Comparative assessment of bone mineral measurements obtained by use of dual-energy x-ray absorptiometry, peripheral quantitative computed tomography, and chemical-physical analyses in femurs of juvenile and adult dogs

Abnormal bone mineralization in a puppy fed an imbalanced raw meat homemade diet diagnosed and monitored using dual-energy X-ray absorptiometry

A 4-month-old male Old English Sheepdog was presented for evaluation of a raw meat-based homemade diet after a 1-month history of progressive lameness. Marked dietary deficiencies were detected, which included calcium, phosphorus and vitamin D. Hypovitaminosis D and hypocalcaemia were diagnosed by serum analysis. Evidence of severe diffuse osteopenia was noted on survey radiographs. Dual-energy X-ray absorptiometry (DEXA) was used to quantify bone mineral content and density and compare to published reference ranges. The puppy's initial bone mineralization was markedly subnormal, with bone mineral density 66% lower than expected, and bone mineral content 40% lower than expected. Subsequent DEXA scans were performed at intervals during the puppy's recovery to document the rate of bone re-mineralization and guide therapeutic recommendations. Marked improvement was achieved within 4 months through exercise control and feeding of a diet appropriately formulated for large breed puppy growth and development. This report reinforces the necessity of thorough dietary history and highlights the potential for malnutrition in pets fed homemade and raw meat-based diets. Use of DEXA has rarely been reported in clinical cases, yet can be a valuable tool for diagnosing and monitoring cases with abnormal bone mineralization. Further studies using DEXA to track bone mineralization in healthy puppies are encouraged to develop a more robust reference range of bone mineralization in growing dogs of varying sizes, weights and ages.

Long-term complications of glycogen storage disease type Ia in the canine model treated with gene replacement therapy

BACKGROUND

Glycogen storage disease type Ia (GSD Ia) in dogs closely resembles human GSD Ia. Untreated patients with GSD Ia develop complications associated with glucose-6-phosphatase (G6Pase) deficiency. Survival of human patients on intensive nutritional management has improved; however, long-term complications persist including renal failure, nephrolithiasis, hepatocellular adenomas (HCA), and a high risk for hepatocellular carcinoma (HCC). Affected dogs fail to thrive with dietary therapy alone. Treatment with gene replacement therapy using adeno-associated viral vectors (AAV) expressing G6Pase has greatly prolonged life and prevented hypoglycemia in affected dogs. However, long-term complications have not been described to date.

METHODS

Five GSD Ia-affected dogs treated with AAV-G6Pase were evaluated. Dogs were euthanized due to reaching humane endpoints related to liver and/or kidney involvement, at 4 to 8 years of life. Necropsies were performed and tissues were analyzed.

RESULTS

Four dogs had liver tumors consistent with HCA and HCC. Three dogs developed renal failure, but all dogs exhibited progressive kidney disease histologically. Urolithiasis was detected in two dogs; uroliths were composed of calcium oxalate and calcium phosphate. One affected and one carrier dog had polycystic ovarian disease. Bone mineral density was not significantly affected.

CONCLUSIONS

Here, we show that the canine GSD Ia model demonstrates similar long-term complications as GSD Ia patients in spite of gene replacement therapy. Further development of gene therapy is needed to develop a more effective treatment to prevent long-term complications of GSD Ia.

Quantitative computed tomographic evaluation of bone mineral density in beagle dogs: comparison with dual-energy x-ray absorptiometry as a gold standard

This study aimed to demonstrate the higher accuracy and reproducibility of quantitative computed tomography (QCT) compared with dual-energy X-ray absorptiometry (DXA) as a gold standard for measuring canine bone mineral density (BMD). Seven middle-aged beagle dogs underwent lumbar vertebral and bilateral femoral DXA and QCT scans. BMD (mg/cm²) was measured at the vertebral body from L2 to L6, femoral neck, and proximal and distal femoral diaphyses. The BMD values were measured 3 times and compared. The BMD value on QCT was higher than that on DXA for femoral BMD but not for vertebral BMD. The correlation was strong for the lumbar vertebrae (r=0.66) and was strongest for L3 (r=0.85). No correlation was found for the femoral neck (P=0.35), and only moderate correlations were found for the proximal and distal femoral diaphyses (r=0.43 and r=0.40, respectively). The limits of agreement were narrower for vertebral BMD than for femoral BMD, and L3 had the narrowest limits of agreement. The intraclass correlation (ICC) was higher for DXA than for QCT at all lumbar and femoral sites measured, but the ICC of QCT was higher than 0.7. In conclusion, L3 can be used to monitor changes in BMD, and relative values and sequential monitoring of femoral BMD can also be useful because of the high reproducibility of QCT measurements. QCT would be a useful technique for evaluation of BMD in veterinary practice.

