Improved accuracy of cortical bone mineralization measured by polychromatic microcomputed tomography using a novel high mineral density composite calibration phantom

Contrast-enhanced micro-computed tomography of compartment and time-dependent changes in femoral cartilage and subchondral plate in a murine model of osteoarthritis

A lack of understanding of the mechanisms underlying osteoarthritis (OA) progression limits the development of effective long-term treatments. Quantitatively tracking spatiotemporal patterns of cartilage and bone degeneration is critical for assessment of more appropriately targeted OA therapies. In this study, we use contrast-enhanced micro-computed tomography (μCT) to establish a timeline of subchondral plate (SCP) and cartilage changes in the murine femur after destabilization of the medial meniscus (DMM). We performed DMM or sham surgery in 10-12-week-old male C57Bl/6J mice. Femora were imaged using μCT after 0, 2, 4, or 8 weeks. Cartilage-optimized scans were performed after immersion in contrast agent CA4+. Bone mineral density distribution (BMDD), cartilage attenuation, SCP, and cartilage thickness and volume were measured, including lateral and medial femoral condyle and patellar groove compartments. As early as 2 weeks post-DMM, cartilage thickness significantly increased and cartilage attenuation, SCP volume, and BMDD mean significantly decreased. Trends in cartilage and SCP metrics within each joint compartment reflected those seen in global measurements, and both BMDD and SCP thickness were consistently greater in the lateral and medial condyles than the patellar groove. Sham surgery also resulted in significant changes to SCP and cartilage metrics, highlighting a potential limitation of using surgical models to study tissue morphology or composition changes during OA progression. Contrast-enhanced μCT analysis is an effective tool to monitor changes in morphology and composition of cartilage, and when combined with bone-optimized μCT, can be used to assess the progression of degenerative changes after joint injury.

Micro-CT analysis of the Lisfranc complex reveals higher bone mineral density in dorsal compared to plantar regions

Injuries to the Lisfranc complex may require surgical fixation, the stability of which may be correlated with bone mineral density (BMD). However, there is limited research on regional BMD variations in the Lisfranc complex. This study used quantitative micro-CT to characterize regional BMD in the four bones (medial cuneiform, intermediate cuneiform, first metatarsal, and second metatarsal) of this complex. Twenty-four cadaveric specimens were imaged with a calibration phantom using micro-CT. Each bone was segmented and divided into eight regions based on an anatomical coordinate system. BMD for each octant was calculated using scan-specific calibration equations and average image intensity. Differences between regions were analyzed using ANOVA with post hoc analysis and differences between groups of four octants in each plane were analyzed with t-tests with significance level α = 0.05. The highest density region in the medial cuneiform was the distal-dorsal-lateral and dorsal regions showed significantly higher BMD than plantar regions. The intermediate cuneiform had the highest density in the distal-dorsal-medial region and the dorsal and medial regions had higher BMD than the plantar and lateral regions, respectively. The densest region of the first metatarsal was the distal-dorsal-lateral and distal regions had significantly higher BMD than proximal regions. In the second metatarsal, the distal-dorsal-medial region had the highest density, and the distal, dorsal, and medial regions had significantly higher BMD than the proximal, plantar, and lateral regions, respectively. The predominant finding was a pattern of increased density in the dorsal bone regions, which may be relevant in the surgical management of Lisfranc injuries.

Cortical and trabecular morphometric properties of the human calvarium

There is currently a gap in the literature that quantitatively describes the complex bone microarchitecture within the diploë (trabecular bone) and cortical layers of the human calvarium. The purpose of this study was to determine the morphometric properties of the diploë and cortical tables of the human calvarium in which key interacting factors of sex, location on the calvarium, and layers of the sandwich structure were considered. Micro-computed tomography (micro-CT) was utilized to capture images at 18 μm resolution of male (n = 26) and female (n = 24) embalmed calvarium specimens in the frontal and parietal regions (N = 50). All images were post-processed and analyzed using vendor bundled CT-Analyzer software to determine the morphometric properties of the diploë and cortical layers. A two-way mixed (repeated measures) analysis of variance (ANOVA) was used to determine diploë morphometric properties accounting for factors of sex and location. A three-way mixed ANOVA was performed to determine cortical morphometric properties accounting for factors of cortical layer (inner and outer table), sex, and location. The study revealed no two-way interaction effects between sex and location on the diploë morphometry except for fractal dimension. Trabecular thickness and separation in the diploë were significantly greater in the male specimens; however, females showed a greater number of trabeculae and fractal dimension on average. Parietal specimens revealed a greater porosity, trabecular separation, and deviation from an ideal plate structure, but a lesser number of trabeculae and connectivity compared to the frontal location. Additionally, the study observed a lower density and greater porosity in the inner cortical layer than the outer which may be due to clear distinctions between each layer's physiological environment. The study provides valuable insight into the quantitative morphometry of the calvarium in which finite element modelers of the skull can refer to when designing detailed heterogenous or subject-specific skull models to effectively predict injury. Furthermore, this study contributes towards the recent developments on physical surrogate models of the skull which require approximate measures of calvarium bone architecture in order to effectively fabricate a model and then accurately simulate a traumatic head impact event.

Semi-automatic micro-CT segmentation of the midfoot using calibrated thresholds

PURPOSE

In the field of skeletal research, accurate and reliable segmentation methods are necessary for quantitative micro-CT analysis to assess bone quality. We propose a method of semi-automatic image segmentation of the midfoot, using the cuneiform bones as a model, based on thresholds set by phantom calibration that allows reproducible results in low cortical thickness bones.

