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Kumar R, Waisberg E, Ong J, Chima K, Amiri D, Tavakkoli A. Optimizing autonomous artificial intelligence diagnostics for neuro-ocular health in space missions. LIFE SCIENCES IN SPACE RESEARCH 2025; 44:64-66. [PMID: 39864913 DOI: 10.1016/j.lssr.2024.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2024] [Revised: 12/19/2024] [Accepted: 12/21/2024] [Indexed: 01/28/2025]
Abstract
Spaceflight-Associated Neuro-Ocular Syndrome (SANS) presents a critical risk in long-duration missions, with microgravity-induced changes that threaten astronaut vision and mission outcomes. Current SANS monitoring, limited to pre- and post-flight exams, lacks in-flight diagnostics, highlighting an urgent need for autonomous tools capable of real-time assessment. Grok, an AI platform by xAI, offers promising potential as an advanced diagnostic tool for space-based health monitoring. Originally developed for broader applications, Grok's high-resolution imaging capabilities could be adapted to detect early SANS indicators such as optic nerve edema and shifts in globe morphology, changes linked to fluid redistribution in space. However, realizing this vision requires algorithmic and hardware adjustments to address the unique physiological shifts astronauts experience. By advancing Grok's diagnostic capability, we strongly believe astronauts could manage SANS autonomously, bringing much-needed real-time, high-accuracy diagnostics to isolated, high-stakes environments-essential as humanity embarks on increasingly ambitious missions to Mars and beyond.
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Affiliation(s)
- Rahul Kumar
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL, United States.
| | - Ethan Waisberg
- Department of Clinical Neuroscience, University of Cambridge, Cambridge, United Kingdom
| | - Joshua Ong
- Department of Ophthalmology and Visual Sciences, University of Michigan Kellogg Eye Center, Ann Arbor, MI, United States
| | - Karsten Chima
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Dylan Amiri
- Mecklenburg Neurology Group, Charlotte, NC, United States
| | - Alireza Tavakkoli
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, NV, United States
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2
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Ronconi G, Ferrara PE, Codazza S, Gatto DM, La Cagnina F, Coraci D, Panunzio M, Ariani M, Ferriero G. Parkinson's disease and posture: evaluation with biometrical holistic of human body device: a pilot study. Front Surg 2024; 11:1413806. [PMID: 39606155 PMCID: PMC11598333 DOI: 10.3389/fsurg.2024.1413806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Accepted: 06/25/2024] [Indexed: 11/29/2024] Open
Abstract
Background Patients with Parkinson's disease (PD) commonly develop severe spinal deformity. The etiology of Parkinson's spinal deformity is not completely understood and in most cases is likely due to multiple factors. These include dystonia and focal myopathy. Clinical, neurophysiological, and radiological data must be considered to monitor the pathology and the effects of rehabilitation. The aim of this pilot study is to evaluate spine alignment with a surface topography analysis of Parkinson's patients with Biometrical Holistic of Human Body (BHOHB®) and to compare results with their x-rays spine standard as already done for adolescent scoliosis. Methods 32 adult patients affected by Parkinson disease, have been evaluated with BHOHB ®. The correspondence of the Cobb angles were evaluated using the BHOHB device and with standard spinal x-rays. Results A total of 32 patients were enrolled. The mean age was 67.45 years. In this pilot study the measurement of the correlations between the radiological and BHOHB® Cobb angles of the patients were excellent. Conclusion This preliminary result supports the use of BHOHB® as a device useful to monitor and measure posture in Parkinson's. This needs to be evaluated on a larger sample and over time. Keywords: Parkinson's disease, scoliosis, postural imbalance, neurophysiology.
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Affiliation(s)
- Gianpaolo Ronconi
- Department of Geriatrics, Orthopedics and Rheumatology, Università Cattolica del Sacro Cuore, Rome, Italy
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Rome, Italy
| | - Paola E. Ferrara
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Rome, Italy
| | | | - Dario M. Gatto
- Department of Neuroscience, Sense Organs and Thorax, Catholic University of the Sacred Heart, Rome, Italy
| | - Fabiana La Cagnina
- Physical and Rehabilitation Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Daniele Coraci
- Department of Neuroscience, Section of Rehabilitation, University of Padova, Padua, Italy
| | | | | | - Giorgio Ferriero
- Unit of Physical and Rehabilitation Medicine, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Varese, Italy
- Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
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3
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Wang Q, Wang Y, Jia Y, Liu Y, Gou Y, Xie X, Zhang Y. Correlation of thyroid function and sensitivity to thyroid hormone with spinal bone mineral content, bone mineral density, and osteoporotic vertebral fracture: A cross-sectional study based on NHANES. Medicine (Baltimore) 2024; 103:e40173. [PMID: 39496031 PMCID: PMC11537616 DOI: 10.1097/md.0000000000040173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 10/02/2024] [Indexed: 11/06/2024] Open
Abstract
Previous studies have demonstrated that thyroid hormone plays an important role in normal bone development, bone metabolism, and establishment of peak bone mass. However, the correlation of thyroid status with bone mineral content (BMC), bone mineral density (BMD), and osteoporotic vertebral fracture (OVF) is rarely discussed. The current study probes into the potential association between thyroid status and spinal BMC, BMD, and OVF from a novel perspective of thyroid function (TF) and sensitivity to thyroid hormone based on the National Health and Nutrition Examination Survey database. A total of 1844 participants were included in this study. The association of thyroid status with outcome variables, like spinal BMC, BMD, and OVF, was analyzed using thyroid function indices and sensitivity to thyroid hormone indices as influence factors. The correlation of them were assessed using univariate and multivariable weighted linear regression, weighted logistic regression models, restricted cubic spline model, and subgroup analyses. The results of this study showed that the association of free triiodothyronine (FT3)/free thyroxine (FT4) with BMC remained negatively associated after adjustment for all covariates. Higher thyroid peroxidase antibody (TPOAb) was significantly associated with an increased risk of developing OVF in both unadjusted and adjusted models. In addition, the results of the restricted cubic spline model were consistent with the weighted multivariate regression analysis after adjustment. The results of this cross-sectional study showed that higher FT3/FT4 and TPOAb were associated with decreased spinal BMC and the increased risk of OVF, indicating a complex link between thyroid status and bone health. Therefore, patients with hyperthyroidism, hypothyroidism, autoimmune thyroid disease, or abnormal peripheral thyroid sensitivity, especially who with elevated TPOAb or FT3/FT4, should focus on the prevention of vertebral osteopenia, osteoporosis, and OVF.
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Affiliation(s)
- Qilin Wang
- Department of Orthopaedics, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China
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4
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Naguib SM, Saleh MK, Hamza HM, Hosny KM, Kassem MA. A new superfluity deep learning model for detecting knee osteoporosis and osteopenia in X-ray images. Sci Rep 2024; 14:25434. [PMID: 39455632 PMCID: PMC11511848 DOI: 10.1038/s41598-024-75549-0] [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: 07/21/2024] [Accepted: 10/07/2024] [Indexed: 10/28/2024] Open
Abstract
This study proposes a new deep-learning approach incorporating a superfluity mechanism to categorize knee X-ray images into osteoporosis, osteopenia, and normal classes. The superfluity mechanism suggests the use of two distinct types of blocks. The rationale is that, unlike a conventional serially stacked layer, the superfluity concept involves concatenating multiple layers, enabling features to flow into two branches rather than a single branch. Two knee datasets have been utilized for training, validating, and testing the proposed model. We use transfer learning with two pre-trained models, AlexNet and ResNet50, comparing the results with those of the proposed model. The results indicate that the performance of the pre-trained models, namely AlexNet and ResNet50, was inferior to that of the proposed Superfluity DL architecture. The Superfluity DL model demonstrated the highest accuracy (85.42% for dataset1 and 79.39% for dataset2) among all the pre-trained models.
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Affiliation(s)
- Soaad M Naguib
- Information Systems Department, Zagazig University, Zagazig, 44519, Egypt
| | - Mohammed K Saleh
- Department of Orthopedic Surgery, Zagazig University, Zagazig, 44519, Egypt
| | - Hanaa M Hamza
- Information Technology Department, Zagazig University, Zagazig, 44519, Egypt
| | - Khalid M Hosny
- Information Technology Department, Zagazig University, Zagazig, 44519, Egypt.
| | - Mohamed A Kassem
- Dept. of Robotics and Intelligent Machines, Kafr El Sheikh University, Kafr El Sheikh, Egypt
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5
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Tseng SC, Lien CE, Lee CH, Tu KC, Lin CH, Hsiao AY, Teng S, Chiang HH, Ke LY, Han CL, Lee YC, Huang AC, Yang DJ, Tsai CW, Chen KH. Clinical Validation of a Deep Learning-Based Software for Lumbar Bone Mineral Density and T-Score Prediction from Chest X-ray Images. Diagnostics (Basel) 2024; 14:1208. [PMID: 38928624 PMCID: PMC11202681 DOI: 10.3390/diagnostics14121208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Revised: 05/31/2024] [Accepted: 06/03/2024] [Indexed: 06/28/2024] Open
Abstract
Screening for osteoporosis is crucial for early detection and prevention, yet it faces challenges due to the low accuracy of calcaneal quantitative ultrasound (QUS) and limited access to dual-energy X-ray absorptiometry (DXA) scans. Recent advances in AI offer a promising solution through opportunistic screening using existing medical images. This study aims to utilize deep learning techniques to develop a model that analyzes chest X-ray (CXR) images for osteoporosis screening. This study included the AI model development stage and the clinical validation stage. In the AI model development stage, the combined dataset of 5122 paired CXR images and DXA reports from the patients aged 20 to 98 years at a medical center was collected. The images were enhanced and filtered for hardware retention such as pedicle screws, bone cement, artificial intervertebral discs or severe deformity in target level of T12 and L1. The dataset was then separated into training, validating, and testing datasets for model training and performance validation. In the clinical validation stage, we collected 440 paired CXR images and DXA reports from both the TCVGH and Joy Clinic, including 304 pared data from TCVGH and 136 paired data from Joy Clinic. The pre-clinical test yielded an area under the curve (AUC) of 0.940, while the clinical validation showed an AUC of 0.946. Pearson's correlation coefficient was 0.88. The model demonstrated an overall accuracy, sensitivity, and specificity of 89.0%, 88.7%, and 89.4%, respectively. This study proposes an AI model for opportunistic osteoporosis screening through CXR, demonstrating good performance and suggesting its potential for broad adoption in preliminary screening among high-risk populations.
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Affiliation(s)
- Sheng-Chieh Tseng
- Department of Orthopedic Surgery, Taichung Veterans General Hospital, Taichung 40705, Taiwan
- Rong Hsing Research Center for Translational Medicine, National Chung Hsing University, Taichung 402202, Taiwan
- PhD Program in Translational Medicine, National Chung Hsing University, Taichung 402202, Taiwan
| | - Chia-En Lien
- Acer Medical Inc., 7F, No. 86, Sec. 1, Xintai 5th Rd. Xizhi, New Taipei City 221421, Taiwan
| | - Cheng-Hung Lee
- Department of Orthopedic Surgery, Taichung Veterans General Hospital, Taichung 40705, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung 402202, Taiwan
| | - Kao-Chang Tu
- Department of Orthopedic Surgery, Taichung Veterans General Hospital, Taichung 40705, Taiwan
- Graduate Institute of Biomedical Engineering, National Chung Hsing University, Taichung 402202, Taiwan
| | - Chia-Hui Lin
- Department of Computer Science and Engineering, National Chung Hsing University, Taichung 402202, Taiwan
| | - Amy Y. Hsiao
- Acer Medical Inc., 7F, No. 86, Sec. 1, Xintai 5th Rd. Xizhi, New Taipei City 221421, Taiwan
| | - Shin Teng
- Acer Medical Inc., 7F, No. 86, Sec. 1, Xintai 5th Rd. Xizhi, New Taipei City 221421, Taiwan
| | - Hsiao-Hung Chiang
- Acer Medical Inc., 7F, No. 86, Sec. 1, Xintai 5th Rd. Xizhi, New Taipei City 221421, Taiwan
| | - Liang-Yu Ke
- Acer Inc., 7F-5, No. 369, Fuxing N. Rd., Songshan Dist., Taipei City 10541, Taiwan
| | - Chun-Lin Han
- Acer Inc., 7F-5, No. 369, Fuxing N. Rd., Songshan Dist., Taipei City 10541, Taiwan
| | - Yen-Cheng Lee
- Acer Inc., 7F-5, No. 369, Fuxing N. Rd., Songshan Dist., Taipei City 10541, Taiwan
| | - An-Chih Huang
- Acer Inc., 7F-5, No. 369, Fuxing N. Rd., Songshan Dist., Taipei City 10541, Taiwan
| | - Dun-Jhu Yang
- Acer Inc., 7F-5, No. 369, Fuxing N. Rd., Songshan Dist., Taipei City 10541, Taiwan
| | - Chung-Wen Tsai
- Joy Clinic, No. 37 Jilin Rd., Luzhu Dist., Taoyuan City 338120, Taiwan
| | - Kun-Hui Chen
- Department of Orthopedic Surgery, Taichung Veterans General Hospital, Taichung 40705, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung 402202, Taiwan
- Department of Computer Science and Information Engineering, Providence University, Taichung 40301, Taiwan
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Chen B, Cui J, Li C, Xu P, Xu G, Jiang J, Xue P, Sun Y, Cui Z. Application of radiomics model based on lumbar computed tomography in diagnosis of elderly osteoporosis. J Orthop Res 2024; 42:1356-1368. [PMID: 38245854 DOI: 10.1002/jor.25789] [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: 08/06/2023] [Revised: 12/31/2023] [Accepted: 01/04/2024] [Indexed: 01/22/2024]
Abstract
A metabolic bone disease characterized by decreased bone formation and increased bone resorption is osteoporosis. It can cause pain and fracture of patients. The elderly are prone to osteoporosis and are more vulnerable to osteoporosis. In this study, radiomics are extracted from computed tomography (CT) images to screen osteoporosis in the elderly. Collect the plain scan CT images of lumbar spine, cut the region of interest of the image and extract radiomics features, use Lasso regression to screen variables and adjust complexity, use python language to model random forests, support vector machines, K nearest neighbor, and finally use receiver operating characteristic curve to evaluate the performance of the model, including precision, recall, accuracy and area under the curve (AUC). For the model, 14 radiolomics features were selected. The diagnosis performance of random forest model and support vector machine is good, all around 0.9. The AUC of K nearest neighbor model in training set and test set is 0.828 and 0.796, respectively. We selected the plain scan CT images of the elderly lumbar spine to build radiomics features model, which has good diagnostic performance and can be used as a tool to assist the diagnosis of osteoporosis in the elderly.