Comparative investigation of bone mineral density using CT and DEXA in a canine femoral model

Bone density measurements using computed tomography (CT) instead of dual-energy X-ray absorptiometry (DEXA) are currently of great interest in human and veterinary medical research as it would be beneficial to use CT scans obtained for other indications also for determining bone density. For Hounsfield units (HU) measured with CT in specific regions of interests (ROIs) in one or several slice/s a correlation with bone mineral density (BMD) measured by DEXA in humans and dogs of between 0.44 and 0.77 is reported in the literature. In the present study, instead certain volumes of interest (VOIs) obtained by CT scan and the corresponding HU to the respective VOIs were compared with the bone mineral density of the corresponding areas measured by DEXA. The aim of the study was to investigate whether this procedure gives more accurate information about bone density of the bones as three-dimensional objects of the respective patient. Correlation between measured HU in the respective VOI and BMD measured with DEXA in the corresponding ROI showed a very good correlation of 0.93. Linear regression with R²  = 0.85 (p = 0.0262) was calculated. Except for VOI5, similar distribution of values and significant differences (p < 0.0001-0.0087) between ROIs/VOIs were detected. Determining HU for assessing bone mineral density in a certain volume provides more accurate results than those previously reported from two-dimensional (2D) CT measurements. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2667-2672, 2017.

Small-sized newborn dogs skeletal development: radiologic, morphometric, and histological findings obtained from spontaneously dead animals

BACKGROUND

Very little is known about neonatal skeletal development in small-sized purebred dogs. In order to improve this knowledge, 27 spontaneously dead puppies belonging to small-sized breeds were enrolled in this study for radiologic, histological and morphometric investigations.

RESULTS

The appearance of the limb secondary ossification centers and the onset of their formation were clearly observed by x rays and confirmed by histological evidences. Radiographic and anatomic measurements of limb bones length and skull length and width were positively correlated with body weight and age of the subjects and the body weight was positively correlated with radius bone mineral density, as demonstrated by dual-energy x-rays absorptiometry.

CONCLUSIONS

These data provided original information on the growth of newborn small-sized breed dogs, and suggest that cadavers may be useful to study skeletal development.

A prospective follow up of age related changes in the subchondral bone density of the talus of healthy Labrador Retrievers

Background

During growth, the skeletal structures adapt to the increased loading conditions and mature to a fully-grown skeleton. Subchondral bone density reflects the effect of long-term joint loading and it is expected to change over time. The aim of this study was to describe the long-term changes in the density distribution of the subchondral bone of the talus of healthy Labrador Retrievers in a prospective study.

Results

The subchondral bone density distribution was evaluated using computed tomographic osteoabsorptiometry (CTOAM). Visually, all joints showed very similar density distribution patterns. No significant differences in the topography of the density maxima were found between t₁ and t₂. The mean density, maximum density, and maximum area ratio (MAR) were significantly increased with increasing age.

Conclusions

The subchondral bone density of the talus of healthy Labrador Retrievers increases with increasing age. It is likely an adaptive response of the subchondral bone due to increased joint loading during growth.

Quantitative CT assessment of bone mineral density in dogs with hyperadrenocorticism

Canine hyperadrenocorticism (HAC) is one of the most common causes of general osteopenia. In this study, quantitative computed tomography (QCT) was used to compare the bone mineral densities (BMD) between 39 normal dogs and 8 dogs with HAC (6 pituitary-dependent hyperadrenocorticism [PDH]; pituitary dependent hyperadrenocorticism, 2 adrenal hyperadrenocorticism [ADH]; adrenal dependent hyperadrenocorticism) diagnosed through hormonal assay. A computed tomogaraphy scan of the 12th thoracic to 7th lumbar vertebra was performed and the region of interest was drawn in each trabecular and cortical bone. Mean Hounsfield unit values were converted to equivalent BMD with bone-density phantom by linear regression analysis. The converted mean trabecular BMDs were significantly lower than those of normal dogs. ADH dogs showed significantly lower BMDs at cortical bone than normal dogs. Mean trabecular BMDs of dogs with PDH using QCT were significantly lower than those of normal dogs, and both mean trabecular and cortical BMDs in dogs with ADH were significantly lower than those of normal dogs. Taken together, these findings indicate that QCT is useful to assess BMD in dogs with HAC.