METHODS

Manual and semi-automatic segmentation methods were compared in micro-CT scans of the medial and intermediate cuneiforms of 24 cadaveric specimens. The manual method used intensity thresholds, hole filling, and manual cleanup. The semi-automatic method utilized calibrated bone and soft tissue thresholds Boolean subtraction to cleanly identify edges before hole filling. Intra- and inter-rater reliability was tested for the semi-automatic method in all specimens. Mask volume and average bone mineral density (BMD) were measured for all masks, and the three-dimensional models were compared to the initial semi-automatic segmentation using an unsigned distance part comparison analysis. Segmentation methods were compared with paired t-tests with significance level 0.05, and reliability was analyzed by calculating intra-class correlation coefficients.

RESULTS

There were statistically significant differences in mask volume and BMD between the manual and semi-automatic segmentation methods in both bones. The intra- and inter-reliability was excellent for mask volume and bone density in both bones. Part comparisons showed a higher maximum distance between surfaces for the manual segmentation than the repeat semi-automatic segmentations.

CONCLUSION

We developed a semi-automatic micro-CT segmentation method based on calibrated thresholds. This method was designed specifically for use in bones with high rates of curvature and low cortical bone density, such as the cuneiforms, where traditional threshold-based segmentation is more challenging. Our method shows improvement over manual segmentation and was highly reliable, making it appropriate for use in quantitative micro-CT analysis.

Liquid Calibration Phantoms in Ultra-Low-Dose QCT for the Assessment of Bone Mineral Density

INTRODUCTION

Cortical bone is affected by metabolic diseases. Some studies have shown that lower cortical bone mineral density (BMD) is related to increases in fracture risk which could be diagnosed by quantitative computed tomography (QCT). Nowadays, hybrid iterative reconstruction-based (HIR) computed tomography (CT) could be helpful to quantify the peripheral bone tissue. A key focus of this paper is to evaluate liquid calibration phantoms for BMD quantification in the tibia and under hybrid iterative reconstruction-based-CT with the different hydrogen dipotassium phosphate (K₂HPO₄) concentrations phantoms.

METHODOLOGY

Four ranges of concentrations of K₂HPO₄ were made and tested with 2 exposure settings. Accuracy of the phantoms with ash gravimetry and intermediate K₂HPO₄ concentration as hypothetical patients were evaluated. The correlations and mean differences between measured equivalent QCT BMD and ash density as a gold standard were calculated. Relative percentage error (RPE) in CT numbers of each concentration over a 6-mo period was reported.

RESULTS

The correlation values (R² was close to 1.0), suggested that the precision of QCT-BMD measurements using standard and ultra-low dose settings were similar for all phantoms. The mean differences between QCT-BMD and the ash density for low concentrations (about 93 mg/cm³) were lower than high concentration phantoms with 135 and 234 mg/cm³ biases. In regard to accuracy test for hypothetical patient, RPE was up to 16.1% for the low concentration (LC) phantom for the case of high mineral content. However, the lowest RPE (0.4 to 1.8%) was obtained for the high concentration (HC) phantom, particularly for the high mineral content case. In addition, over 6 months, the K₂HPO₄ concentrations increased 25% for 50 mg/cm³ solution and 0.7 % for 1300 mg/cm³ solution in phantoms.

CONCLUSION

The excellent linear correlations between the QCT equivalent density and the ash density gold standard indicate that QCT can be used with submilisivert radiation dose. We conclude that using liquid calibration phantoms with a range of mineral content similar to that being measured will minimize bias. Finally, we suggest performing BMD measurements with ultra-low dose scan concurrent with iterative-based reconstruction to reduce radiation exposure.

Mineral deposition and vascular invasion of hydroxyapatite reinforced collagen scaffolds seeded with human adipose-derived stem cells

Background

Collagen-based scaffolds reinforced with hydroxyapatite (HA) are an attractive choice for bone tissue engineering because their composition mimics that of bone. We previously reported the development of compression-molded collagen-HA scaffolds that exhibited high porosity, interconnected pores, and mechanical properties that were well-suited for surgical handling and fixation. The objective of this study was to investigate these novel collagen-HA scaffolds in combination with human adipose-derived stem cells (hASCs) as a template for bone formation in a subcutaneous athymic mouse model.

Methods

Collagen-HA scaffolds and collagen-only scaffolds were fabricated as previously described, and a clinically approved bone void filler was used as a control for the material. Constructs were seeded with hASCs and were pre-treated with either control or osteogenic media. A cell-free group was also included. Scaffolds were implanted subcutaneously in the backs of athymic nude mice for 8 weeks. Mineral deposition was quantified via micro-computed tomography. Histological and immunofluorescence images of the explants were used to analyze their vascular invasion, remodeling and cellularity.

Results

Cell-free collagen-HA scaffolds and those that were pre-seeded with osteogenically differentiated hASCs supported mineral deposition and vascular invasion at comparable rates, while cell-seeded constructs treated with the control medium showed lower mineralization after implantation. HA-reinforcement allowed collagen constructs to maintain their shape, provided improved cell-tissue-scaffold integration, and resulted in a more organized tissue when pre-treated in an osteogenic medium. Scaffold type and pre-treatment also determined osteoclast activity and therefore potential remodeling of the constructs.