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Affiliation(s)
- Baisen Chen
- Department of Orthopedics, Nantong City No. 1 People's Hospital and Second Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, China
- Nantong University, Nantong, Jiangsu Province, China
| | - Jiaming Cui
- Department of Orthopedics, Nantong City No. 1 People's Hospital and Second Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, China
| | - Chaochen Li
- Department of Orthopedics, Nantong City No. 1 People's Hospital and Second Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, China
- Nantong University, Nantong, Jiangsu Province, China
- Key Laboratory for Restoration Mechanism and Clinical Translation of Spinal Cord Injury, Nantong, China
- Research Institute for Spine and Spinal Cord Disease of Nantong University, Nantong, China
| | - Pengjun Xu
- Department of Orthopedics, Nantong University Affiliated Hospital, Nantong, Jiangsu, China
| | - Guanhua Xu
- Department of Orthopedics, Nantong City No. 1 People's Hospital and Second Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, China
| | - Jiawei Jiang
- Department of Orthopedics, Nantong City No. 1 People's Hospital and Second Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, China
| | - Pengfei Xue
- Department of Orthopedics, Nantong City No. 1 People's Hospital and Second Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, China
| | - Yuyu Sun
- Department of Orthopedic, Nantong Third People's Hospital, Nantong, Jiangsu Province, China
| | - Zhiming Cui
- Department of Orthopedics, Nantong City No. 1 People's Hospital and Second Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, China
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Shin M, Seo M, Lee K, Yoon K. Super-resolution techniques for biomedical applications and challenges. Biomed Eng Lett 2024; 14:465-496. [PMID: 38645589 PMCID: PMC11026337 DOI: 10.1007/s13534-024-00365-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 02/12/2024] [Accepted: 02/18/2024] [Indexed: 04/23/2024] Open
Abstract
Super-resolution (SR) techniques have revolutionized the field of biomedical applications by detailing the structures at resolutions beyond the limits of imaging or measuring tools. These techniques have been applied in various biomedical applications, including microscopy, magnetic resonance imaging (MRI), computed tomography (CT), X-ray, electroencephalogram (EEG), ultrasound, etc. SR methods are categorized into two main types: traditional non-learning-based methods and modern learning-based approaches. In both applications, SR methodologies have been effectively utilized on biomedical images, enhancing the visualization of complex biological structures. Additionally, these methods have been employed on biomedical data, leading to improvements in computational precision and efficiency for biomedical simulations. The use of SR techniques has resulted in more detailed and accurate analyses in diagnostics and research, essential for early disease detection and treatment planning. However, challenges such as computational demands, data interpretation complexities, and the lack of unified high-quality data persist. The article emphasizes these issues, underscoring the need for ongoing development in SR technologies to further improve biomedical research and patient care outcomes.
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Affiliation(s)
- Minwoo Shin
- School of Mathematics and Computing (Computational Science and Engineering), Yonsei University, 50 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722 Republic of Korea
| | - Minjee Seo
- School of Mathematics and Computing (Computational Science and Engineering), Yonsei University, 50 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722 Republic of Korea
| | - Kyunghyun Lee
- School of Mathematics and Computing (Computational Science and Engineering), Yonsei University, 50 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722 Republic of Korea
| | - Kyungho Yoon
- School of Mathematics and Computing (Computational Science and Engineering), Yonsei University, 50 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722 Republic of Korea
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Almeida OP, Page A, Sanfilippo FM, Etherton-Beer C. Prospective Association Between the Dispensing of Antidepressants and of Medications to Treat Osteoporosis in Older Age. Am J Geriatr Psychiatry 2024; 32:349-357. [PMID: 37919102 DOI: 10.1016/j.jagp.2023.10.004] [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: 08/11/2023] [Revised: 09/15/2023] [Accepted: 10/04/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUND Osteoporosis is a common condition associated with fragility fractures, especially in older individuals and women. Antidepressants have emerged as a potential risk factor, but their association with bone fragility remains uncertain because the results of past studies are difficult to generalize. We aimed to investigate the association between antidepressant exposure and subsequent treatment for osteoporosis in a nationally representative sample of Australians. METHODS Cohort study using a 10% random sample of the Pharmaceutical Benefits Scheme (PBS) data for 2012, that included 566,707 individuals aged older than or equal to 50 years not dispensed osteoporosis medications. The effect of exposure to antidepressants during 2012 (prevalent or incident) or later (up to 2022) was examined using Cox regression models adjusted for age, sex, comorbidities and other psychotropic medications. RESULTS Over 10 years, 73,360 (12.94%) received osteoporosis medications; 16,216 (22.10%) had been dispensed antidepressants in 2012. The hazard of osteoporosis medication dispensing was higher among those exposed to antidepressants (HR = 1.16, 99% CI = 1.14-1.18; average duration of follow up: 8.0 ± 3.1 years, range: 1-10 years). The hazard of osteoporosis medication diminished with increasing age, and the effect of antidepressants was 37%-76% more pronounced among men in the 50s and 60s. Different classes of antidepressants had a similar risk profile. CONCLUSION The dispensing of antidepressants in older age is associated with higher hazard of subsequent dispensing of medications for osteoporosis, and this association is more marked for young older adults, particularly men. Clinicians should monitor the bone health of older individuals treated with antidepressants in order to decrease the morbidity associated with fragility fractures.
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Affiliation(s)
- Osvaldo P Almeida
- Medical School (OPA, CE-B), University of Western Australia, Perth, Australia.
| | - Amy Page
- School of Allied Health (AP), University of Western Australia, Perth, Australia
| | - Frank M Sanfilippo
- School of Population and Global Health (FMS), University of Western Australia, Perth, Australia
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Xu W, Xie W, Yu D, Sun H, Gu Y, Tao X, Qian M, Cheng L, Wang H, Cheng Q. Theoretical and experimental study of attenuation in cancellous bone. JOURNAL OF BIOMEDICAL OPTICS 2024; 29:S11526. [PMID: 38505736 PMCID: PMC10949015 DOI: 10.1117/1.jbo.29.s1.s11526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 02/16/2024] [Accepted: 02/19/2024] [Indexed: 03/21/2024]
Abstract
Significance Photoacoustic (PA) technology shows great potential for bone assessment. However, the PA signals in cancellous bone are complex due to its complex composition and porous structure, making such signals challenging to apply directly in bone analysis. Aim We introduce a photoacoustic differential attenuation spectrum (PA-DAS) method to separate the contribution of the acoustic propagation path to the PA signal from that of the source, and theoretically and experimentally investigate the propagation attenuation characteristics of cancellous bone. Approach We modified Biot's theory by accounting for the high frequency and viscosity. In parallel with the rabbit osteoporosis model, we build an experimental PA-DAS system featuring an eccentric excitation differential detection mechanism. Moreover, we extract a PA-DAS quantization parameter-slope-to quantify the attenuation of high- and low-frequency components. Results The results show that the porosity of cancellous bone can be evaluated by fast longitude wave attenuation at different frequencies and the PA-DAS slope of the osteoporotic group is significantly lower compared with the normal group (**p < 0.01 ). Conclusions Findings demonstrate that PA-DAS effectively differentiates osteoporotic bone from healthy bone, facilitating quantitative assessment of bone mineral density, and osteoporosis diagnosis.
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Affiliation(s)
- Wenyi Xu
- Tongji University, Institute of Acoustics, School of Physics Science and Engineering, Shanghai, China
| | - Weiya Xie
- Tongji University, Institute of Acoustics, School of Physics Science and Engineering, Shanghai, China
| | - Dong Yu
- Tongji University, Institute of Acoustics, School of Physics Science and Engineering, Shanghai, China
| | - Haohan Sun
- Tongji University, Institute of Acoustics, School of Physics Science and Engineering, Shanghai, China
| | - Ying Gu
- Tongji University, Institute of Acoustics, School of Physics Science and Engineering, Shanghai, China
| | - Xingliang Tao
- Tongji University, Institute of Acoustics, School of Physics Science and Engineering, Shanghai, China
| | - Menglu Qian
- Tongji University, Institute of Acoustics, School of Physics Science and Engineering, Shanghai, China
| | - Liming Cheng
- Tongji University, Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Shanghai, China
| | - Hao Wang
- Tongji University, Institute of Acoustics, School of Physics Science and Engineering, Shanghai, China
| | - Qian Cheng
- Tongji University, Institute of Acoustics, School of Physics Science and Engineering, Shanghai, China
- National Key Laboratory of Autonomous Intelligent Unmanned Systems, Shanghai, China
- Frontiers Science Center for Intelligent Autonomous Systems, Ministry of Education, Shanghai, China
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10
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Gu Y, Otake Y, Uemura K, Soufi M, Takao M, Talbot H, Okada S, Sugano N, Sato Y. Bone mineral density estimation from a plain X-ray image by learning decomposition into projections of bone-segmented computed tomography. Med Image Anal 2023; 90:102970. [PMID: 37774535 DOI: 10.1016/j.media.2023.102970] [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: 03/01/2023] [Revised: 07/25/2023] [Accepted: 09/11/2023] [Indexed: 10/01/2023]
Abstract
Osteoporosis is a prevalent bone disease that causes fractures in fragile bones, leading to a decline in daily living activities. Dual-energy X-ray absorptiometry (DXA) and quantitative computed tomography (QCT) are highly accurate for diagnosing osteoporosis; however, these modalities require special equipment and scan protocols. To frequently monitor bone health, low-cost, low-dose, and ubiquitously available diagnostic methods are highly anticipated. In this study, we aim to perform bone mineral density (BMD) estimation from a plain X-ray image for opportunistic screening, which is potentially useful for early diagnosis. Existing methods have used multi-stage approaches consisting of extraction of the region of interest and simple regression to estimate BMD, which require a large amount of training data. Therefore, we propose an efficient method that learns decomposition into projections of bone-segmented QCT for BMD estimation under limited datasets. The proposed method achieved high accuracy in BMD estimation, where Pearson correlation coefficients of 0.880 and 0.920 were observed for DXA-measured BMD and QCT-measured BMD estimation tasks, respectively, and the root mean square of the coefficient of variation values were 3.27 to 3.79% for four measurements with different poses. Furthermore, we conducted extensive validation experiments, including multi-pose, uncalibrated-CT, and compression experiments toward actual application in routine clinical practice.
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Affiliation(s)
- Yi Gu
- Graduate School of Science and Technology, Nara Institute of Science and Technology, Ikoma, Nara 630-0192, Japan; CentraleSupélec, Université Paris-Saclay, Inria, Gif-sur-Yvette 91190, France.
| | - Yoshito Otake
- Graduate School of Science and Technology, Nara Institute of Science and Technology, Ikoma, Nara 630-0192, Japan.
| | - Keisuke Uemura
- Department of Orthopeadic Medical Engineering, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan.
| | - Mazen Soufi
- Graduate School of Science and Technology, Nara Institute of Science and Technology, Ikoma, Nara 630-0192, Japan
| | - Masaki Takao
- Department of Bone and Joint Surgery, Ehime University Graduate School of Medicine, Toon, Ehime 791-0295, Japan
| | - Hugues Talbot
- CentraleSupélec, Université Paris-Saclay, Inria, Gif-sur-Yvette 91190, France
| | - Seiji Okada
- Department of Orthopaedics, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan
| | - Nobuhiko Sugano
- Department of Orthopeadic Medical Engineering, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan
| | - Yoshinobu Sato
- Graduate School of Science and Technology, Nara Institute of Science and Technology, Ikoma, Nara 630-0192, Japan.