Knee osteoarthritis patients with severe nocturnal pain have altered proximal tibial subchondral bone mineral density

OBJECTIVE

Our objective was to investigate relationships between proximal tibial subchondral bone mineral density (BMD) and nocturnal pain in patients with knee osteoarthritis (OA).

METHODS

The preoperative knee of 42 patients booked for knee arthroplasty was scanned using quantitative computed tomography (QCT). Pain was measured using the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and participants were categorized into three groups: 'no pain', 'moderate pain', and 'severe pain' while lying down at night. We used depth-specific image processing to assess tibial subchondral BMD at normalized depths of 0-2.5 mm, 2.5-5.0 mm and 5-10 mm relative to the subchondral surface. Regional analyses of each medial and lateral plateau included total BMD and maximum BMD within a 10 mm diameter core or 'focal spot'. The association between WOMAC pain scores and BMD measurements was assessed using Spearman's rank correlation. Regional BMD was compared pairwise between pain and no pain groups using multivariate analysis of covariance using age, sex, and BMI as covariates and Bonferroni adjustment for multiple comparisons.

RESULTS

Lateral focal BMD at the 2.5-5 mm depth was related to nocturnal pain (ρ = 0.388, P = 0.011). The lateral focal BMD was 33% higher in participants with 'severe pain' than participants with 'no pain' at 2.5-5 mm depth (P = 0.028) and 32% higher at 5-10 mm depth (P = 0.049). There were no BMD differences at 0-2.5 mm from the subchondral surface.

CONCLUSION

This study suggests that local subchondral bone density may have a role in elucidating OA-related pain pathogenesis.

Development and optimization of a high-throughput micro-computed tomography imaging method incorporating a novel analysis technique to evaluate bone mineral density of arthritic joints in a rodent model of collagen induced arthritis

Rheumatoid arthritis (RA) is a chronic autoimmune disease resulting in joint inflammation, pain, and eventual bone loss. Bone loss and remodeling caused by symmetric polyarthritis, the hallmark of RA, is readily detectable by bone mineral density (BMD) measurement using micro-CT. Abnormalities in these measurements over time reflect the underlying pathophysiology of the bone. To evaluate the efficacy of anti-rheumatic agents in animal models of arthritis, we developed a high throughput knee and ankle joint imaging assay to measure BMD as a translational biomarker. A bone sample holder was custom designed for micro-CT scanning, which significantly increased assay throughput. Batch processing 3-dimensional image reconstruction, followed by automated image cropping, significantly reduced image processing time. In addition, we developed a novel, automated image analysis method to measure BMD and bone volume of knee and ankle joints. These improvements significantly increased the throughput of ex vivo bone sample analysis, reducing data turnaround from 5 days to 24 hours for a study with 200 rat hind limbs. Taken together, our data demonstrate that BMD, as quantified by micro-CT, is a robust efficacy biomarker with a high degree of sensitivity. Our innovative approach toward evaluation of BMD using optimized image acquisition and novel image processing techniques in preclinical models of RA enables high throughput assessment of anti-rheumatic agents offering a powerful tool for drug discovery.

Densitometria óssea em gatos hígidos por tomografia computadorizada quantitativa

Estabeleceram-se valores de média radiodensidade do osso trabecular das vértebras lombares de 16 gatos adultos, hígidos, por meio da tomografia computadorizada quantitativa (TCQ). O valor médio de radiodensidade do osso trabecular da segunda vértebra lombar foi de 436,1±42,1 unidades Hounsfield, com distribuição não homogênea da radiodensidade no corpo vertebral.