Conclusions

The results of this study cumulatively indicate that treatment medium and scaffold composition direct mineralization and angiogenic tissue formation in an ectopic model. The data suggest that it may be necessary to match the scaffold with a particular cell type and cell-specific pre-treatment to achieve optimal bone formation.

Design and Validation of Synchronous QCT Calibration Phantom: Practical Methodology

INTRODUCTION

Quantitative computed tomography (QCT) can supplement dual x-ray absorptiometry by enabling geometric and compartmental bone assessments. Whole-body spiral CT scanners are widely available and require a short scanning time of seconds, in contrast to peripheral QCT scanners, which require several minutes of scanning time. This study designed and evaluated the accuracy and precision of a homemade QCT calibration phantom using a whole-body spiral CT scanner.

MATERIALS AND METHODS

The QCT calibration phantom consisted of K₂HPO₄ solutions as reference. The reference material with various concentrations of 0, 50, 100, 200, 400, 1000, and 1200 mg/cc of K₂HPO₄ in water were used. For designing the phantom, we used the ABAQUS software.

RESULTS

The phantoms were used for performance assessment of QCT method through measurement of accuracy and precision errors, which were generally less than 5.1% for different concentrations. The correlation between CT numbers and concentration were close to one (R² = 0.99).

DISCUSSION

Because whole-body spiral CT scanners allow central bone densitometry, evaluating the accuracy and precision for the easy to use calibration phantom may improve the QCT bone densitometry test.

CONCLUSION

This study provides practical directions for applying a homemade calibration phantom for bone mineral density quantification in QCT technique.

Spatiotemporal characterization of microdamage accumulation in rat ulnae in response to uniaxial compressive fatigue loading

Repetitive fatigue loading can induce microdamage accumulation in bone matrix, which results in impaired mechanical properties and increased fracture susceptibility. However, the spatial distribution and time-variant process of microdamage accumulation in fatigue-loaded skeleton, especially for linear microcracks which are known to initiate bone remodeling, remain not fully understood. In this study, the time-varying process of the morphology and distribution of microcracks in rat ulnae subjected to uniaxial compressive fatigue loading was investigated. Right forelimbs of thirty four-month-old male Sprague-Dawley rats were subjected to one bout of cyclic ramp loading with 0.67 Hz at a normalized peak force of 0.055 N/g body weight for 6000 cycles, and the contralateral left ulnae were not loaded as the control samples. Ten rats were randomly euthanized on Days 3, 5, and 7 post fatigue loading. Our findings via two-dimensional histomorphometric measurements based on basic fuchsin staining and three-dimensional quantifications using contrast-enhanced micro-computed tomography (MicroCT) with precipitated BaSO₄ staining demonstrated that the accumulation of linear microcracks (increase in the amount of linear microcracks) on Day 5 was significantly higher than that on Day 3 and Day 7 post fatigue loading. Our histological and histomorphometric results revealed that linear microcrack density (Cr.Dn) in the tensile cortex at Days 3, 5 and 7 post fatigue loading was significantly higher than that in the compressive side, whereas linear microcrack length (Cr.Le) in the tensile cortex at Day 3 was significantly lower than that in the compressive cortex. Our findings revealed that microcrack accumulation exhibited a non-linear time-varying process at 3, 5 and 7 days post axial compressive fatigue loading (with observable peak Cr.Dn at Day 5). Our findings also revealed distinct distribution of microcrack density and morphology in rat ulnae with tensile and compressive strains, as characterized by more microcracks accumulated in tensile cortices, and longer cracks shown in compressive cortices.

Quantification of Volumetric Bone Mineral Density of Proximal Femurs Using a Two-Compartment Model and Computed Tomography Images

Objectives

Dual-energy X-ray absorptiometry (DXA) is frequently used to measure the areal bone mineral density (aBMD) in clinical practice. However, DXA measurements are affected by the bone thickness and the body size and are unable to indicate nonosseous areas within the trabecular bone. This study aims to quantify the volumetric bone mineral density (vBMD) using computed tomography (CT) images and the two-compartment model (TCM) methods.

Methods

The TCM method was proposed and validated by dipotassium phosphate (K₂HPO₄) phantoms and a standard forearm phantom. 28 cases with DXA scans and pelvic CT scans acquired within six months were retrospectively collected. The vBMD calculated by TCM was compared with the aBMD obtained from DXA.

Results

For the K₂HPO₄ phantoms with vBMD ranging from 0.135 to 0.467 g/cm³, the average difference between the real and calculated vBMD was 0.009 g/cm³ and the maximum difference was 0.019 g/cm³. For the standard forearm phantom with vBMD of 0.194, 0.103, and 0.054 g/cm³, the average differences between the real and calculated vBMD were 0.017, 0.014, and 0.011 g/cm³. In the clinical CT image validation, a good linear relationship between vBMD and aBMD was observed with the Pearson correlation coefficient of 0.920 (p < 0.01).

Conclusions

The proposed TCM method in combination with the homemade cortical bone equivalent phantom provides accurate quantification and spatial distribution of bone mineral content.