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Glushkov EV, Glushkova NV, Ermolenko OA, Tatarinov AM. Study of Ultrasonic Guided Wave Propagation in Bone Composite Structures for Revealing Osteoporosis Diagnostic Indicators. MATERIALS (BASEL, SWITZERLAND) 2023; 16:6179. [PMID: 37763457 PMCID: PMC10532914 DOI: 10.3390/ma16186179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/30/2023] [Accepted: 09/09/2023] [Indexed: 09/29/2023]
Abstract
Tubular bones are layered waveguide structures composed of soft tissue, cortical and porous bone tissue, and bone marrow. Ultrasound diagnostics of such biocomposites are based on the guided wave excitation and registration by piezoelectric transducers applied to the waveguide surface. Meanwhile, the upper sublayers shield the diseased interior, creating difficulties in extracting information about its weakening from the surface signals. To overcome these difficulties, we exploit the advantages of the Green's matrix-based approach and adopt the methods and algorithms developed for the guided wave structural health monitoring of industrial composites. Based on the computer models implementing this approach and experimental measurements performed on bone phantoms, we analyze the feasibility of using different wave characteristics to detect hidden diagnostic signs of developing osteoporosis. It is shown that, despite the poor excitability of the most useful modes associated with the diseased inner layers, the use of the improved matrix pencil method combined with objective functions based on the Green's matrix allows for effective monitoring of changes in the elastic moduli of the deeper sublayers. We also note the sensitivity and monotonic dependence of the resonance response frequencies on the degradation of elastic properties, making them a promising indicator for osteoporosis diagnostics.
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Affiliation(s)
- Evgeny V. Glushkov
- Institute for Mathematics, Mechanics and Informatics, Kuban State University, Krasnodar 350040, Russia; (N.V.G.); (O.A.E.)
| | - Natalia V. Glushkova
- Institute for Mathematics, Mechanics and Informatics, Kuban State University, Krasnodar 350040, Russia; (N.V.G.); (O.A.E.)
| | - Olga A. Ermolenko
- Institute for Mathematics, Mechanics and Informatics, Kuban State University, Krasnodar 350040, Russia; (N.V.G.); (O.A.E.)
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Al-Rawaf HA, Gabr SA, Iqbal A, Alghadir AH. MicroRNAs as potential biopredictors for premenopausal osteoporosis: a biochemical and molecular study. BMC Womens Health 2023; 23:481. [PMID: 37689658 PMCID: PMC10493018 DOI: 10.1186/s12905-023-02626-3] [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: 06/06/2023] [Accepted: 08/29/2023] [Indexed: 09/11/2023] Open
Abstract
BACKGROUND Circulating micro-RNAs have been proposed as a new type of biomarker in several diseases, particularly those related to bone health. They have shown great potential due to their feasibility and simplicity of measurement in all body fluids, especially urine, plasma, and serum. AIM This study aimed to evaluate the expression of a set of mRNAs, namely miR-21, miR-24, mir-100, miR-24a, miR-103-3p, and miR-142-3p. Their proposed roles in the progression of osteoporosis were identified using a real-time polymerase chain reaction (RT-PCR) analysis in premenopausal women. In addition, their correlations with osteocalcin (OC), bone-specific alkaline phosphatase (BAP), and deoxypyridinoline (DPD) bone markers were explored. METHODS A total of 85 healthy premenopausal women aged 25-50 years old were included in this study. Based on a DXA scan (Z-score) analysis and calcaneus broadband ultrasound attenuation scores (c-BUAs), measured via quantitative ultrasound (QUS), the subjects were classified into three groups: normal group (n = 25), osteopenia (n = 30), and osteoporosis (n = 30). Real-time-PCR and immunoassay analyses were performed to determine miRNA expression levels and serum OC, s-BAP, and DPD, respectively, as biomarkers of bone health. RESULTS Among the identified miRNAs, only miR-21, miR-24, and mir-100 were significantly upregulated and increased in the serum of patients with osteopenia and osteoporosis, and miR-24a, miR-103-3p, and miR-142-3p were downregulated and significantly decreased in osteoporosis. Both upregulated and downregulated miRNAs were significantly correlated with BMD, c-BUA, OC, s-BAP, and DPD. CONCLUSION A group of circulating miRNAs was shown to be closely correlated with the parameters BMD, c-BUA, OC, s-BAP, and DPD, which are traditionally used for bone-health measurements. They could be identified as non-invasive biomarkers in premenopausal patients with osteoporosis. More studies with large sample sizes are recommended to estimate the mechanistic role of miRNAs in osteoporosis pathogenesis and to provide evidence for the use of these miRNAs as a non-invasive method of diagnosing clinical osteoporosis, especially in premenopausal patients.
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Affiliation(s)
- Hadeel A. Al-Rawaf
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, 11433 Saudi Arabia
| | - Sami A. Gabr
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, 11433 Saudi Arabia
| | - Amir Iqbal
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, 11433 Saudi Arabia
| | - Ahmad H. Alghadir
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, 11433 Saudi Arabia
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Anupama D, Noronha JA, Acharya KK, Prabhu M, Ravishankar N, Nayak BS. Effect of Lifestyle Modification Intervention Programme on Bone Mineral Density among Postmenopausal Women with Osteoporosis. Sultan Qaboos Univ Med J 2023; 23:387-393. [PMID: 37655089 PMCID: PMC10467558 DOI: 10.18295/squmj.1.2023.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 01/15/2023] [Accepted: 02/08/2023] [Indexed: 02/24/2023] Open
Abstract
Objectives Osteoporosis is one of the major public health problems worldwide among postmenopausal osteoporotic women. Lifestyle modification interventions along with pharmacotherapy help to revert bone loss and prevent complications. Methods A randomised controlled trial was conducted at Kasturba Hospital, Manipal from January 2019 to December 2021 among postmenopausal women with osteoporosis. The postmenopausal women who attended the osteoporosis clinic and were within the age group of 45-65 years, could speak and understand English or Kannada and whose bone mineral density (BMD) score was between -1 and -3 were included in the study. The total sample size of the study was 120 with 60 in each of the experimental and control groups. After obtaining informed consent, a stratified block randomisation method was used to allocate the participants to intervention and control groups. The BMD was monitored by the portable ultrasound densitometer by a technician at the outpatient departments. The baseline information was collected by a structured demographic questionnaire. Intervention group participants received a lifestyle modification intervention program (LMIP) whereas the control group received standard regular care from the physician. Follow-up was done at three and six months. Results The results revealed that the increase in the BMD median score among the experimental group was from -2.2 (-2.5- -1.8) to -1.5 (-1.8- -0.65) whereas in the control group, it was from -2.3 (-2.6- -1.9) to -2.0 (-2.4- -1.5). The results of the Mann Whitey U test showed a statistical significance between the intervention and control groups in the post-test after six months (U = 505.5; P <0.05). Wilcoxon signed rank test showed a significant change in both the intervention and control groups from pre-test to post-test I (3 months) and post-test II (6 months; P <0.001). Conclusion The lifestyle modification intervention was found to be effective in improving the bone health status of postmenopausal women. Hence it is very important to integrate it into regular therapy.
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Affiliation(s)
- D.S Anupama
- Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, India
| | - Judith A. Noronha
- Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, India
| | | | - Mukhyaprana Prabhu
- Departments of Medicine, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India
| | - N. Ravishankar
- Department of Biostatistics, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India
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Al Hajj Ibrahim S, El-Khatib K. To segment or not to segment: COVID-19 detection for chest X-rays. INFORMATICS IN MEDICINE UNLOCKED 2023; 40:101280. [PMID: 37346468 PMCID: PMC10211251 DOI: 10.1016/j.imu.2023.101280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 05/17/2023] [Accepted: 05/22/2023] [Indexed: 06/23/2023] Open
Abstract
Artificial intelligence (AI) has been integrated into most technologies we use. One of the most promising applications in AI is medical imaging. Research demonstrates that AI has improved the performance of most medical imaging analysis systems. Consequently, AI has become a fundamental element of the state of the art with improved outcomes across a variety of medical imaging applications. Moreover, it is believed that computer vision (CV) algorithms are highly effective for image analysis. Recent advances in CV facilitate the recognition of patterns in medical images. In this manner, we investigate CV segmentation techniques for COVID-19 analysis. We use different segmentation techniques, such as k-means, U-net, and flood fill, to extract the lung region from CXRs. Afterwards, we compare the effectiveness of these three segmentation approaches when applied to CXRs. Then, we use machine learning (ML) and deep learning (DL) models to identify COVID-19 lesion molecules in both healthy and pathological lung x-rays. We evaluate our ML and DL findings in the context of CV techniques. Our results indicate that the segmentation-related CV techniques do not exhibit comparable performance to DL and ML techniques. The most optimal AI algorithm yields an accuracy range of 0.92-0.94, whereas the addition of CV algorithms leads to a reduction in accuracy to approximately the range of 0.81-0.88. In addition, we test the performance of DL models under real-world noise, such as salt and pepper noise, which negatively impacts the overall performance.
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Gokcek A, Karabay EO, Yegin MA, Cakmakci E, Gencer S. Can Ultrasonographic Measurement of Bone Cortical Thickness Predict Osteoporosis? Acad Radiol 2023; 30:516-527. [PMID: 36050265 DOI: 10.1016/j.acra.2022.07.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/21/2022] [Accepted: 07/24/2022] [Indexed: 01/25/2023]
Abstract
RATIONALE AND OBJECTIVES In this study, we aimed to describe a more accessible and safe diagnostic tool for osteoporosis or osteopenia diagnosis. We utilized cortical thickness (CoT) measurement of various bones via ultrasonography and evaluated the method's accuracy relative to bone mineral density (BMD) results determined by dual-energy X-ray absorptiometry (DXA). MATERIALS AND METHODS A total of 200 volunteers (all female) who agreed to participate in the study and had undergone BMD measurement (femoral or vertebral) were included in the study. Patients with normal BMD result (≥-1.0 T-score) were defined as controls. CoT measurements were made from three bones (radius, tibia, and second metatarsal) for each patient via ultrasonography. RESULTS Radius CoT and tibial CoT measurements of both femoral and vertebral osteoporotic or osteopenic patients were significantly higher compared to controls. Second metatarsal CoT of femoral osteoporotic and osteopenic patients was also found to be significantly higher than the control group. We found tibia CoT and radius CoT to have high sensitivity and positive predictive value in identifying patients with abnormal femoral T-scores (<-1). In multivariable analyzes, radius CoT was found to be independently predictive in distinguishing patients with abnormal T-score (<-1) from controls in both the femur and vertebral BMD groups. CONCLUSION Radius CoT and tibia CoT values appear to have value in predicting patients with abnormal T-scores measured via DXA. This method may be a very simple technique that can be used for early detection of osteoporosis and osteopenia, but its results need to be supported by more comprehensive studies.
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Affiliation(s)
- Atila Gokcek
- Department of Radiology, Ankara Atatürk Sanatorium Training and Research Hospital, Ankara, Turkey
| | | | - Merve Aktimur Yegin
- Department of Physical Therapy and Rehabilitation, Iskenderun State Hospital, Hatay, Turkey
| | - Emin Cakmakci
- Department of Radiology, Ankara Atatürk Sanatorium Training and Research Hospital, Ankara, Turkey.
| | - Serap Gencer
- Department of Radiology, Ankara Atatürk Sanatorium Training and Research Hospital, Ankara, Turkey
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16
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Fan J, Lv Y, Xu X, Zhou F, Zhang Z, Tian Y, Ji H, Guo Y, Yang Z, Hou G. Evaluation of femoral head bone quality by Hounsfield units: A predictor of implant failure for intertrochanteric fractures after intramedullary nail fixation. Front Surg 2023; 9:816742. [PMID: 36684160 PMCID: PMC9852507 DOI: 10.3389/fsurg.2022.816742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 10/21/2022] [Indexed: 01/09/2023] Open
Abstract
Purpose The aim of present study is to evaluate the femoral head bone quality by Hounsfield units and its relationship to the occurrence of implant failure for intertrochanteric fractures after intramedullary nail fixation. Methods This retrospective study assessed 160 intertrochanteric fractures treated with intramedullary fixation. Patients with and without implant failure were divided into failure and control groups, respectively. The demographic information, femoral head Hounsfield unit (HU) value, the reduction quality, status of posteromedial support and position of the screw/blade were collected and compared. The logistic regression analyses were performed to evaluate risk factors of implant failure in intertrochanteric fractures after intramedullary nail fixation. Results Of the patients, 15 (9.38%) suffered from implant failure after intramedullary fixation. The mean HU value of femoral head was much lower in the failure group than the control group (133.25 ± 34.10 vs. 166.12 ± 42.68, p = 0.004). And the univariate analyses showed that A3 fracture and poor reduction quality were associated with implant failure (p < 0.05). After adjustment for confounding variables, the multivariable logistic regression analyzes showed that femoral head HU value (odds ratio [OR], 0.972; 95% CI, 0.952-0.993; p = 0.008) and poor reduction quality (OR, 7.614; 95% CI, 1.390-41.717; p = 0.019) were independent influencing factors for implant failure. Conclusion The femoral head HU value was significantly correlated with the incidence of implant failure and can be used as an independent factor to predict implant failure for intertrochanteric fractures after intramedullary fixation.