Physiological values and factors affecting the metacarpal bone density of healthy feedlot beef cattle as measured by dual-energy X-ray absorptiometry

The metacarpal bone mineral density of 136 healthy feedlot beef cattle of four different breeds (Charolaise, Limousine, Irish Crossbreed and Slovakian Crossbreed) raised and fed on standard conditions was measured by means of a dual-energy X-ray absorptiometry technique in an ex vivo study design. The average reference values (mean ± SD) of bone mineral density (BMD) for animals aged between 12 and 22 months and weighing between 236 and 546 kg have been reported and the effects of (i) breed, (ii) gender, (iii) age and (iv) body weight on bone mineral density have been considered. A significant difference (i) among different breeds and (ii) between genders resulted, whereas a high correlation between bone density and (iii) age and (iv) body weight was detected within the same breed and gender, with body weight being the most important factor affecting BMD. A modern new technological insight into the study of bovine bone physio-pathology is proposed.

Aging and bone

Bones provide mechanical and protective function, while also serving as housing for marrow and a site for regulation of calcium ion homeostasis. The properties of bones do not remain constant with age; rather, they change throughout life, in some cases improving in function, but in others, function deteriorates. Here we review the modifications in the mechanical function and shape of bones, the bone cells, the matrix they produce, and the mineral that is deposited on this matrix, while presenting recent theories about the factors leading to these changes.

Computed tomography topographic mapping of subchondral density (CT-TOMASD) in osteoarthritic and normal knees: methodological development and preliminary findings

OBJECTIVES

To develop a precise imaging tool which measures three-dimensional (3D) subchondral bone mineral density (BMD), and investigate its ability to distinguish subchondral bone properties in osteoarthritic and normal cadaveric tibiae.

METHODS

We developed a novel imaging tool [Computed tomography topographic mapping of subchondral density (CT-TOMASD)], which employs a surface projection image processing technique to map 3D subchondral BMD measured in relation to depth from the joint surface. Sixteen intact cadaver knees from 10 donors (8M:2F; age: 77.8+/-7.4) were scanned using quantitative computed tomography (QCT). Projections of average BMD to normalized depths of 2.5mm and 5.0mm were acquired, with regional analyses including: (1) medial and lateral BMD, (2) anterior/central/posterior compartmental BMD, (3) max BMD contained within a 10mm diameter 'core', and (4) medial:lateral BMD ratio. Precision was assessed using coefficients of variation (CV%). Osteoarthritis (OA) severity was assessed by examination of computed tomography (CT) and fluoroscopic radiographic images, and categorized using modified Kellgren-Lawrence (mKL) scoring.

RESULTS

Precision errors for CT-TOMASD BMD measures were focused around 1.5%, reaching a maximum CV% of 3.5%. OA was identified in eight compartments of six knees. Substantial qualitative and quantitative differences were observed between the OA and normal knees, with the medial:lateral BMD ratio and peak core regional analyses demonstrating differences greater than 4.7 standard deviations (SDs) when compared with normals. Preliminary results revealed effect sizes ranging from 1.6 to 4.3 between OA and normal knees.

CONCLUSIONS

CT-TOMASD offers precise 3D measures of subchondral BMD. Preliminary results demonstrate large qualitative and quantitative differences and large effect sizes between OA and normal knees. This method has the potential to identify and quantify changes in subchondral BMD associated with OA disease progression.

Correlation of quantitative computed tomographic subchondral bone density and ash density in horses

The purpose of this study was to compare subchondral bone density obtained using quantitative computed tomography with ash density values from intact equine joints, and to determine if there are measurable anatomic variations in mean subchondral bone density. Five adult equine metacarpophalangeal joints were scanned with computed tomography (CT), disarticulated, and four 1-cm(3) regions of interest (ROI) cut from the distal third metacarpal bone. Bone cubes were ashed, and percent mineralization and ash density were recorded. Three-dimensional models were created of the distal third metacarpal bone from CT images. Four ROIs were measured on the distal aspect of the third metacarpal bone at axial and abaxial sites of the medial and lateral condyles for correlation with ash samples. Overall correlations of mean quantitative CT (QCT) density with ash density (r=0.82) and percent mineralization (r=0.93) were strong. There were significant differences between abaxial and axial ROIs for mean QCT density, percent bone mineralization and ash density (p<0.05). QCT appears to be a good measure of bone density in equine subchondral bone. Additionally, differences existed between axial and abaxial subchondral bone density in the equine distal third metacarpal bone.