The fracture toughness of small animal cortical bone measured using arc-shaped tension specimens: Effects of bisphosphonate and deproteinization treatments

Small animal models, and especially transgenic models, have become widespread in the study of bone mechanobiology and metabolic bone disease, but test methods for measuring fracture toughness on multiple replicates or at multiple locations within a single small animal bone are lacking. Therefore, the objective of this study was to develop a method to measure cortical bone fracture toughness in multiple specimens and locations along the diaphysis of small animal bones. Arc-shaped tension specimens were prepared from the mid-diaphysis of rabbit ulnae and loaded to failure to measure the radial fracture toughness in multiple replicates per bone. The test specimen dimensions, crack length, and maximum load met requirements for measuring the plane strain fracture toughness. Experimental groups included a control group, bisphosphonate treatment group, and an ex vivo deproteinization treatment following bisphosphonate treatment (5 rabbits/group and 15 specimens/group). The fracture toughness of ulnar cortical bone from rabbits treated with zoledronic acid for six months exhibited no difference compared with the control group. Partially deproteinized specimens exhibited significantly lower fracture toughness compared with both the control and bisphosphonate treatment groups. The deproteinization treatment increased tissue mineral density (TMD) and resulted in a negative linear correlation between the measured fracture toughness and TMD. Fracture toughness measurements were repeatable with a coefficient of variation of 12-16% within experimental groups. Retrospective power analysis of the control and deproteinization treatment groups indicated a minimum detectable difference of 0.1MPa·m^1/2. Therefore, the overall results of this study suggest that arc-shaped tension specimens offer an advantageous new method for measuring the fracture toughness in small animal bones.

Validation of cortical bone mineral density distribution using micro-computed tomography

Changes in the bone mineral density distribution (BMDD), due to disease or drugs, can alter whole bone mechanical properties such as strength, stiffness and toughness. The methods currently available for assessing BMDD are destructive and two-dimensional. Micro-computed tomography (μCT) has been used extensively to quantify the three-dimensional geometry of bone and to measure the mean degree of mineralization, commonly called the tissue mineral density (TMD). The TMD measurement has been validated to ash density; however parameters describing the frequency distribution of TMD have not yet been validated. In the current study we tested the ability of μCT to estimate six BMDD parameters: mean, heterogeneity (assessed by the full-width-at-half-maximum (FWHM) and the coefficient of variation (CoV)), the upper and lower 5% cutoffs of the frequency distribution, and peak mineralization) in rat sized femoral cortical bone samples. We used backscatter scanning electron microscopy (bSEM) as the standard. Aluminum and hydroxyapatite phantoms were used to identify optimal scanner settings (70kVp, and 57μA, with a 1500ms integration time). When using hydroxyapatite samples that spanned a broad range of mineralization levels, high correlations were found between μCT and bSEM for all BMDD parameters (R2≥0.92, p<0.010). When using cortical bone samples from rats and various species machined to mimic rat cortical bone geometry, significant correlations between μCT and bSEM were found for mean mineralization (R2=0.65, p<0.001), peak mineralization (R2=0.61, p<0.001) the lower 5% cutoff (R2=0.62, p<0.001) and the upper 5% cutoff (R2=0.33, p=0.021), but not for heterogeneity, measured by FWHM (R2=0.05, p=0.412) and CoV (R2=0.04, p=0.469). Thus, while mean mineralization and most parameters used to characterize the BMDD can be assessed with μCT in rat sized cortical bone samples, caution should be used when reporting the heterogeneity.

Ectopic models for endochondral ossification: comparing pellet and alginate bead culture methods

Key aspects of native endochondral bone development and fracture healing can be mimicked in mesenchymal stem cells (MSCs) through standard in vitro chondrogenic induction. Exploiting this phenomenon has recently emerged as an attractive technique to engineer bone tissue, however, relatively little is known about the best conditions for doing so. The objective of the present study was to compare the bone-forming capacity and angiogenic induction of hypertrophic cell constructs containing human adipose-derived stem cells (hASCs) primed for chondrogenesis in two different culture systems: high-density pellets and alginate bead hydrogels. The hASC constructs were subjected to 4 weeks of identical chondrogenic induction in vitro, encapsulated in an agarose carrier, and then implanted subcutaneously in immune-compromised mice for 8 weeks to evaluate their endochondral potential. At the time of implantation, both pellets and beads expressed aggrecan and type II collagen, as well as alkaline phosphatase (ALP) and type X collagen. Interestingly, ASCs in pellets formed a matrix containing higher glycosaminoglycan and collagen contents than that in beads, and ALP activity per cell was higher in pellets. However, after 8 weeks in vivo, pellets and beads induced an equivalent volume of mineralized tissue and a comparable level of vascularization. Although osteocalcin and osteopontin-positive osteogenic tissue and new vascular growth was found within both types of constructs, all appeared to be better distributed throughout the hydrogel beads. The results of this ectopic model indicate that hydrogel culture may be an attractive alternative to cell pellets for bone tissue engineering via the endochondral pathway. Copyright © 2016 John Wiley & Sons, Ltd.

VALIDATION OF A BONE MINERAL DENSITY CALIBRATION PROTOCOL FOR MICRO-COMPUTED TOMOGRAPHY

Micro-computed tomography (micro-CT) is widely used for in vitro studies to characterize bone structure at the resolution of 10–100 microns. However, a densitometric calibration protocol is necessary to convert the X-ray attenuation coefficient provided by micro-CT in bone mineral density (BMD). The lastest one has an important role to improve the accuracy of subject-specific finite element models. This work presents a simple calibration protocol based on the use of solid hydroxyapatite phantoms with the correction of the beam hardening effect. The method was validated in comparison to ashing measures of cortical and trabecular human bone. In addition, bone samples tissue mineral density (TMD) was calculated with two different methods. The correlation between ash density and BMD was linear both for cortical ([Formula: see text]) and trabecular bone ([Formula: see text]). The analysis stratified by tissue type versus the pooled analysis confirmed the validity of a common linear model for both types of tissue ([Formula: see text]). Despite its simplicity, the correlation obtained in this work does not depend on the acquisition settings of the micro-CT. TMD was shown to be dependent on the tissue investigated, with values in the range of 1.15–1.21[Formula: see text]mg/mm3 for trabecular bone, and 1.19–1.29[Formula: see text]mg/mm3 for cortical bone. Results are of some interest for generating micro finite elements models.