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Affiliation(s)
- Jixing Fan
- Department of Orthopedics, Peking University Third Hospital, Beijing, China,Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, China
| | - Yang Lv
- Department of Orthopedics, Peking University Third Hospital, Beijing, China,Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, China
| | - Xiangyu Xu
- Department of Orthopedics, Peking University Third Hospital, Beijing, China,Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, China
| | - Fang Zhou
- Department of Orthopedics, Peking University Third Hospital, Beijing, China,Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, China,Correspondence: Fang Zhou
| | - Zhishan Zhang
- Department of Orthopedics, Peking University Third Hospital, Beijing, China,Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, China
| | - Yun Tian
- Department of Orthopedics, Peking University Third Hospital, Beijing, China,Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, China
| | - Hongquan Ji
- Department of Orthopedics, Peking University Third Hospital, Beijing, China,Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, China
| | - Yan Guo
- Department of Orthopedics, Peking University Third Hospital, Beijing, China,Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, China
| | - Zhongwei Yang
- Department of Orthopedics, Peking University Third Hospital, Beijing, China,Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, China
| | - Guojin Hou
- Department of Orthopedics, Peking University Third Hospital, Beijing, China,Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, China
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Wang F, Zheng K, Lu L, Xiao J, Wu M, Kuo CF, Miao S. Lumbar Bone Mineral Density Estimation From Chest X-Ray Images: Anatomy-Aware Attentive Multi-ROI Modeling. IEEE TRANSACTIONS ON MEDICAL IMAGING 2023; 42:257-267. [PMID: 36155432 DOI: 10.1109/tmi.2022.3209648] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Osteoporosis is a common chronic metabolic bone disease often under-diagnosed and under-treated due to the limited access to bone mineral density (BMD) examinations, e.g., via Dual-energy X-ray Absorptiometry (DXA). This paper proposes a method to predict BMD from Chest X-ray (CXR), one of the most commonly accessible and low-cost medical imaging examinations. The proposed method first automatically detects Regions of Interest (ROIs) of local CXR bone structures. Then a multi-ROI deep model with transformer encoder is developed to exploit both local and global information in the chest X-ray image for accurate BMD estimation. The proposed method is evaluated on 13719 CXR patient cases with ground truth BMD measured by the gold standard DXA. The model predicted BMD has a strong correlation with the ground truth (Pearson correlation coefficient 0.894 on lumbar 1). When applied in osteoporosis screening, it achieves a high classification performance (average AUC of 0.968). As the first effort of using CXR scans to predict the BMD, the proposed algorithm holds strong potential to promote early osteoporosis screening and public health.
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18
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Clements M, Heffernan M, Ward M, Hoey L, Doherty LC, Hack Mendes R, Clarke MM, Hughes CF, Love I, Murphy S, McDermott E, Grehan J, McCann A, McAnena LB, Strain JJ, Brennan L, McNulty H. A 2-Year Randomized Controlled Trial With Low-Dose B-Vitamin Supplementation Shows Benefits on Bone Mineral Density in Adults With Lower B12 Status. J Bone Miner Res 2022; 37:2443-2455. [PMID: 36128889 PMCID: PMC10092614 DOI: 10.1002/jbmr.4709] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 09/04/2022] [Accepted: 09/17/2022] [Indexed: 01/19/2023]
Abstract
Folate, vitamins B12, B6, and riboflavin are required for one-carbon metabolism and may affect bone health, but no previous randomized trial has investigated all four nutrients in this context. We investigated the effect of low-dose B-vitamins for 2 years on bone mineral density (BMD) in a dual-centered, 2-year randomized controlled trial (RCT) in adults aged ≥50 years. Eligible participants not consuming B-vitamin supplements or fortified foods >4 times weekly were randomized to receive daily either combined folic acid (200 μg), vitamin B12 (10 μg), vitamin B6 (10 mg), and riboflavin (5 mg), or "active" placebo, whereby both the intervention and placebo groups received vitamin D (10 μg). BMD was assessed before and after intervention using dual-energy X-ray absorptiometry (DXA) scanning of the total hip, femoral neck, and lumbar spine (L1 to L4). Of 205 eligible participants randomized, 167 completed the trial in full. B-vitamin intervention resulted in increases in serum folate (p < 0.001), serum B12 (p < 0.001), and plasma pyridoxal-5-phosphate (p < 0.001) and decreases in functional biomarkers of B-vitamin status, erythrocyte glutathione reductase activation coefficient (p < 0.001), serum methylmalonic acid (MMA; p < 0.001), and serum total homocysteine (p < 0.001). B-vitamin intervention had no overall effect on BMD, which declined in both treatment groups by approximately 1% (ranging from -0.7% to -1.4%). However, in participants with lower baseline B12 status (serum B12 <246 pmol/L or MMA ≥0.22 μmol/L), B-vitamin intervention reduced the 2-year BMD decline versus placebo: adjusted mean (95% confidence interval [CI]) change of -0.003 (-0.008, 0.002) versus -0.015 (-0.021, -0.010) g/cm2 at the total hip and -0.004 (-0.010, 0.001) versus -0.013 (-0.018, -0.007) g/cm2 at the femoral neck. In conclusion, the findings indicate that although low-dose B-vitamin intervention for 2 years had no overall effect on BMD, improving B-vitamin status appears to have specific benefits for bone health in adults with lower B12 status. © 2022 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Michelle Clements
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Maria Heffernan
- UCD School of Agriculture and Food Science, Institute of Food and Health, Conway Institute, University College Dublin, Dublin, Ireland
| | - Mary Ward
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Leane Hoey
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Leanne C Doherty
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Roberta Hack Mendes
- UCD School of Agriculture and Food Science, Institute of Food and Health, Conway Institute, University College Dublin, Dublin, Ireland
| | - Michelle M Clarke
- UCD School of Agriculture and Food Science, Institute of Food and Health, Conway Institute, University College Dublin, Dublin, Ireland
| | - Catherine F Hughes
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Ingrid Love
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Shauna Murphy
- Section of Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Dublin, Ireland
| | - Eilish McDermott
- Section of Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Dublin, Ireland
| | - Jennifer Grehan
- Section of Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Dublin, Ireland
| | | | - Liadhan B McAnena
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - J J Strain
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Lorraine Brennan
- UCD School of Agriculture and Food Science, Institute of Food and Health, Conway Institute, University College Dublin, Dublin, Ireland
| | - Helene McNulty
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
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Miura K, Khantachawana A, Wakamori T, Matsubara H, Tanaka SM. Optical bone densitometry insensitive to skin thickness. BIOMED ENG-BIOMED TE 2022; 67:503-512. [DOI: 10.1515/bmt-2021-0314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 08/25/2022] [Indexed: 11/15/2022]
Abstract
Abstract
Skin thickness, including the adipose layer, which varies from individual to individual, affects the bone density measurement using light. In this study, we proposed a method to measure skin thickness using light and to correct the bias caused by differences in skin thickness and verified the proposed method by experiments using a phantom. We measured simulated skin of different thicknesses and bovine trabecular bone of different bone mineral densities (BMDs) using an optical system consisting of lasers of 850 and 515 nm wavelengths, lenses, and slits. Although the slope of the light intensity distribution formed on the surface of the material when irradiated by the 850 nm laser is affected by the thickness of the skin phantom. The difference of the intensity distribution peaks (δy) between the 850 and 515 nm lasers was strongly correlated with the thickness of the skin phantom. The coefficient of determination between the measurements and the BMD was improved by correcting the 850 nm laser measurements with δy. This result suggests that the method is applicable to optical bone densitometry, which is insensitive to differences in skin thickness.
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Affiliation(s)
- Kaname Miura
- Mechanical Science and Engineering , Graduate School of Natural Science and Technology, Kanazawa University , Kanazawa , Ishikawa, Japan
- Biological Engineering Program , Faculty of Engineering, King Mongkut’s University of Technology Thonburi , Bangkok , Thailand
| | - Anak Khantachawana
- Department of Mechanical Engineering , Faculty of Engineering, King Mongkut’s University of Technology Thonburi , Bangkok , Thailand
| | - Tsuyoshi Wakamori
- Mechanical Science and Engineering , Graduate School of Natural Science and Technology, Kanazawa University , Kanazawa , Ishikawa, Japan
| | - Hidenori Matsubara
- Department of Orthopaedic Surgery , Graduate School of Medical Sciences, Kanazawa University , Kanazawa , Ishikawa, Japan
| | - Shigeo M. Tanaka
- Institute of Science and Engineering, Faculty of Frontier Engineering, Kanazawa University , Kanazawa , Ishikawa, Japan
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Current Status of the Diagnosis and Management of Osteoporosis. Int J Mol Sci 2022; 23:ijms23169465. [PMID: 36012730 PMCID: PMC9408932 DOI: 10.3390/ijms23169465] [Citation(s) in RCA: 138] [Impact Index Per Article: 46.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/17/2022] [Accepted: 08/19/2022] [Indexed: 11/29/2022] Open
Abstract
Osteoporosis has been defined as the silent disease of the 21st century, becoming a public health risk due to its severity, chronicity and progression and affecting mainly postmenopausal women and older adults. Osteoporosis is characterized by an imbalance between bone resorption and bone production. It is diagnosed through different methods such as bone densitometry and dual X-rays. The treatment of this pathology focuses on different aspects. On the one hand, pharmacological treatments are characterized by the use of anti-resorptive drugs, as well as emerging regenerative medicine treatments such as cell therapies and the use of bioactive hydrogels. On the other hand, non-pharmacological treatments are associated with lifestyle habits that should be incorporated, such as physical activity, diet and the cessation of harmful habits such as a high consumption of alcohol or smoking. This review seeks to provide an overview of the theoretical basis in relation to bone biology, the existing methods for diagnosis and the treatments of osteoporosis, including the development of new strategies.
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21
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Xie W, Feng T, Yu D, Ta D, Cheng L, Cheng Q. Photoacoustic characterization of bone physico-chemical information. BIOMEDICAL OPTICS EXPRESS 2022; 13:2668-2681. [PMID: 35774314 PMCID: PMC9203098 DOI: 10.1364/boe.457278] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 03/27/2022] [Accepted: 03/28/2022] [Indexed: 06/15/2023]
Abstract
Osteoporosis usually alters the chemical composition and physical microstructure of bone. Currently, most clinical techniques for bone assessment are focused on the either bone microstructure or bone mineral density (BMD). In this study, a novel multi-wavelength photoacoustic time-frequency spectral analysis (MWPA-TFSA) method was introduced based on the optical absorption spectra and photoacoustic effects of biological macromolecules, which evaluates changes in bone chemical composition and microstructure. The results demonstrated that osteoporotic bones had decreased BMD, more lipids, and wider trabecular separation filled with larger marrow clusters, which were consistent with multiple gold-standard results, suggesting that the MWPA-TFSA method has the potential to provide a thorough bone physico-chemical information evaluation noninvasively and nonradiatively.
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Affiliation(s)
- Weiya Xie
- Institute of Acoustics, School of Physics Science and Engineering, Tongji University, Shanghai, China
- The Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration, Ministry of Education; Department of Orthopaedics, Tongji Hospital, Tongji University School of Medicine, Shanghai, China
- These authors contributed equally to this paper
| | - Ting Feng
- Institute of Acoustics, School of Physics Science and Engineering, Tongji University, Shanghai, China
- School of Electronic and Optical Engineering, Nanjing University of Science and Technology, Nanjing, China
- These authors contributed equally to this paper
| | - Dong Yu
- Institute of Acoustics, School of Physics Science and Engineering, Tongji University, Shanghai, China
| | - Dean Ta
- Department of Electronic Engineering, Fudan University, Shanghai, China
| | - Liming Cheng
- The Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration, Ministry of Education; Department of Orthopaedics, Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Qian Cheng
- Institute of Acoustics, School of Physics Science and Engineering, Tongji University, Shanghai, China
- The Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration, Ministry of Education; Department of Orthopaedics, Tongji Hospital, Tongji University School of Medicine, Shanghai, China
- Shanghai Research Institute for Intelligent Autonomous Systems, Shanghai, China
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22
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Liao CY, Chien CL, Pu TW, Shen SC, Yang CY, Yen CH, Lin CL. Assessment of Lumbar Vertebrae Morphology by Computed Tomography in Older Adults with Osteoporosis. Curr Med Imaging 2022; 18:1195-1203. [PMID: 35379138 DOI: 10.2174/1573405618666220404160213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 01/17/2022] [Accepted: 02/21/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Hounsfield units (HU) values derived from computerized tomography (CT) have been used in diagnosis for osteoporosis in the lumbar spine. OBJECTIVE This study aimed to identify anatomical dimensions of lumbar vertebrae on CT images, which were different between older normal, osteopenic and osteoporotic subjects. METHODS This prospective pilot study enrolled 79 older adults. Based on CT measurements of lumbar vertebrae in HU, participants were classified into three groups: normal (HU > 109), osteopenia (HU: 94-108), and osteoporosis (HU < 93). Altogether, 42 anatomical variables of lumbar vertebrae, L2, L3, L4, and L5, were measured in each participant by CT, including 24 parameters measurable by MRI or plain X-ray, and 18 parameters measurable by MRI only. RESULTS Among the morphological measurements also measurable by MRI and plain X-ray, the length upper curve, 50% and 75% of L5, length upper with cortex of L4, length center of cortex of L3, as well as width upper curve 75% of L2, were significantly different between the three groups (p= 0.008, 0.007, 0.035, 0.036, and 0.003 respectively). Among the morphological measurements also measurable by MRI, only width upper cortex 75% of L5 and width lower cortex 25% of L3 were significantly different between the three groups (p= 0.031 and 0.020, respectively). CONCLUSION Seven CT morphological measurements may be used as "reference standard" CT measurements for preliminarily diagnosing osteoporosis and osteopenia in older adults.
