4 to 444.6 ± 70.1 mg/cm3, with T12 having the lowest BMD (p < 0.001, T12 vs. L2). Cancellous BMD ranged from 128.5 ± 58.4 to 140.9 ± 58.9 mg/cm3, with L3 having the lowest BMD. OVCF patients had lower cortical BMD of 365.0 ± 78.9 to 429.3 ± 156.7 mg/cm3, with a further decrease in T12 BMD. Cancellous BMD ranged from 71.68 ± 52.07 to 123.9 ± 126.2 mg/cm3, with L3 still having the lowest BMD. Fractured vertebrae in OVCF patients (T12, L1, and L2) had lower cortical bone density compared to their corresponding vertebrae without fractures (p < 0.05). CONCLUSIONS T12 had the lowest cortical BMD and L3 had the lowest cancellous BMD in OVCF patients, with T12 also having the highest incidence of osteoporotic fractures. These findings suggest that reduction in cortical BMD has a greater impact on OVCF than reduction in cancellous BMD, along with biomechanical factors.
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Affiliation(s)
- Yong Yang
- Department of Orthopaedics, Fourth Medical Center of PLA General Hospital, Beijing, PR China
- National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation, Beijing, 10048, PR China
- Department of Orthopedics, General Hospital of Western Theater Command, Rongdu Avenue No. 270, Chengdu, 610083, PR China
| | - Feng Liao
- Department of Orthopaedics, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, PR China
| | - Xingbo Xing
- Department of Radiology, Fourth Medical Center of PLA General Hospital, Beijing, 10048, PR China
| | - Nianxi Liao
- Yizhun medical AI Co.Ltd, No.7, Zhichun road, Haidian district, Beijing, 100088, PR China
| | - Dawei Wang
- Department of Orthopaedics, Fourth Medical Center of PLA General Hospital, Beijing, PR China
- National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation, Beijing, 10048, PR China
| | - Xin Yin
- Department of Orthopaedics, Fourth Medical Center of PLA General Hospital, Beijing, PR China
| | - Yihao Liu
- Department of Orthopaedics, Fourth Medical Center of PLA General Hospital, Beijing, PR China
| | - Jidong Guo
- Department of Orthopaedics, Fourth Medical Center of PLA General Hospital, Beijing, PR China
- National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation, Beijing, 10048, PR China
| | - Li Li
- Department of Orthopaedics, Fourth Medical Center of PLA General Hospital, Beijing, PR China
- National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation, Beijing, 10048, PR China
| | - Huadong Wang
- Department of Orthopaedics, Fourth Medical Center of PLA General Hospital, Beijing, PR China.
- National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation, Beijing, 10048, PR China.
| | - Chunyan Li
- Department of Clinical Laboratory, Beijing Jishuitan Hospital, Xicheng District, Beijing, 100035, PR China.
| | - Yang Zheng
- Department of Orthopaedics, Fourth Medical Center of PLA General Hospital, Beijing, PR China.
- National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation, Beijing, 10048, PR China.
- Department of Orthopedics, General Hospital of Western Theater Command, Rongdu Avenue No. 270, Chengdu, 610083, PR China.