Small teleost fish provide new insights into human skeletal diseases

Small teleost fish such as zebrafish and medaka are increasingly studied as models for human skeletal diseases. Efficient new genome editing tools combined with advances in the analysis of skeletal phenotypes provide new insights into fundamental processes of skeletal development. The skeleton among vertebrates is a highly conserved organ system, but teleost fish and mammals have evolved unique traits or have lost particular skeletal elements in each lineage. Several unique features of the skeleton relate to the extremely small size of early fish embryos and the small size of adult fish used as models. A detailed analysis of the plethora of interesting skeletal phenotypes in zebrafish and medaka pushes available skeletal imaging techniques to their respective limits and promotes the development of new imaging techniques. Impressive numbers of zebrafish and medaka mutants with interesting skeletal phenotypes have been characterized, complemented by transgenic zebrafish and medaka lines. The advent of efficient genome editing tools, such as TALEN and CRISPR/Cas9, allows to introduce targeted deficiencies in genes of model teleosts to generate skeletal phenotypes that resemble human skeletal diseases. This review will also discuss other attractive aspects of the teleost skeleton. This includes the capacity for lifelong tooth replacement and for the regeneration of dermal skeletal elements, such as scales and fin rays, which further increases the value of zebrafish and medaka models for skeletal research.

Hafnia (HfO2) nanoparticles as an X-ray contrast agent and mid-infrared biosensor

The interaction of hafnium oxide (HfO2) nanoparticles (NPs) with X-ray and mid-infrared radiation was investigated to assess the potential as a multifunctional diagnostic probe for X-ray computed tomography (CT) and/or mid-infrared biosensing. HfO2 NPs of controlled size were prepared by a sol-gel process and surface functionalized with polyvinylpyrrolidone, resulting in relatively spherical and monodispersed NPs with a tunable mean diameter in the range of ∼7-31 nm. The X-ray attenuation of HfO2 NPs was measured over 0.5-50 mM concentration and compared with Au NPs and iodine, which are the most prominent X-ray contrast agents currently used in research and clinical diagnostic imaging, respectively. At clinical CT tube potentials >80 kVp, HfO2 NPs exhibited superior or similar X-ray contrast compared to Au NPs, while both exhibited significantly greater X-ray contrast compared to iodine, due to the favorable location of the k-shell absorption edge for hafnium and gold. Moreover, energy-dependent differences in X-ray attenuation enabled simultaneous quantitative molecular imaging of each agent using photon-counting spectral (multi-energy) CT. HfO2 NPs also exhibited a strong mid-infrared absorption in the Reststrahlen band from ∼250-800 cm(-1) and negative permittivity below 695 cm(-1), which can enable development of mid-infrared biosensors and contrast agents, leveraging surface enhanced mid-infrared and/or phonon polariton absorption.

Acellular hydroxyapatite-collagen scaffolds support angiogenesis and osteogenic gene expression in an ectopic murine model: Effects of hydroxyapatite volume fraction

Acellular hydroxyapatite (HA) reinforced collagen scaffolds were previously reported to induce angiogenesis and osteogenesis after ectopic implantation but the effect of the HA volume fraction was not investigated. Therefore, the objective of this study was to investigate the effect of HA volume fraction on in vivo angiogenesis and osteogenesis in acellular collagen scaffolds containing 0, 20, and 40 vol % HA after subcutaneous ectopic implantation for up to 12 weeks in mice. Endogenous cell populations were able to completely and uniformly infiltrate the entire scaffold within 6 weeks independent of the HA content, but the cell density was increased in scaffolds containing HA versus collagen alone. Angiogenesis, remodeling of the original scaffold matrix, mineralization, and osteogenic gene expression were evident in scaffolds containing HA, but were not observed in collagen scaffolds. Moreover, HA promoted a dose-dependent increase in measured vascular density, cell density, matrix deposition, and mineralization. Therefore, the results of this study suggest that HA promoted the recruitment and differentiation of endogenous cell populations to support angiogenic and osteogenic activity in collagen scaffolds after subcutaneous ectopic implantation. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 104A: 2178-2188, 2016.

Fabrication and control of CT number through polymeric composites based on coronary plaque CT phantom applications

Biomedical phantoms are commonly used for various medical imaging modalities to improve imaging quality and procedures. Current biomedical phantoms fabricated commercially are high in cost and limited in the specificity of human environments and structures that can be mimicked. This study aimed to control the measurable computed tomography (CT) number in Hounsfield units through polymeric biomedical phantom materials using controlled amounts of hydroxyapatite (hA). The purpose was to fabricate CT phantoms capable of mimicking various coronary plaque types while introducing a fabrication technique and basis for a numerical model to which the technique may be applied. The CT number is tunable based on the controlled material properties of electron density and atomic numbers. Three different polymeric matrices of polyethylene (PE), thermoplastic polyurethane (TPU), and polyvinylidene fluoride (PVDF) were selected due to their varied specific densities and ease of fabrication acting as integral properties for CT phantom fabrication. These polymers were processed together with additions of hA in mass percentages of 2.5, 5, 10, and 20% hA as well as a 0% hA as a control for each polymeric material. By adding hA to PE, TPU, and PVDF an increasing trend was exhibited between CT number and weight percent of hA.