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Affiliation(s)
- Chi-Yang Liao
- Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taiwan.,Department of Orthopedics, Tri-Service General Hospital Songshan Branch, National Defense Medical Center, Taiwan
| | - Chia-Liang Chien
- Department of Orthopedics, Tri-Service General Hospital Songshan Branch, National Defense Medical Center, Taiwan
| | - Ta-Wei Pu
- Department of Surgery, Tri-Service General Hospital Songshan Branch, National Defense Medical Center, Taiwan
| | - Shin-Chieh Shen
- Department of Surgery, Tri-Service General Hospital Songshan Branch, National Defense Medical Center, Taiwan
| | - Chien-Yi Yang
- Department of Surgery, Tri-Service General Hospital Songshan Branch, National Defense Medical Center, Taiwan
| | - Ching-Heng Yen
- Department of Surgery, Tri-Service General Hospital Songshan Branch, National Defense Medical Center, Taiwan
| | - Chun-Li Lin
- Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taiwan
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23
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Regular Exercise and Weight-Control Behavior Are Protective Factors against Osteoporosis for General Population: A Propensity Score-Matched Analysis from Taiwan Biobank Participants. Nutrients 2022; 14:nu14030641. [PMID: 35277000 PMCID: PMC8838409 DOI: 10.3390/nu14030641] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 01/22/2022] [Accepted: 01/27/2022] [Indexed: 02/04/2023] Open
Abstract
The rising prevalence of osteoporosis, which can lead to osteoporotic fractures, increases morbidity, mortality, and socioeconomic burden. Multiple factors influencing bone mass have already been identified. The aim of this study was to investigate whether exercise habits and weight-control behaviors can lower the incidence of osteoporosis in the general population. This retrospective study recruited all participants aged 35–70 years who underwent dual-energy X-ray absorptiometry (DXA) from Taiwan Biobank (TWB). The final analysis consisted of 3320 eligible participants divided into two groups; demographic characteristics, prevalence of clinical symptoms, comorbidities, and daily behavior were collected using a self-reported questionnaire. After propensity score matching with a 1:1 ratio, 1107 out of 2214 individuals were classified into the osteoporosis group. Age, body fat rate, body shape, diabetes mellitus, and social status were found to affect the incidence of osteoporosis. Subjects with a habit of regular exercise and weight-control behavior showed decreased odds of osteoporosis. (odds ratio: 0.709 and 0.753, 95% confidence interval: 0.599–0.839 and 0.636–0.890). In the general population, regular exercise or weight-control behavior lowers the incidence of osteoporosis.
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24
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Yazdanpanah Z, Beigrezaei S, Mohseni-Takalloo S, Soltani S, Rajaie SH, Zohrabi T, Kaviani M, Forbes SC, Baker JS, Salehi-Abargouei A. Does exercise affect bone mineral density and content when added to a calorie-restricted diet? A systematic review and meta-analysis of controlled clinical trials. Osteoporos Int 2022; 33:339-354. [PMID: 34643754 DOI: 10.1007/s00198-021-06187-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 09/29/2021] [Indexed: 10/20/2022]
Abstract
The effects of exercise in conjunction with weight-loss diets on bone health are mixed. Our objective was to systematically review and meta-analyze controlled clinical trials in adults investigating the addition of exercise to a weight-loss diet compared with a calorie-matched weight-loss diet without exercise on bone measures. Online databases including PubMed/MEDLINE, EMBASE, ISI (Web of Science), Scopus, and Google Scholar were searched up to April 2021 with no restriction. A random effects model was used to calculate the overall estimates. Quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. Fourteen eligible controlled clinical trials were included in the systematic review. The meta-analysis revealed that, compared to weight-loss diets alone, the addition of exercise did not improve total body bone mineral density (BMD) [weighted mean difference (WMD) = 0.002 g/cm2, P = 0.62, n = 8], lumbar BMD (WMD = 0.007 g/cm2, P = 0.44, n = 9), total hip BMD (WMD = 0.015 g/cm2, P = 0.14, n = 4) and total bone mineral content (BMC) (WMD = - 11.97 g, P = 0.29, n = 7). Subgroup analysis revealed that resistance exercise in conjunction with hypocaloric diets positively affects total BMD compared to an energy restrictive diet alone (WMD = 0.01 g/cm2, P = 0.003, n = 3). Overall, it appears that only resistance exercise beneficially affects total BMD during a calorie-restricted diet in adults. Further well-controlled and long-term clinical trials are still needed to confirm these results. PROSPERO registration number: CRD42020173434.
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Affiliation(s)
- Zeinab Yazdanpanah
- Department of Nutrition, Faculty of Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, PO Code 8915173160 , Yazd, Iran
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Sara Beigrezaei
- Department of Nutrition, Faculty of Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, PO Code 8915173160 , Yazd, Iran
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Sahar Mohseni-Takalloo
- Department of Nutrition, Faculty of Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, PO Code 8915173160 , Yazd, Iran
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Noncommunicable Diseases Research Center, Bam University of Medical Sciences, Bam, Iran
| | - Sepideh Soltani
- Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Seyede Hamide Rajaie
- Department of Nutrition, Faculty of Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, PO Code 8915173160 , Yazd, Iran
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Tayebeh Zohrabi
- Department of Nutrition, Faculty of Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, PO Code 8915173160 , Yazd, Iran
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mojtaba Kaviani
- School of Nutrition and Dietetics, Faculty of Pure & Applied Science, Acadia University, Wolfville, NS, Canada
| | - Scott C Forbes
- Department of Physical Education Studies, Faculty of Education, Brandon University, Brandon, MB, Canada
| | - Julien S Baker
- Centre for Health and Exercise Science Research, Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon Tong, Hong Kong
| | - Amin Salehi-Abargouei
- Department of Nutrition, Faculty of Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, PO Code 8915173160 , Yazd, Iran.
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
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25
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Pulse-Echo Measurements of Bone Tissues. Techniques and Clinical Results at the Spine and Femur. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1364:145-162. [DOI: 10.1007/978-3-030-91979-5_7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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26
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Pan F, Cui W, Gao L, Shi X, Zhang M, Li M, Yang H, Hu Y. A Risk Assessment Tool for Identifying Osteoporosis in Older Women with Type 2 Diabetes Mellitus. Exp Clin Endocrinol Diabetes 2021; 130:426-433. [PMID: 34911084 DOI: 10.1055/a-1702-5168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To develop a simple and clinically useful assessment tool for osteoporosis in older women with type 2 diabetes mellitus (T2DM). METHODS A total of 601 women over 60 years of age with T2DM were enrolled in this study. The levels of serum sex hormones and bone metabolism markers were compared between the osteoporosis and non-osteoporosis groups. The least absolute shrinkage and selection operator regularization (LASSO) model was applied to generate a risk assessment tool. The risk score formula was evaluated using receiver operating characteristic analysis and the relationship between the risk score and the bone mineral density (BMD) and T-value were investigated. RESULTS Serum sex hormone-binding globulin (SHBG), cross-linked C-telopeptide of type 1 collagen (CTX), and osteocalcin (OC) were significantly higher in the osteoporosis group. After adjustment for age and body mass index (BMI), SHBG was found to be correlated with the T-value or BMD. Then, a risk score was specifically generated with age, BMI, SHBG, and CTX using the LASSO model. The risk score was significantly negatively correlated with the T-value and BMD of the lumbar spine, femoral neck, and total hip (all P<0.05). CONCLUSION A risk score using age, BMI, SHBG, and CTX performs well for identifying osteoporosis in older women with T2DM.
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Affiliation(s)
- Fenghui Pan
- Division of Geriatrics, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu 210008, China
| | - Wenxia Cui
- Division of Geriatrics, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu 210008, China
| | - Lei Gao
- Division of Geriatrics, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu 210008, China
| | - Xiaoting Shi
- Division of Geriatrics, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu 210008, China
| | - Mingrui Zhang
- Division of Geriatrics, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu 210008, China
| | - Man Li
- Division of Geriatrics, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu 210008, China
| | - Haiyan Yang
- Division of Geriatrics, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu 210008, China
| | - Yun Hu
- Division of Geriatrics, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu 210008, China
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Viano AM, Ankersen JP, Hoffmeister BK, Huang J, Fairbanks LC. Ultrasonic Bone Assessment: Ability of Apparent Backscatter Techniques to Detect Changes in the Microstructure of Human Cancellous Bone. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2021; 68:3309-3325. [PMID: 34138705 DOI: 10.1109/tuffc.2021.3090359] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Ultrasonic backscatter techniques may offer a useful approach for detecting changes in bone caused by osteoporosis. The goal of this study was to investigate how bone mineral density (BMD) and the microstructure of human cancellous bone affect three ultrasonic backscatter parameters that have been identified as potentially useful for ultrasonic bone assessment purposes: the apparent integrated backscatter (AIB), the frequency slope of apparent backscatter (FSAB), and the frequency intercept of apparent backscatter (FIAB). Ultrasonic measurements were performed with a 3.5-MHz broadband transducer on 54 specimens of human cancellous bone prepared from the proximal femur. Microstructural parameters and BMD were measured using X-ray microcomputed tomography (micro-CT). Relationships between AIB, FSAB, FIAB, and the micro-CT parameters were investigated using univariate and multivariate statistical analysis techniques. Moderate-to-strong univariate correlations were observed between the backscatter parameters and microstructure and BMD in many cases. The partial correlation analysis indicated that the backscatter parameters are dependent on microstructure independently of BMD in some cases. Multiple stepwise linear regression analysis used to generate multivariate models found that microstructure was a significant predictor of the backscatter parameters in most cases.
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28
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Akil S, Al-Mohammed H, Al-Batati N, Tirsen M, Al-Otaibi A, AlZahrani A, Bakhder D, AlSubaie R, AbuAlsaud S. Quantitative ultrasound assessment of the effect of parity on bone mineral density in females. BMC WOMENS HEALTH 2021; 21:380. [PMID: 34717605 PMCID: PMC8557593 DOI: 10.1186/s12905-021-01516-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 10/19/2021] [Indexed: 11/29/2022]
Abstract
Background The effect of pregnancy and breastfeeding on a female’s bone mineral density (BMD) is controversial. This prospective study aims to investigate the effect of parity on BMD among pre-menopausal multiparous females using quantitative ultrasound as a screening method and females with no pregnancies (nulliparous) as a control group. Methods A portable ultrasound-based bone densitometer (DMS PEGASUS SMART, Mauguio, France) was used to indirectly assess the BMD in 51 multiparous (29–45 years) and 51 nulliparous Arabic females (18–35 years) by quantifying the broadband ultrasound attenuation (BUA) from their right calcaneus bone. BUA > 70 db/mhz = normal, BUA 65–69.9 db/mhz = below average, BUA 55–64.9 db/mhz = osteopenia and BUA < 55 db/mhz = osteoporosis. Results There was a significant difference in mean BUA between multiparous and nulliparous females (74.1 db/mhz vs. 69.3 db/mhz, p = 0.006). The prevalence of normal BMD was significantly higher in the nulliparous group than in the multiparous group (70.6% vs. 47.1%, p = 0.02). Osteoporosis was found in the multiparous group only (3/51). Among the multiparous females who breastfed (43/51), a total of 51.2% (22/43) had normal BMD, 25.6% (11/43) had BMD below average, 18.6% (8/43) had osteopenia and 4.7% (2/43) had osteoporosis. No significant differences in mean BUA (p = 0.2) were found between the group of females who breastfed for one year (13/43; BUA: 70.5 ± 9.4), the group of females who breastfed for 6–11 months (8/43; BUA: 70.6 ± 10.0) and those who breastfed for less than six months (22/43; BUA: 71.6 ± 9.4). A binary logistic regression model built for predicting BMD normality showed significance for the variable parity (p = 0.03), while the effect of the possible confounding variables BMI and age on BMD normality was found to be non- significant (p = 0.1 and p = 0.6, respectively). Conclusion Parity affects the BMD, as assessed by a portable ultrasound-based bone densitometer, of young and middle-aged females as compared to the BMD of nulliparous females. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-021-01516-w.
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Affiliation(s)
- Shahnaz Akil
- Department of Radiological Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia. .,Department of Laboratory Medicine, Clinical Physiology, Karolinska Institutet, Huddinge, Sweden. .,Department of Clinical Physiology, Karolinska University Hospital, 141 86, Stockholm, Sweden.
| | - Huda Al-Mohammed
- Department of Radiological Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Norah Al-Batati
- Department of Radiological Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Maissa Tirsen
- Department of Radiological Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Ahad Al-Otaibi
- Department of Radiological Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Aram AlZahrani
- Department of Radiological Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Deena Bakhder
- Department of Radiological Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Ruba AlSubaie
- Department of Radiological Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Samar AbuAlsaud
- Department of Radiological Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
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Prediction of osteoporosis from simple hip radiography using deep learning algorithm. Sci Rep 2021; 11:19997. [PMID: 34620976 PMCID: PMC8497544 DOI: 10.1038/s41598-021-99549-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 09/22/2021] [Indexed: 11/17/2022] Open
Abstract
Despite being the gold standard for diagnosis of osteoporosis, dual-energy X-ray absorptiometry (DXA) could not be widely used as a screening tool for osteoporosis. This study aimed to predict osteoporosis via simple hip radiography using deep learning algorithm. A total of 1001 datasets of proximal femur DXA with matched same-side cropped simple hip bone radiographic images of female patients aged ≥ 55 years were collected. Of these, 504 patients had osteoporosis (T-score ≤ − 2.5), and 497 patients did not have osteoporosis. The 1001 images were randomly divided into three sets: 800 images for the training, 100 images for the validation, and 101 images for the test. Based on VGG16 equipped with nonlocal neural network, we developed a deep neural network (DNN) model. We calculated the confusion matrix and evaluated the accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). We drew the receiver operating characteristic (ROC) curve. A gradient-based class activation map (Grad-CAM) overlapping the original image was also used to visualize the model performance. Additionally, we performed external validation using 117 datasets. Our final DNN model showed an overall accuracy of 81.2%, sensitivity of 91.1%, and specificity of 68.9%. The PPV was 78.5%, and the NPV was 86.1%. The area under the ROC curve value was 0.867, indicating a reasonable performance for screening osteoporosis by simple hip radiography. The external validation set confirmed a model performance with an overall accuracy of 71.8% and an AUC value of 0.700. All Grad-CAM results from both internal and external validation sets appropriately matched the proximal femur cortex and trabecular patterns of the radiographs. The DNN model could be considered as one of the useful screening tools for easy prediction of osteoporosis in the real-world clinical setting.