Comparison of mean bone densities of three preparations of the distal portion of the equine third metacarpal bone measured by use of quantitative computed tomography

OBJECTIVE

To evaluate whether cutting equine subchondral bone to demarcate specific regions of interest (ROIs) influences the mean density for that bone as measured via quantitative computed tomography (QCT). Sample population-2 metacarpophalangeal joints from equine cadavers.

PROCEDURES

The distal portion of the third metacarpal bone of each intact metacarpophalangeal joint was scanned via CT to simulate in vivo conditions. Each joint was subsequently disarticulated and dissected, and the distal portion of the dissected third metacarpal bone in air was scanned. Then, six 1-cm(2) areas representing ROIs were cut into the distal condylar surfaces to depths of approximately 1 cm, and the bone was scanned again. Three-dimensional CT models of the 3 bone preparations were generated for each third metacarpal bone on the basis of data from each set of scan images, and densities of the 6 ROIs were measured. Mean bone densities for the 6 ROIs were compared among models of intact, dissected, and cut third metacarpal bone scans.

RESULTS

Mean bone density was significantly lower in cut bone preparations, compared with that in intact or dissected bone. Differences between mean bone densities for intact and dissected bone preparations were not significant.

CONCLUSIONS AND CLINICAL RELEVANCE

Cutting subchondral bone to demarcate specific ROIs prior to CT imaging significantly lowered mean bone density as measured via QCT and thus introduced substantial artifacts. These findings have direct implications on techniques for CT modeling of equine subchondral bone in the characterization of joint diseases in horses.

Bone microstructure and its associated genetic variability in 12 inbred mouse strains: microCT study and in silico genome scan

MicroCT analysis of 12 inbred strains of mice identified 5 novel chromosomal regions influencing skeletal phenotype. Bone morphology varied in a compartment- and site-specific fashion across strains and genetic influences contributed to the morphometric similarities observed in femoral and vertebral bone within the trabecular bone compartment.

INTRODUCTION

Skeletal development is known to be regulated by both heritable and environmental factors, but whether genetic influence on peak bone mass is site- or compartment-specific is unknown. This study examined the genetic variation of cortical and trabecular bone microarchitecture across 12 strains of mice.

MATERIALS AND METHODS

MicroCT scanning was used to measure trabecular and cortical bone morphometry in the femur and vertebra of 12 strains of 4-month-old inbred male mice. A computational genome mapping technique was used to identify chromosomal intervals associated with skeletal traits.

RESULTS

Skeletal microarchitecture varied in a compartment- and site-specific fashion across strains. Genome mapping identified 13 chromosomal intervals associated with skeletal traits and 5 of these intervals were novel. Trabecular microarchitecture in different bone sites correlated across strains and most of the chromosomal intervals associated with these trabecular traits were shared between skeletal sites. Conversely, no chromosomal intervals were shared between the trabecular and cortical bone compartments in the femur, even though there was a strong correlation for these different bone compartments across strains, suggesting site-specific regulation by environmental or intrinsic factors.

CONCLUSION

In summary, these data confirm that there are distinct genetic determinants that define the skeletal phenotype at the time when peak bone mass is being acquired, and that genomic regulation of bone morphology is specific for skeletal compartment.

Dual-energy X-ray Absorptiometry in Canine Legg-Calve-Perthes Disease

Radiographic examination and subsequent dual-energy X-ray absorptiometry scans of the hips were performed in seven dogs with monolateral Legg-Perthes-Calvé disease to quantify bone changes produced by osteonecrosis in the proximal femur on the affected and unaffected side. All dogs were found to be affected with grade 2 and 3 of the radiographic classification proposed by Ljunggren. Bone mineral density (g/cm(2)) of the femoral neck and proximal femoral metaphysis were evaluated on the affected and unaffected side; we detected no differences in bone mineral density for both regions of interest within the population studied in relation to gender, body weight and side analysed nor between the affected and the unaffected limb. We therefore assume that radiographic areas of decreased density in the proximal femoral epiphysis during chronic stages of Legg-Calvé-Perthes disease do not alter the global mineral content of the scanned region.