Development of an in vivo rabbit ulnar loading model

Ulnar and tibial cyclic compression in rats and mice have become the preferred animal models for investigating the effects of mechanical loading on bone modeling/remodeling. Unlike rodents, rabbits provide a larger bone volume and normally exhibit intracortical Haversian remodeling, which may be advantageous for investigating mechanobiology and pharmaceutical interventions in cortical bone. Therefore, the objective of this study was to develop and validate an in vivo rabbit ulnar loading model. Ulnar tissue strains during loading of intact forelimbs were characterized and calibrated to applied loads using strain gauge measurements and specimen-specific finite element models. Periosteal bone formation in response to varying strain levels was measured by dynamic histomorphometry at the location of maximum strain in the ulnar diaphysis. Ulnae loaded at 3000 microstrain did not exhibit periosteal bone formation greater than the contralateral controls. Ulnae loaded at 3500, 4000, and 4500 microstrain exhibited a dose-dependent increase in periosteal mineralizing surface (MS/BS) compared with contralateral controls during the second week of loading. Ulnae loaded at 4500 microstrain exhibited the most robust response with significantly increased MS/BS at multiple time points extending at least 2weeks after loading was ceased. Ulnae loaded at 5250 microstrain exhibited significant woven bone formation. Rabbits required greater strain levels to produce lamellar and woven bone on periosteal surfaces compared with rats and mice, perhaps due to lower basal levels of MS/BS. In summary, bone adaptation during rabbit ulnar loading was tightly controlled and may provide a translatable model for human bone biology in preclinical investigations of metabolic bone disease and pharmacological treatments.

Power and challenges of using zebrafish as a model for skeletal tissue imaging

The zebrafish (Danio rerio) is now a widely used model organism in biomedical research. The species is also increasingly used for studying skeletal development and regeneration and for understanding human skeletal diseases. The small size of this model organism is an advantage and an extreme challenge for visualizing and diagnosing the animals' skeleton. This applies especially to early stages of skeletal development. Similar challenges arise for the analysis of the skeleton of other small fish species, such as medaka (Oryzias latipes). High quality histological preparations and knowledge about the special quality of the zebrafish skeleton remain prerequisites for a correct analysis. In addition, new methods for fast and high-resolution 2D and 3D skeletal tissue screening are required for a maximal understanding of skeletal development. We, in this study, review advantages and limitations of adapting current visualization techniques for zebrafish skeletal research. We discuss the methods for in toto visualization, such as X-raying, micro-CT, Alizarin red staining and optical projection tomography. Techniques for in vivo imaging, such as second harmonic generation microscopy and two-photon excitation fluorescence, are also discussed. Finally, we explore the possibilities of light-sheet microscopy for the analysis of the zebrafish skeleton.

Hydroxyapatite reinforced collagen scaffolds with improved architecture and mechanical properties

Hydroxyapatite (HA) reinforced collagen scaffolds have shown promise for synthetic bone graft substitutes and tissue engineering scaffolds. Freeze-dried HA-collagen scaffolds are readily fabricated and have exhibited osteogenicity in vivo, but are limited by an inherent scaffold architecture that results in a relatively small pore size and weak mechanical properties. In order to overcome these limitations, HA-collagen scaffolds were prepared by compression molding HA reinforcements and paraffin microspheres within a suspension of concentrated collagen fibrils (∼ 180 mg/mL), cross-linking the collagen matrix, and leaching the paraffin porogen. HA-collagen scaffolds exhibited an architecture with high porosity (85-90%), interconnected pores ∼ 300-400 μm in size, and struts ∼ 3-100 μm in thickness containing 0-80 vol% HA whisker or powder reinforcements. HA reinforcement enabled a compressive modulus of up to ∼ 1 MPa, which was an order of magnitude greater than unreinforced collagen scaffolds. The compressive modulus was also at least one order of magnitude greater than comparable freeze-dried HA-collagen scaffolds and two orders of magnitude greater than absorbable collagen sponges used clinically. Moreover, scaffolds reinforced with up to 60 vol% HA exhibited fully recoverable elastic deformation upon loading to 50% compressive strain for at least 100,000 cycles. Thus, the scaffold mechanical properties were well-suited for surgical handling, fixation, and bearing osteogenic loads during bone regeneration. The scaffold architecture, permeability, and composition were shown to be conducive to the infiltration and differentiation of adipose-derive stromal cells in vitro. Acellular scaffolds were demonstrated to induce angiogenesis and osteogenesis after subcutaneous ectopic implantation by recruiting endogenous cell populations, suggesting that the scaffolds were osteoinductive.

Implications of high-dosage bisphosphonate treatment on bone tissue in the jaw and knee joint

Bisphosphonates are bone antiresorptive agents traditionally used on a relatively large scale for treatment of bone metabolic diseases and on a smaller scale for bone metastasis treatment. A study on the effects of bisphosphonate treatment on healthy instead of diseased animals will give more insight into the basic mechanisms of bisphosphonates and their effects on different bone sites. We aimed to assess the effect of BP on the mouse knee and jaw joint. Three-month old female C57BL/6 mice were used (twenty-four and eighteen control and experimental group, respectively). At baseline and after treatment with zoledronic acid (ZA) for one, three or six months, we combined bone assessment via µCT and additional histology. Our results showed that, in the knee joint, ZA treatment increased TMD, bone volume, trabecular thickness but did not influence cortical thickness. In both control and ZA group, a higher trabecular TMD compared to cortical TMD was seen. Unseen in the knee joint, ZA treatment in the jaw joint resulted in bone-site specific changes in mineralization; a significant time-dependent higher TMD was evident in the subchondral bone compared to the most distal region of the condyle. MicroCT images revealed the presence of mineral in this region and histology showed that this region did not contain mature bone tissue but cartilage-like tissue. Our data indicate the possibility of site-specific negative side effects, i.e., disturbing normal mandibular development under the influence of bisphosphonate therapy.