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30
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Noel SE, Santos MP, Wright NC. Racial and Ethnic Disparities in Bone Health and Outcomes in the United States. J Bone Miner Res 2021; 36:1881-1905. [PMID: 34338355 PMCID: PMC8607440 DOI: 10.1002/jbmr.4417] [Citation(s) in RCA: 79] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 07/12/2021] [Accepted: 07/21/2021] [Indexed: 11/10/2022]
Abstract
Osteoporosis is a bone disease classified by deterioration of bone microarchitecture and decreased bone strength, thereby increasing subsequent risk of fracture. In the United States, approximately 54 million adults aged 50 years and older have osteoporosis or are at risk due to low bone mass. Osteoporosis has long been viewed as a chronic health condition affecting primarily non-Hispanic white (NHW) women; however, emerging evidence indicates racial and ethnic disparities in bone outcomes and osteoporosis management. The primary objective of this review is to describe disparities in bone mineral density (BMD), prevalence of osteoporosis and fracture, as well as in screening and treatment of osteoporosis among non-Hispanic black (NHB), Hispanic, and Asian adults compared with NHW adults living on the US mainland. The following areas were reviewed: BMD, osteoporosis prevalence, fracture prevalence and incidence, postfracture outcomes, DXA screening, and osteoporosis treatments. Although there are limited studies on bone and fracture outcomes within Asian and Hispanic populations, findings suggest that there are differences in bone outcomes across NHW, NHB, Asian, and Hispanic populations. Further, NHB, Asian, and Hispanic populations may experience suboptimal osteoporosis management and postfracture care, although additional population-based studies are needed. There is also evidence that variation in BMD and osteoporosis exists within major racial and ethnic groups, highlighting the need for research in individual groups by origin or background. Although there is a clear need to prioritize future quantitative and qualitative research in these populations, initial strategies for addressing bone health disparities are discussed. © 2021 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Sabrina E Noel
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA, USA.,Center for Population Health, University of Massachusetts Lowell, Lowell, MA, USA
| | - Michelly P Santos
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA, USA.,Center for Population Health, University of Massachusetts Lowell, Lowell, MA, USA
| | - Nicole C Wright
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
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Karlas A, Pleitez MA, Aguirre J, Ntziachristos V. Optoacoustic imaging in endocrinology and metabolism. Nat Rev Endocrinol 2021; 17:323-335. [PMID: 33875856 DOI: 10.1038/s41574-021-00482-5] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/19/2021] [Indexed: 02/02/2023]
Abstract
Imaging is an essential tool in research, diagnostics and the management of endocrine disorders. Ultrasonography, nuclear medicine techniques, MRI, CT and optical methods are already used for applications in endocrinology. Optoacoustic imaging, also termed photoacoustic imaging, is emerging as a method for visualizing endocrine physiology and disease at different scales of detail: microscopic, mesoscopic and macroscopic. Optoacoustic contrast arises from endogenous light absorbers, such as oxygenated and deoxygenated haemoglobin, lipids and water, or exogenous contrast agents, and reveals tissue vasculature, perfusion, oxygenation, metabolic activity and inflammation. The development of high-performance optoacoustic scanners for use in humans has given rise to a variety of clinical investigations, which complement the use of the technology in preclinical research. Here, we review key progress with optoacoustic imaging technology as it relates to applications in endocrinology; for example, to visualize thyroid morphology and function, and the microvasculature in diabetes mellitus or adipose tissue metabolism, with particular focus on multispectral optoacoustic tomography and raster-scan optoacoustic mesoscopy. We explain the merits of optoacoustic microscopy and focus on mid-infrared optoacoustic microscopy, which enables label-free imaging of metabolites in cells and tissues. We showcase current optoacoustic applications within endocrinology and discuss the potential of these technologies to advance research and clinical practice.
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Affiliation(s)
- Angelos Karlas
- Chair of Biological Imaging, Center for Translational Cancer Research (TranslaTUM), Technical University of Munich, Munich, Germany
- Institute of Biological and Medical Imaging, Helmholtz Zentrum München, Neuherberg, Germany
- Department of Vascular and Endovascular Surgery, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- Munich Partner Site, German Center for Cardiovascular Research (DZHK), Munich, Germany
| | - Miguel A Pleitez
- Chair of Biological Imaging, Center for Translational Cancer Research (TranslaTUM), Technical University of Munich, Munich, Germany
- Institute of Biological and Medical Imaging, Helmholtz Zentrum München, Neuherberg, Germany
| | - Juan Aguirre
- Chair of Biological Imaging, Center for Translational Cancer Research (TranslaTUM), Technical University of Munich, Munich, Germany
- Institute of Biological and Medical Imaging, Helmholtz Zentrum München, Neuherberg, Germany
| | - Vasilis Ntziachristos
- Chair of Biological Imaging, Center for Translational Cancer Research (TranslaTUM), Technical University of Munich, Munich, Germany.
- Institute of Biological and Medical Imaging, Helmholtz Zentrum München, Neuherberg, Germany.
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Xie W, Feng T, Zhang M, Li J, Ta D, Cheng L, Cheng Q. Wavelet transform-based photoacoustic time-frequency spectral analysis for bone assessment. PHOTOACOUSTICS 2021; 22:100259. [PMID: 33777692 PMCID: PMC7985564 DOI: 10.1016/j.pacs.2021.100259] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 02/17/2021] [Accepted: 03/01/2021] [Indexed: 05/08/2023]
Abstract
In this study, we investigated the feasibility of using photoacoustic time-frequency spectral analysis (PA-TFSA) for evaluating the bone mineral density (BMD) and bone structure. Simulations and ex vivo experiments on bone samples with different BMDs and mean trabecular thickness (MTT) were conducted. All photoacoustic signals were processed using the wavelet transform-based PA-TFSA. The power-weighted mean frequency (PWMF) was evaluated to obtain the main frequency component at different times. The y-intercept, midband-fit, and slope of the linearly fitted curve of the PWMF over time were also quantified. The results show that the osteoporotic bone samples with lower BMD and thinner MTT have higher frequency components and lower acoustic frequency attenuation over time, thus higher y-intercept, midband-fit, and slope. The midband-fit and slope were found to be sensitive to the BMD; therefore, both parameters could be used to distinguish between osteoporotic and normal bones (p < 0.05).
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Key Words
- ARTB, area ratio of trabecular bone
- BMD, bone mineral density
- Bone assessment
- CWT, continuous wavelet transform
- DEXA, dual energy X-ray absorptiometry
- EDTA, ethylenediaminetetraacetic acid
- MTT, mean trabecular thickness
- PA, photoacoustic
- PA-TFS, photoacoustic time-frequency spectrum
- PA-TFSA, photoacoustic time-frequency spectral analysis
- PWMF, power-weighted mean frequency
- Photoacoustic measurement
- QUS, quantitative ultrasound
- ROI, region of interest
- Time-frequency spectral analysis
- US, ultrasound
- Wavelet transform
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Affiliation(s)
- Weiya Xie
- Institute of Acoustics, School of Physics Science and Engineering, Tongji University, Shanghai, PR China
- The Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration, Ministry of Education, Department of Orthopaedics, Tongji Hospital, Tongji University School of Medicine, Shanghai, PR China
| | - Ting Feng
- Institute of Acoustics, School of Physics Science and Engineering, Tongji University, Shanghai, PR China
- School of Electronic and Optical Engineering, Nanjing University of Science and Technology, Nanjing, PR China
| | - Mengjiao Zhang
- Institute of Acoustics, School of Physics Science and Engineering, Tongji University, Shanghai, PR China
| | - Jiayan Li
- Institute of Acoustics, School of Physics Science and Engineering, Tongji University, Shanghai, PR China
| | - Dean Ta
- Department of Electronic Engineering, Fudan University, Shanghai, PR China
| | - Liming Cheng
- The Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration, Ministry of Education, Department of Orthopaedics, Tongji Hospital, Tongji University School of Medicine, Shanghai, PR China
| | - Qian Cheng
- Institute of Acoustics, School of Physics Science and Engineering, Tongji University, Shanghai, PR China
- The Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration, Ministry of Education, Department of Orthopaedics, Tongji Hospital, Tongji University School of Medicine, Shanghai, PR China
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Li GHY, Cheung CL, Au PCM, Tan KCB, Wong ICK, Sham PC. Positive effects of low LDL-C and statins on bone mineral density: an integrated epidemiological observation analysis and Mendelian randomization study. Int J Epidemiol 2021; 49:1221-1235. [PMID: 31302685 DOI: 10.1093/ije/dyz145] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Low-density lipoprotein cholesterol (LDL-C) is suggested to play a role in osteoporosis but its association with bone metabolism remains unclear. Effects of LDL-C-lowering drugs on bone are also controversial. We aim to determine whether LDL-C is linked causally to bone mineral density (BMD) and assess the effects of LDL-C-lowering drugs on BMD. METHODS Association between blood lipid levels and BMD was examined by epidemiological observation analyses in a US representative cohort NHANES III (n = 3638) and the Hong Kong Osteoporosis Study (HKOS; n = 1128). Two-sample Mendelian randomization (MR), employing genetic data from a large-scale genome-wide association study (GWAS) of blood lipids (n = 188 577), total body BMD (TB-BMD) (n = 66 628) and estimated BMD (eBMD) (n= 142 487), was performed to infer causality between LDL-C and BMD. Genetic proxies for LDL-C-lowering drugs were used to examine the drugs' effects on BMD. RESULTS In the NHANES III cohort, each standard deviation (SD) decrease in LDL-C was associated with a 0.045 SD increase in femoral neck BMD (95% CI: 0.009 - 0.081; P = 0.015). A similar increase in BMD was observed in the HKOS at femoral neck and lumbar spine. In MR analysis, a decrease in genetically predicted LDL-C was associated with an increase in TB-BMD {estimate per SD decrease, 0.038 [95% confidence interval (CI): 0.002 - 0.074]; P = 0.038} and eBMD [0.076 (0.042 - 0.111); P = 1.20x10-5]. Reduction in TB-BMD was causally associated with increased LDL-C [0.035 (0.033 - 0.066); P = 0.034]. Statins' LDL-C-lowering proxies were associated with increased TB-BMD [0.18 (0.044 - 0.316); P = 9.600x10-3] and eBMD [0.143 (0.062 - 0.223); P = 5.165x10-4]. CONCLUSIONS Negative causal association exists between LDL-C level and BMD. Statins' LDL-C-lowering effect increases BMD, suggesting their protective effect on bone.
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Affiliation(s)
- Gloria Hoi-Yee Li
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Ching-Lung Cheung
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong.,Centre for Genomic Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong.,Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong Pokfulam, Hong Kong
| | - Philip Chun-Ming Au
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Kathryn Choon-Beng Tan
- Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong Pokfulam, Hong Kong
| | - Ian Chi-Kei Wong
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong.,Research Department of Practice and Policy, School of Pharmacy, University College London, London, UK
| | - Pak-Chung Sham
- Centre for Genomic Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong.,Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
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Suehs CM, Menzies-Gow A, Price D, Bleecker ER, Canonica GW, Gurnell M, Bourdin A. Expert Consensus on the Tapering of Oral Corticosteroids for the Treatment of Asthma. A Delphi Study. Am J Respir Crit Care Med 2021; 203:871-881. [PMID: 33112646 DOI: 10.1164/rccm.202007-2721oc] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Rationale: There is a need to minimize oral corticosteroid (OCS) use in patients with asthma to prevent their costly and burdensome adverse effects. Current guidelines do not provide recommendations for OCS tapering in patients with asthma.Objectives: To develop expert consensus on OCS tapering among international experts.Methods: A modified Delphi method was used to develop expert consensus statements relating to OCS use, tapering, adverse effects, adrenal insufficiency, and patient-physician shared decision-making. Initial statements proposed by experts were categorized, filtered for repetition, and presented back to experts over three ranking rounds to obtain consensus (≥70% agreement).Measurements and Main Results: One hundred thirty-one international experts participated in the study, and 296 statements were ranked. Numerous recommendations and guidance regarding appropriate OCS use were established. Experts agreed that OCS tapering should be attempted in all patients with asthma receiving maintenance OCS therapy, with personalization of tapering rhythm and speed. The importance of recognizing individual adverse effects was also established; however, a unified approach to the assessment of adrenal insufficiency was not reached. Shared decision-making was considered an important goal during the tapering process.Conclusions: In this Delphi study, expert consensus statements were generated on OCS use, tapering, adverse-effect screening, and shared decision-making, which may be used to inform clinical practice. Areas of nonconsensus were identified, highlighting uncertainty among the experts around some aspects of OCS use in asthma, such as adrenal insufficiency, which underscores the need for further research in these domains.