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Cheng J, Su W, Wang Y, Zhan Y, Wang Y, Yan S, Yuan Y, Chen L, Wei Z, Zhang S, Gao X, Tang Z. Magnetic resonance imaging based on radiomics for differentiating T1-category nasopharyngeal carcinoma from nasopharyngeal lymphoid hyperplasia: a multicenter study. Jpn J Radiol 2024; 42:709-719. [PMID: 38409300 DOI: 10.1007/s11604-024-01544-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 01/29/2024] [Indexed: 02/28/2024]
Abstract
PURPOSE To investigate the role of magnetic resonance imaging (MRI) based on radiomics using T2-weighted imaging fat suppression (T2WI-FS) and contrast enhanced T1-weighted imaging (CE-T1WI) sequences in differentiating T1-category nasopharyngeal carcinoma (NPC) from nasopharyngeal lymphoid hyperplasia (NPH). MATERIALS AND METHODS This study enrolled 614 patients (training dataset: n = 390, internal validation dataset: n = 98, and external validation dataset: n = 126) of T1-category NPC and NPH. Three feature selection methods were used, including analysis of variance, recursive feature elimination, and relief. The logistic regression classifier was performed to construct the radiomics signatures of T2WI-FS, CE-T1WI, and T2WI-FS + CE-T1WI to differentiate T1-category NPC from NPH. The performance of the optimal radiomics signature (T2WI-FS + CE-T1WI) was compared with those of three radiologists in the internal and external validation datasets. RESULTS Twelve, 15, and 15 radiomics features were selected from T2WI-FS, CE-T1WI, and T2WI-FS + CE-T1WI to develop the three radiomics signatures, respectively. The area under the curve (AUC) values for radiomics signatures of T2WI-FS + CE-T1WI and CE-T1WI were significantly higher than that of T2WI-FS (AUCs = 0.940, 0.935, and 0.905, respectively) for distinguishing T1-category NPC and NPH in the training dataset (Ps all < 0.05). In the internal and external validation datasets, the radiomics signatures based on T2WI-FS + CE-T1WI and CE-T1WI outperformed T2WI-FS with no significant difference (AUCs = 0.938, 0.925, and 0.874 for internal validation dataset and 0.932, 0.918, and 0.882 for external validation dataset; Ps > 0.05). The radiomics signature of T2WI-FS + CE-T1WI significantly performed better than three radiologists in the internal and external validation datasets. CONCLUSION The MRI-based radiomics signature is meaningful in differentiating T1-category NPC from NPH and potentially helps clinicians select suitable therapy strategies.
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Affiliation(s)
- Jingfeng Cheng
- Department of Radiology, Eye & ENT Hospital of Fudan University, Shanghai Medical School, Fudan University, 83 Fenyang Road, Shanghai, 200031, China
| | - Wenzhe Su
- Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China
| | - Yuzhe Wang
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Yang Zhan
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Yin Wang
- Department of Radiology, Eye & ENT Hospital of Fudan University, Shanghai Medical School, Fudan University, 83 Fenyang Road, Shanghai, 200031, China
| | - Shuyu Yan
- Fudan University, Shanghai, 200032, China
| | - Yuan Yuan
- Fudan University, Shanghai, 200032, China
| | | | - Zixun Wei
- Fudan University, Shanghai, 200032, China
| | - Shengjian Zhang
- Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China
| | - Xin Gao
- Shanghai Universal Medical Imaging Diagnostic Center, Shanghai, 200233, China.
| | - Zuohua Tang
- Department of Radiology, Eye & ENT Hospital of Fudan University, Shanghai Medical School, Fudan University, 83 Fenyang Road, Shanghai, 200031, China.