Fatigue microcracks that initiate fracture are located near elevated intracortical porosity but not elevated mineralization

In vivo microcracks in cortical bone are typically observed within more highly mineralized interstitial tissue, but postmortem investigations are inherently limited to cracks that did not lead to fracture which may be misleading with respect to understanding fracture mechanisms. We hypothesized that the one fatigue microcrack which initiates fracture is located spatially adjacent to elevated intracortical porosity but not elevated mineralization. Therefore, the spatial correlation between intracortical porosity, elevated mineralization, and fatigue microdamage was investigated by combining, for the first time, sequential, nondestructive, three-dimensional micro-computed tomography (micro-CT) measurements of each in cortical bone specimens subjected to compressive fatigue loading followed by a tensile overload to fracture. Fatigue loading resulted in significant microdamage accumulation and compromised mechanical properties upon tensile overload compared to control specimens. The microdamage that initiated fracture upon tensile overload was able to be identified in all fatigue-loaded specimens using contrast-enhanced micro-CT and registered images. Two-point (or pair) correlation functions revealed a spatial correlation between microdamage at the fracture initiation site and intracortical porosity, but not highly mineralized tissue, confirming the hypothesis. This difference was unique to the fracture initiation site. Intracortical porosity and highly mineralized tissue exhibited a significantly lower and higher probability, respectively, of being located spatially adjacent to all sites of microdamage compared to the fracture initiation site. Therefore, the results of this study suggest that human cortical bone is tolerant of most microcracks, which are generally compartmentalized within the more highly mineralized interstitial tissue, but a single microcrack of sufficient size located in spatial proximity to intracortical porosity can compromise fracture resistance.

Application of ultrasound on monitoring the evolution of the collagen fiber reinforced nHAC/CS composites in vivo

To date, fiber reinforce scaffolds have been largely applied to repair hard and soft tissues. Meanwhile, monitoring the scaffolds for long periods in vivo is recognized as a crucial issue before its wide use. As a consequence, there is a growing need for noninvasive and convenient methods to analyze the implantation remolding process in situ and in real time. In this paper, diagnostic medical ultrasound was used to monitor the in vivo bone formation and degradation process of the novel mineralized collagen fiber reinforced composite which is synthesized by chitosan (CS), nanohydroxyapatite (nHA), and collagen fiber (Col). To observe the impact of cells on bone remodeling process, the scaffolds were planted into the back of the SD rats with and without rat bone mesenchymal stem cells (rBMSCs). Systematic data of scaffolds in vivo was extracted from ultrasound images. Significant consistency between the data from the ultrasound and DXA could be observed (P < 0.05). This indicated that ultrasound may serve as a feasible alternative for noninvasive monitoring the evolution of scaffolds in situ during cell growth.

Viscoelastic properties of human cortical bone tissue depend on gender and elastic modulus

Bone exhibits rate-dependent failure behavior, suggesting that viscoelasticity is a factor in the damage and fracture of bone. Microdamage initiates at scales below the macroscopic porosity in bone, and, as such, is affected by the intrinsic viscoelasticity of the bone tissue. The viscoelasticity of the bone tissue can be measured by nanoindentation and recording the creep behavior at constant load. The viscoelastic properties have been used to assess differences in tissue behavior with respect to fracture healing, aging, and mouse strains. In this study, we compared the viscoelastic behavior of human cortical bone between genders by using nanoindentation at a fixed load of 10 mN to measure the creep time constant. Bones from females had a significantly greater time constant, indicating slower creep and relaxation, than bones from males. The creep time constants decreased with increasing tissue modulus. The mineralization, collagen content, and collagen cross-link density, which were bulk measurements, were analyzed to determine if the differences in viscoelastic behavior were explained by compositional differences in the bone. However, none of the parameters differed between genders, nor were they correlated to the viscoelastic time constant. As such, the difference must depend on other matrix proteins that we did not assess or differences in the microstructural organization. This is one of the only intrinsic bone material properties that has been found to differ between males and females, and it may be important for assessing differences in fracture risk, since crack propagation is generally sensitive to viscoelastic properties.