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Affiliation(s)
| | - Andrew Menzies-Gow
- PhyMedExp, Université de Montpellier, Institut National de la Santé et de la Recherche Médicale, Centre National de la Recherche Scientifique, Centre Hospitalier Universitaire Montpellier, Montpellier, France
| | - David Price
- Royal Brompton and Harefield National Health Service Foundation Trust, London, United Kingdom.,Observational and Pragmatic Research Institute, Singapore
| | - Eugene R Bleecker
- Division of Applied Health Sciences, Centre of Academic Primary Care, University of Aberdeen, Aberdeen, United Kingdom
| | | | - Mark Gurnell
- Personalized Medicine, Asthma and Allergy Center, Humanitas University and IRCCS Research Hospital, Milan, Italy; and.,Wellcome Trust-Medical Research Council Institute of Metabolic Science and
| | - Arnaud Bourdin
- Département des Maladies Respiratoires and.,Cambridge National Institute for Health Research Biomedical Research Centre, University of Cambridge and Addenbrooke's Hospital, Cambridge, United Kingdom
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Tannir H, Itani L, Kreidieh D, El Masri D, Traboulsi S, El Ghoch M. Body Composition in Adolescents and Young Adults with Anorexia Nervosa: A Clinical Review. Curr Rheumatol Rev 2021; 16:92-98. [PMID: 30806320 DOI: 10.2174/1573397115666190222200704] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 01/31/2019] [Accepted: 02/13/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Anorexia nervosa is a serious health condition characterized by a significant low body weight and alteration in body composition components. AIM In the current paper, we aim to summarize the available literature concerning changes in body fat, lean, and bone masses, during anorexia nervosa and after complete weight restoration. METHODS Data were summarized using a narrative approach based on clinical expertise in the interpretation of the available evidence base in the literature. RESULTS The available data revealed three main findings. Firstly, anorexia nervosa causes a significant reduction in body fat mass, however it is completely restored after short-term weight normalization but with a central adiposity phenotype that does not seem to negatively influence treatment outcomes and appears to normalize after 1 year of normal weight maintenance. Secondly, anorexia nervosa causes a significant reduction in bone mineral density, but weight restoration is associated first (≈12 months) with stabilization of bone mineral density, followed by improvements (after ≈16 months); and finally, with complete normalization (after ≈30 months) after normal-weight maintenance. Thirdly, during anorexia nervosa loss of lean and skeletal body mass occurring in particular from the extremities rather than the central regions has been consistently reported, especially in patients with a Body Mass Index (BMI) ≤ 16.5 Kg/m2 however short-term weight restoration is associated with complete normalization. CONCLUSION Anorexia nervosa adversely affects body composition, however this medical complication seems to be reversible through the main treatment strategy of body weight restoration followed by normal weight maintenance, and this should be openly discussed with patients.
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Affiliation(s)
- Hana Tannir
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon
| | - Leila Itani
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon
| | - Dima Kreidieh
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon
| | - Dana El Masri
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon
| | - Samira Traboulsi
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon
| | - Marwan El Ghoch
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon
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Cortet B, Dennison E, Diez-Perez A, Locquet M, Muratore M, Nogués X, Ovejero Crespo D, Quarta E, Brandi ML. Radiofrequency Echographic Multi Spectrometry (REMS) for the diagnosis of osteoporosis in a European multicenter clinical context. Bone 2021; 143:115786. [PMID: 33278653 DOI: 10.1016/j.bone.2020.115786] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 11/24/2020] [Accepted: 11/29/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Radiofrequency Echographic Multi Spectrometry (REMS) is a non-ionizing technology for the densitometric assessment of osteoporosis. It has already been validated in Italian women with respect to the current clinical reference technology, Dual-energy X-ray Absorptiometry (DXA). PURPOSE Aim of the current study was to assess the diagnostic accuracy of REMS technology with respect to DXA in a wider European clinical context. METHODS A total of 4307 female Caucasian patients aged between 30 and 90 years underwent DXA and REMS scans at femoral neck and/or lumbar spine (the site depending on the medical prescription). The acquired data underwent a rigorous quality check in order to exclude the erroneous DXA and REMS reports. The diagnostic agreement between the two technologies was assessed, also stratifying for patients' age groups. The ability to recognise previously fractured patients was also investigated. RESULTS Overall, 4245 lumbar spine scans and 4271 femoral neck scans were performed. The ability to discriminate patients with and without osteoporosis by femoral neck investigation resulted in sensitivity and specificity of 90.4% and 95.5%, respectively. For lumbar spine scans, a sensitivity of 90.9% and a specificity of 95.1% were obtained. The areas under the curve (AUCs) of the Receiver Operating Characteristic (ROC) curve evaluating the ability to discriminate groups of patients with previous osteoporotic fracture using DXA and REMS T-score values were 0.631 and 0.683 (p < 0.0001), respectively, for femoral neck scans, whereas 0.603 and 0.640 (p = 0.0002), respectively, for lumbar spine scans. CONCLUSION The diagnostic effectiveness of REMS technology at reference anatomical sites for the assessment of osteoporosis has been confirmed in a large series of female patients, spanning from younger and pre-menopausal to elderly women up to 90 years, in a multicenter European clinical context.
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Affiliation(s)
- Bernard Cortet
- Department of Rheumatology and EA 4490, University-Hospital of Lille, Lille, France
| | - Elaine Dennison
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, UK
| | - Adolfo Diez-Perez
- Musculoskeletal Research Group, IMIM (Hospital del Mar Medical Research Institute), Centro de Investigación Biomédica en Red en Fragilidad y Envejecimiento Saludable (CIBERFES), ISCIII, Barcelona, Catalonia, Spain
| | - Médéa Locquet
- Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | | | - Xavier Nogués
- Musculoskeletal Research Group, IMIM (Hospital del Mar Medical Research Institute), Centro de Investigación Biomédica en Red en Fragilidad y Envejecimiento Saludable (CIBERFES), ISCIII, Barcelona, Catalonia, Spain
| | - Diana Ovejero Crespo
- Musculoskeletal Research Group, IMIM (Hospital del Mar Medical Research Institute), Centro de Investigación Biomédica en Red en Fragilidad y Envejecimiento Saludable (CIBERFES), ISCIII, Barcelona, Catalonia, Spain
| | | | - Maria Luisa Brandi
- FirmoLab Fondazione F.I.R.M.O., Florence, Italy; Department of Biological, Experimental and Clinical Science, University of Florence, Florence, Italy.
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Tang K, Zhang Q, Peng N, Hu Y, Xu S, Zhang M, Wang R, Shi L. Brachial-ankle pulse wave velocity is associated with the risk of osteoporosis: a cross-sectional evidence from a Chinese community-based cohort. J Orthop Surg Res 2021; 16:3. [PMID: 33397452 PMCID: PMC7783987 DOI: 10.1186/s13018-020-02125-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 11/27/2020] [Indexed: 12/30/2022] Open
Abstract
Background Association of arterial stiffness and osteoporosis has been well documented in elderly population. However, it is not clear whether they co-progress from the early stages through common mechanisms. The object of this study was to evaluate possible associations between arterial stiffness and osteoporosis by measuring brachial-ankle pulse wave velocity (baPWV) and the Osteoporosis Self-Assessment Tool for Asia (OSTA) index among a healthy population of Chinese aged 40 years and older. Whether baPWV can be used as a predictor of osteoporosis on OSTA was further assessed. Methods This study was cross-sectional in design. Of 3984 adults aged 40 years and older in the Yunyan district of Guiyang (Guizhou, China) who underwent both OSTA and baPWV measurements within 1 month, 1407 were deemed eligible for inclusion (women, 1088; men, 319). Results The mean baPWV was 1475 ± 302 cm/s (range,766–3459 cm/s). baPWV in 110 individuals with high risk of osteoporosis (OSTA index < − 4) was higher than that of individuals with non-high risk (1733 ± 461 cm/s vs. 1447 ± 304 cm/s, P < 0.001). OSTA index was negatively correlated with baPWV(ρ = − 0.296, P < 0.001) after adjusting for age, sex, body mass index, waist circumference, diastolic blood pressure, and creatinine clearance rate. baPWV was an independent predictor for the presence of high risk of osteoporosis (β = − 0.001, P < 0.001) and was consistent across age and sex subgroups, and the optimal baPWV cutoff value for predicting the presence of high risk of osteoporosis and fracture was 1693 cm/s. The AUC was 0.722 (95% confidence interval [CI], 0.667–0.777; P < 0.001, sensitivity of 52.8% and specificity of 83.6%). Conclusions We conclude that arterial stiffness measured by baPWV is well correlated with the severity of osteoporosis evaluated by OSTA. baPWV index may be a valuable tool for identifying individuals with risk of developing osteoporosis. Supplementary Information The online version contains supplementary material available at 10.1186/s13018-020-02125-3.
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Affiliation(s)
- Kun Tang
- Department of Endocrinology, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, China.,Department of Endocrinology, The Affiliated Hospital of Guizhou Medical University, Guiyang, 550000, China
| | - Qiao Zhang
- Department of Endocrinology, The Affiliated Hospital of Guizhou Medical University, Guiyang, 550000, China
| | - Nianchun Peng
- Department of Endocrinology, The Affiliated Hospital of Guizhou Medical University, Guiyang, 550000, China
| | - Ying Hu
- Department of Endocrinology, The Affiliated Hospital of Guizhou Medical University, Guiyang, 550000, China
| | - Shujing Xu
- Department of Endocrinology, The Affiliated Hospital of Guizhou Medical University, Guiyang, 550000, China
| | - Miao Zhang
- Department of Endocrinology, The Affiliated Hospital of Guizhou Medical University, Guiyang, 550000, China
| | - Rui Wang
- Department of Endocrinology, The Affiliated Hospital of Guizhou Medical University, Guiyang, 550000, China
| | - Lixin Shi
- Department of Endocrinology, The Affiliated Hospital of Guizhou Medical University, Guiyang, 550000, China.
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Bhargava A, Bansal A. Novel coronavirus (COVID-19) diagnosis using computer vision and artificial intelligence techniques: a review. MULTIMEDIA TOOLS AND APPLICATIONS 2021; 80:19931-19946. [PMID: 33686333 PMCID: PMC7928188 DOI: 10.1007/s11042-021-10714-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 10/23/2020] [Accepted: 02/10/2021] [Indexed: 05/07/2023]
Abstract
The universal transmission of pandemic COVID-19 (Coronavirus) causes an immediate need to commit in the fight across the whole human population. The emergencies for human health care are limited for this abrupt outbreak and abandoned environment. In this situation, inventive automation like computer vision (machine learning, deep learning, artificial intelligence), medical imaging (computed tomography, X-Ray) has developed an encouraging solution against COVID-19. In recent months, different techniques using image processing are done by various researchers. In this paper, a major review on image acquisition, segmentation, diagnosis, avoidance, and management are presented. An analytical comparison of the various proposed algorithm by researchers for coronavirus has been carried out. Also, challenges and motivation for research in the future to deal with coronavirus are indicated. The clinical impact and use of computer vision and deep learning were discussed and we hope that dermatologists may have better understanding of these areas from the study.
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Tanishima S, Hagino H, Matsumoto H, Tanimura C, Nagashima H. The Risk Factor of Worsening Low Back Pain in Older Adults Living in a Local Area of Japan: The GAINA Study. Yonago Acta Med 2020; 63:319-325. [PMID: 33253329 DOI: 10.33160/yam.2020.11.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 10/22/2020] [Indexed: 11/05/2022]
Abstract
Background Several factors, particularly osteoporosis, obesity, and a lack of exercise, contribute to low back pain (LBP). This observational longitudinal cohort study to identify the risk factors for worsening low back pain. Methods We sent a self-administered questionnaire and a consent form for this study to 1,450 subjects aged > 40 years in Hino, Japan. Baseline assessments of 273 individuals undergoing medical check-ups were conducted from 2014 to 2016. The subjects were divided into Group A (no change or improvement in LBP) and Group B (worsening LBP). LBP was assessed using a visual analog scale; body mass index (BMI), bone mineral density, skeletal muscle index (SMI), standing posture, and habitual exercise frequency were also evaluated. We defined, habitual exercise as nontherapeutic exercise (e.g. swimming, walking, physical exercise and work out). Results Overall, 81.2% subjects performed habitual exercise in Group A, a greater number of subjects than the 40.8% in Group B. BMI, SMI, and bone mineral density (BMD) were not significantly different between the two groups. Lack of exercise was a significant risk factor for worsening of LBP. On the other hand, the lack of osteoporosis treatment was significantly different between subjects with worsening LBP despite habitual exercise and those who did not perform habitual exercise. Conclusion Although habitual exercise is useful to prevent LBP, it may not necessarily be useful for those with a lack of osteoporosis treatment. Although exercise is typically posited to prevent LBP, it may not be effective in preventing LBP associated with osteoporosis.