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Minonzio JG, Ramiandrisoa D, Schneider J, Kohut E, Streichhahn M, Stervbo U, Wirth R, Westhoff TH, Raum K, Babel N. Bi-Directional Axial Transmission measurements applied in a clinical environment. PLoS One 2022; 17:e0277831. [PMID: 36584002 PMCID: PMC9803229 DOI: 10.1371/journal.pone.0277831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 11/03/2022] [Indexed: 12/31/2022] Open
Abstract
Accurate measurement of cortical bone parameters may improve fracture risk assessment and help clinicians on the best treatment strategy. Patients at risk of fracture are currently detected using the current X-Ray gold standard DXA (Dual XRay Absorptiometry). Different alternatives, such as 3D X-Rays, Magnetic Resonance Imaging or Quantitative Ultrasound (QUS) devices, have been proposed, the latter having advantages of being portable and sensitive to mechanical and geometrical properties. The objective of this cross-sectional study was to evaluate the performance of a Bi-Directional Axial Transmission (BDAT) device used by trained operators in a clinical environment with older subjects. The device, positioned at one-third distal radius, provides two velocities: VFAS (first arriving signal) and VA0 (first anti-symmetrical guided mode). Moreover, two parameters are obtained from an inverse approach: Ct.Th (cortical thickness) and Ct.Po (cortical porosity), along with their ratio Ct.Po/Ct.Th. The areal bone mineral density (aBMD) was obtained using DXA at the femur and spine. One hundred and six patients (81 women, 25 men) from Marien Hospital and St. Anna Hospital (Herne, Germany) were included in this study. Age ranged from 41 to 95 years, while body mass index (BMI) ranged from 16 to 47 kg.m-2. Three groups were considered: 79 non-fractured patients (NF, 75±13years), 27 with non-traumatic fractures (F, 80±9years) including 14 patients with non-vertebral fractures (NVF, 84±7years). Weak to moderate significant Spearman correlations (R ranging from 0.23 to 0.53, p < 0.05) were found between ultrasound parameters and age, BMI. Using multivariate Partial Least Square discrimination analyses with Leave-One-Out Cross-Validation (PLS-LOOCV), we found the combination of VFAS and the ratio Ct.Po/Ct.Th to be predictive for all non traumatic fractures (F) with the odds ratio (OR) equals to 2.5 [1.6-3.4] and the area under the ROC curve (AUC) equal to 0.63 [0.62-0.65]. For the group NVF, combination of four parameters VA0. Ct.Th, Ct.Po and Ct.Po/Ct.Po, along with age provides a discrimination model with OR and AUC equals to 7.5 [6.0-9.1] and 0.75 [0.73-0.76]. When restricted to a smaller population (87 patients) common to both BDAT and DXA, BDAT ORs and AUCs are comparable or slightly higher to values obtained with DXA. The fracture risk assessment by BDAT method in older patients, in a clinical setting, suggests the benefit of the affordable and transportable device for the routine use.
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Affiliation(s)
- Jean-Gabriel Minonzio
- Sorbonne Université, INSERM UMR S 1146, CNRS UMR 7371, Laboratoire d’Imagerie Biomédicale, Paris, France
- Escuela de Ingeniería Informática, Universidad de Valparaíso, Valparaíso, Chile
- Centro de Investigación y Desarrollo en Ingeniería en Salud, Universidad de Valparaíso, Valparaíso, Chile
- * E-mail:
| | | | - Johannes Schneider
- Berlin-Brandenburg School for Regenerative Therapies, Charité - Universitätsmedizin Berlin, Germany
| | - Eva Kohut
- Medical Clinic I, Marien Hospital Herne, Ruhr University, Bochum, Herne, Germany
| | - Melanie Streichhahn
- Medical Clinic I, Marien Hospital Herne, Ruhr University, Bochum, Herne, Germany
| | - Ulrik Stervbo
- Berlin-Brandenburg School for Regenerative Therapies, Charité - Universitätsmedizin Berlin, Germany
- Center for Translational Medicine and Immune Diagnostics Laboratory, Medical Department I, Marien Hospital Herne, Ruhr University, Bochum, Herne, Germany
| | - Rainer Wirth
- Department for Geriatric Medicine, Marien Hospital Herne, Ruhr University Bochum, Herne, Germany
| | - Timm Henning Westhoff
- Center for Translational Medicine and Immune Diagnostics Laboratory, Medical Department I, Marien Hospital Herne, Ruhr University, Bochum, Herne, Germany
| | - Kay Raum
- Berlin-Brandenburg School for Regenerative Therapies, Charité - Universitätsmedizin Berlin, Germany
| | - Nina Babel
- Berlin-Brandenburg School for Regenerative Therapies, Charité - Universitätsmedizin Berlin, Germany
- Center for Translational Medicine and Immune Diagnostics Laboratory, Medical Department I, Marien Hospital Herne, Ruhr University, Bochum, Herne, Germany
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