Further improvements on the factors affecting bone mineral density measured by quantitative micro-computed tomography

The effects of imaging parameters and special configuration of objects within the reconstruction space on the micro computed tomography (μCT) based mineral density have been explored, and a series of density correction curves have been presented. A manufacturer-provided calibration phantom (0, 100, 200, 400, 800 mg HA/cm(3)) was imaged at all possible imaging conditions (n=216) based on energy, resolution, vial diameter, beam hardening correction factor and averaging. For each imaging condition, a linear regression model was fitted to the observed versus expected densities, and the intercepts (β(0)) and slopes (β(1)) of the regression lines and each density level were modeled using multiple regression modeling. Additionally, a custom made phantom (0, 50, 150, 500, 800, 1000 and 1500 mg HA/cm(3)) was scanned in order to study the effects of location and orientation of an object within the reconstruction space and presence of surrounding objects on μCT based mineral density. The energy, vial diameter and beam hardening correction factor were significant predictors of cumineral density (P values<0.001), while averaging and resolution did not have a significant effect on the observed density values (P values>0.1) except for 0.0 density (P values<0.04). Varying the location of an object within the reconstruction space from the center to the periphery resulted in a drop in observed mineral density up to 10% (P values<0.005). The presence of surrounding densities resulted in decreased observed mineral density up to 17% at the center and up to 14% at the periphery of the reconstruction space (P values<0.001 for all densities). Changing the orientation of the sample also had a significant effect on the observed mineral density, resulting in up to 16% lower observed mineral density for vertical vs. horizontal orientation at the center of the reconstruction space (P value<0.001). We conclude that energy, resolution and post processing correction factor are significant predictors of the observed mineral density in μCT.

Deriving tissue density and elastic modulus from microCT bone scans

Tissue level density and elastic modulus are intrinsic properties that can be used to quantify bone material and analyses incorporating those quantities have been used to evaluate bone on a macroscopic scale. Micro-computed tomography (microCT) technology has been used to construct tissue level finite element models to simulate macroscopic fracture strength, however, a single method for assigning voxel-specific tissue density and elastic modulus based on those data has not been universally accepted. One method prevalent in the literature utilizes an empirical relationship that derives tissue stiffness as a function of bone calcium content weight fraction. To derive calcium content weight fraction from microCT scans, a measure of tissue density is required and a constant value is traditionally used. However, experimental data suggest a non-trivial amount of tissue heterogeneity suggesting a constant tissue density may not be appropriate. A theoretical derivation for determining the relationship between voxel-specific tissue density and microCT scan data (i.e., microCT derived tissue mineral density (TMD), mgHA/cm(3)) and bone constituent properties is proposed. Constant model parameters used in the derivation include the density of water, ash, and organics (i.e., bone constituents) and the volume fraction of the organics constituent. The effect of incorporating the theoretically derived tissue density (instead of a constant value) in determining voxel-specific elastic modulus resulted in a maximum observed increase of 12GPa (5.9GPa versus 17.9GPa, for the constant value and derived tissue density formulations, respectively) for a measured TMD of 1.02gHA/cm(3). Average and bounding quantities for the four constant model parameters were defined from the literature and the influence of those values on the derived tissue density and elastic modulus relationships were also evaluated. The theoretical relationships of tissue density and elastic modulus, with the average constant model parameters applied, were consistent with previously published empirical relationships derived from experimental data. Tissue density as a function of microCT TMD was formulated as a linear relationship and the density of water and ash was shown to solely influence the proportionality (i.e., slope) between those values. The density of water and organics (i.e., collagen) and the volume fraction of the organics constituent were shown to influence the constant offset (intercept) between tissue density and TMD with no influence from ash density. Incorporating tissue density heterogeneity into the derivation of elastic modulus resulted in a significant increase in predicted modulus (for microCT TMD ranges observed for healthy tissue) as compared to when a constant tissue density was used. The presented approach provides a novel method for deriving tissue-level bone material properties and quantifies the effect of assuming tissue homogeneity when calculating elastic modulus (when using a prevalent method in the literature) from microCT scan data.

Contrast-enhanced micro-computed tomography of fatigue microdamage accumulation in human cortical bone

Conventional methods used to image and quantify microdamage accumulation in bone are limited to histological sections, which are inherently invasive, destructive, two-dimensional, and tedious. These limitations inhibit investigation of microdamage accumulation with respect to volumetric spatial variation in mechanical loading, bone mineral density, and microarchitecture. Therefore, the objective of this study was to investigate non-destructive, three-dimensional (3-D) detection of microdamage accumulation in human cortical bone using contrast-enhanced micro-computed tomography (micro-CT), and to validate micro-CT measurements against conventional histological methods. Unloaded controls and specimens loaded in cyclic uniaxial tension to a 5% and 10% reduction in secant modulus were labeled with a precipitated BaSO₄ stain for micro-CT and basic fuchsin for histomorphometry. Linear microcracks were similarly labeled by BaSO₄ and basic fuchsin as shown by backscattered electron microscopy and light microscopy, respectively. The higher X-ray attenuation of BaSO₄ relative to the bone extracellular matrix provided enhanced contrast for the detection of damage that was otherwise not able to be detected by micro-CT prior to staining. Therefore, contrast-enhanced micro-CT was able to nondestructively detect the presence, 3-D spatial location, and accumulation of fatigue microdamage in human cortical bone specimens in vitro. Microdamage accumulation was quantified on segmented micro-CT reconstructions as the ratio of BaSO₄ stain volume (SV) to total bone volume (BV). The amount of microdamage measured by both micro-CT (SV/BV) and histomorphometry (Cr.N, Cr.Dn, Cr.S.Dn) progressively increased from unloaded controls to specimens loaded to a 5% and 10% reduction in secant modulus (p < 0.001). Group means for micro-CT measurements of damage accumulation were strongly correlated to those using histomorphometry (p < 0.05), validating the new methods. Limitations of the new methods in the present study included that the precipitated BaSO₄ stain was non-specific and non-biocompatible, and that micro-CT measurements exhibited greater variability compared to conventional histology. Nonetheless, contrast-enhanced micro-CT enabled non-destructive imaging and 3-D spatial information, which are not possible using conventional histological methods.