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Affiliation(s)
- Shinji Tanishima
- Division of Orthopedic Surgery, Department of Sensory of Motor Organs, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Hiroshi Hagino
- Department of Fundamental Nursing, School of Health Science, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan
| | - Hiromi Matsumoto
- Department of Physical Therapy, Faculty of Rehabilitation, Kawasaki University of Medical Welfare, Kurashiki 701-0193
| | - Chika Tanimura
- Department of Adult and Elderly Nursing, School of Health Science, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan
| | - Hideki Nagashima
- Division of Orthopedic Surgery, Department of Sensory of Motor Organs, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
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Feng T, Zhu Y, Morris R, Kozloff KM, Wang X. Functional Photoacoustic and Ultrasonic Assessment of Osteoporosis: A Clinical Feasibility Study. BME FRONTIERS 2020; 2020:1081540. [PMID: 37849970 PMCID: PMC10521673 DOI: 10.34133/2020/1081540] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 09/02/2020] [Indexed: 10/19/2023] Open
Abstract
Objective and Impact Statement. To study the feasibility of combined functional photoacoustic (PA) and quantitative ultrasound (US) for diagnosis of osteoporosis in vivo based on the detection of chemical and microarchitecture (BMA) information in calcaneus bone. Introduction. Clinically available X-ray or US technologies for the diagnosis of osteoporosis do not report important parameters such as chemical information and BMA. With unique advantages, including good sensitivity to molecular and metabolic properties, PA bone assessment techniques hold a great potential for clinical translation. Methods. By performing multiwavelength PA measurements, the chemical information in the human calcaneus bone, including mineral, lipid, oxygenated-hemoglobin, and deoxygenated-hemoglobin, were assessed. In parallel, by performing PA spectrum analysis, the BMA as an important bone physical property was quantified. An unpaired t -test and a two-way ANOVA test were conducted to compare the outcomes from the two subject groups. Results. Multiwavelength PA measurement is capable of assessing the relative contents of several chemical components in the trabecular bone in vivo, including both minerals and organic materials such as oxygenated-hemoglobin, deoxygenated-hemoglobin, and lipid, which are relevant to metabolic activities and bone health. In addition, PA measurements of BMA show good correlations (R 2 up to 0.65) with DEXA. Both the chemical and microarchitectural measurements from PA techniques can differentiate the two subject groups. Conclusion. The results from this initial clinical study suggest that PA techniques, by providing additional chemical and microarchitecture information relevant to bone health, may lead to accurate and early diagnosis, as well as sensitive monitoring of the treatment of osteoporosis.
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Affiliation(s)
- Ting Feng
- Department of Biomedical Engineering, University of Michigan Medical School, MI 48109, USA
| | - Yunhao Zhu
- Department of Biomedical Engineering, University of Michigan Medical School, MI 48109, USA
| | | | - Kenneth M. Kozloff
- Department of Biomedical Engineering, University of Michigan Medical School, MI 48109, USA
- Department of Orthopaedic Surgery, University of Michigan Medical School, MI 48109, USA
| | - Xueding Wang
- Department of Biomedical Engineering, University of Michigan Medical School, MI 48109, USA
- Department of Radiology, University of Michigan Medical School, MI 48109, USA
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Ulhaq A, Born J, Khan A, Gomes DPS, Chakraborty S, Paul M. COVID-19 Control by Computer Vision Approaches: A Survey. IEEE ACCESS : PRACTICAL INNOVATIONS, OPEN SOLUTIONS 2020; 8:179437-179456. [PMID: 34812357 PMCID: PMC8545281 DOI: 10.1109/access.2020.3027685] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 09/26/2020] [Indexed: 05/03/2023]
Abstract
The COVID-19 pandemic has triggered an urgent call to contribute to the fight against an immense threat to the human population. Computer Vision, as a subfield of artificial intelligence, has enjoyed recent success in solving various complex problems in health care and has the potential to contribute to the fight of controlling COVID-19. In response to this call, computer vision researchers are putting their knowledge base at test to devise effective ways to counter COVID-19 challenge and serve the global community. New contributions are being shared with every passing day. It motivated us to review the recent work, collect information about available research resources, and an indication of future research directions. We want to make it possible for computer vision researchers to find existing and future research directions. This survey article presents a preliminary review of the literature on research community efforts against COVID-19 pandemic.
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Affiliation(s)
- Anwaar Ulhaq
- School of Computing and MathematicsCharles Sturt UniversityPort MacquarieNSW2795Australia
| | - Jannis Born
- Department for Biosystems Science and EngineeringETH Zurich4058BaselSwitzerland
| | - Asim Khan
- College of Engineering and ScienceVictoria UniversityMelbourneVIC3011Australia
| | | | - Subrata Chakraborty
- Faculty of Engineering and Information TechnologyUniversity of Technology SydneySydneyNSW2007Australia
| | - Manoranjan Paul
- School of Computing and MathematicsCharles Sturt UniversityPort MacquarieNSW2795Australia
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Tarasco M, Cordelières FP, Cancela ML, Laizé V. ZFBONE: An ImageJ toolset for semi-automatic analysis of zebrafish bone structures. Bone 2020; 138:115480. [PMID: 32534223 DOI: 10.1016/j.bone.2020.115480] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 06/09/2020] [Indexed: 12/15/2022]
Abstract
The last decade has seen an increased interest in the discovery of compounds with bone anabolic activity to treat skeletal disorders such as osteoporosis and increase the well-being of patients. Due to the many technical advantages over classical rodent systems, zebrafish (Danio rerio) has been increasingly used in screening pipelines, in particular those aiming at identifying osteoactive compounds with pharmacological potential. Because compound osteoactivity is mostly determined in zebrafish through the morphometric analysis of bone structures, image analysis, rather than screening assay implementation, molecule availability and image acquisition, represents a bottleneck to the screening throughput. The absence of auto/semi-automatic tools for image analysis of fish bone structures is also a limitation to a broader usage of zebrafish screening pipelines. We present here ZFBONE (for ZebraFish BONE), an open-source, freely available, user-friendly, rapid and reliable toolset, aiming at accelerating image analysis by automating the morphometric assessment of zebrafish bone structures, but also at increasing data accuracy by reducing operator bias. Tools included in ZFBONE allow users to assess, from 2D images, morphometric parameters of several bone structures (e.g. operculum, caudal fin rays and scales) but also the extent and the intensity of bone-specific colorations. ZFBONE has been developed using the open-source ImageJ software, to make it available to the whole zebrafish research community, but also to have it easily modifiable according to user demands. ZFBONE can also be used toward the standardization of zebrafish screening protocols in academia and industry.
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Affiliation(s)
- Marco Tarasco
- Centre of Marine Sciences, University of Algarve, Faro, Portugal.
| | - Fabrice P Cordelières
- Bordeaux Imaging Center, UMS 3420 CNRS - University of Bordeaux - US4 INSERM, Bordeaux, France
| | - M Leonor Cancela
- Centre of Marine Sciences, University of Algarve, Faro, Portugal; Department of Biomedical Sciences and Medicine, Algarve Biomedical Centre and Centre for Biomedical Research, University of Algarve, Faro, Portugal
| | - Vincent Laizé
- Centre of Marine Sciences, University of Algarve, Faro, Portugal
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Horry MJ, Chakraborty S, Paul M, Ulhaq A, Pradhan B, Saha M, Shukla N. COVID-19 Detection Through Transfer Learning Using Multimodal Imaging Data. IEEE ACCESS : PRACTICAL INNOVATIONS, OPEN SOLUTIONS 2020; 8:149808-149824. [PMID: 34931154 PMCID: PMC8668160 DOI: 10.1109/access.2020.3016780] [Citation(s) in RCA: 160] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 08/11/2020] [Indexed: 05/02/2023]
Abstract
Detecting COVID-19 early may help in devising an appropriate treatment plan and disease containment decisions. In this study, we demonstrate how transfer learning from deep learning models can be used to perform COVID-19 detection using images from three most commonly used medical imaging modes X-Ray, Ultrasound, and CT scan. The aim is to provide over-stressed medical professionals a second pair of eyes through intelligent deep learning image classification models. We identify a suitable Convolutional Neural Network (CNN) model through initial comparative study of several popular CNN models. We then optimize the selected VGG19 model for the image modalities to show how the models can be used for the highly scarce and challenging COVID-19 datasets. We highlight the challenges (including dataset size and quality) in utilizing current publicly available COVID-19 datasets for developing useful deep learning models and how it adversely impacts the trainability of complex models. We also propose an image pre-processing stage to create a trustworthy image dataset for developing and testing the deep learning models. The new approach is aimed to reduce unwanted noise from the images so that deep learning models can focus on detecting diseases with specific features from them. Our results indicate that Ultrasound images provide superior detection accuracy compared to X-Ray and CT scans. The experimental results highlight that with limited data, most of the deeper networks struggle to train well and provides less consistency over the three imaging modes we are using. The selected VGG19 model, which is then extensively tuned with appropriate parameters, performs in considerable levels of COVID-19 detection against pneumonia or normal for all three lung image modes with the precision of up to 86% for X-Ray, 100% for Ultrasound and 84% for CT scans.
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Affiliation(s)
- Michael J. Horry
- Centre for Advanced Modelling and
Geospatial Information Systems (CAMGIS), School of Information, Systems, and
Modeling, Faculty of Engineering and ITUniversity of Technology
SydneySydneyNSW2007Australia
- IBM Australia LimitedSydneyNSW2065Australia
| | - Subrata Chakraborty
- Centre for Advanced Modelling and
Geospatial Information Systems (CAMGIS), School of Information, Systems, and
Modeling, Faculty of Engineering and ITUniversity of Technology
SydneySydneyNSW2007Australia
| | - Manoranjan Paul
- Machine Vision and Digital Health (MaViDH),
School of Computing and MathematicsCharles Sturt UniversityBathurstNSW2795Australia
| | - Anwaar Ulhaq
- Machine Vision and Digital Health (MaViDH),
School of Computing and MathematicsCharles Sturt UniversityBathurstNSW2795Australia
| | - Biswajeet Pradhan
- Centre for Advanced Modelling and
Geospatial Information Systems (CAMGIS), School of Information, Systems, and
Modeling, Faculty of Engineering and ITUniversity of Technology
SydneySydneyNSW2007Australia
- Department of Energy and Mineral
Resources EngineeringSejong UniversitySeoul05006South Korea
| | - Manas Saha
- Manning Rural Referral
HospitalTareeNSW2430Australia
| | - Nagesh Shukla
- Centre for Advanced Modelling and
Geospatial Information Systems (CAMGIS), School of Information, Systems, and
Modeling, Faculty of Engineering and ITUniversity of Technology
SydneySydneyNSW2007Australia
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Adami G, Arioli G, Bianchi G, Brandi ML, Caffarelli C, Cianferotti L, Gatti D, Girasole G, Gonnelli S, Manfredini M, Muratore M, Quarta E, Quarta L. Radiofrequency echographic multi spectrometry for the prediction of incident fragility fractures: A 5-year follow-up study. Bone 2020; 134:115297. [PMID: 32092480 DOI: 10.1016/j.bone.2020.115297] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 02/13/2020] [Accepted: 02/20/2020] [Indexed: 01/20/2023]
Abstract
PURPOSE To investigate the effectiveness of the T-score values provided by Radiofrequency Echographic Multi Spectrometry (REMS) in the identification of patients at risk for incident osteoporotic fractures. METHODS A population of Caucasian women (30-90 years), enrolled from 2013 to 2016, underwent dual X-ray absorptiometry (DXA) and REMS scans at axial sites. The incidence of fragility fractures was assessed during a follow-up period up to 5 years. Afterwards, patients with and without incident fractures were stratified in two age-matched groups with a 1: 2 proportion (Group F' and Group NF', respectively). The performance of REMS T-score in discriminating between the two groups was quantitatively assessed and compared with DXA. RESULTS 1516 patients were enrolled and 1370 completed the follow-up (mean ± SD: 3.7 ± 0.8 years; range: 1.9-5.0 years). Fracture incidence was 14.0%. Age-matched groups included 175 fractured patients and 350 non-fractured ones, respectively (median age 70.2 [interquartile range: 61.0-73.3] and 67.3 [65.4-69.8] years, p-value ns). The groups resulted also balanced for height, weight and BMI (p-values ns). As expected, the differences in REMS T-score (for vertebral site, -2.9 [-3.6 to -1.9] in Group F', -2.2 [-2.9 to -1.2] in Group NF') and DXA T-score (-2.8 [-3.3 to -1.9] in Group F', -2.2 [-2.9 to -1.4] in Group NF') were statistically significant (p-value <0.001). Analogous results were obtained for femoral neck. Considering the T-score cut-off of -2.5, REMS identified Group F' patients with a sensitivity of 65.1% and specificity of 57.7% of (OR = 2.6, 95%CI: 1.77-3.76, p < 0.001), whereas DXA showed a sensitivity of 57.1% and a specificity of 56.3% (OR = 1.7, 95%CI: 1.20-2.51, p-value = 0.0032). For femoral neck, REMS sensitivity and specificity were 40.2% and 79.9%, respectively, with an OR of 2.81 (95%CI: 1.80-4.39, p < 0.001). DXA, instead, showed a sensitivity and specificity of 42.3% and 79.3%, respectively, with an OR of 2.68 (95%CI: 1.71-4.21, p < 0.001). CONCLUSIONS REMS T-score resulted an effective predictor for the risk of incident fragility fractures in a population-based sample of female subjects, representing a promising parameter to enhance osteoporosis diagnosis in the clinical routine.
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Affiliation(s)
- Giovanni Adami
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Giovanni Arioli
- Department of Neurosciences and Rehabilitation, "Carlo Poma" Hospital, ASST-Mantova, Mantova, Italy
| | | | - Maria Luisa Brandi
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, Metabolic Bone Diseases Unit, University Hospital of Florence, Florence, Italy
| | - Carla Caffarelli
- Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Luisella Cianferotti
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, Metabolic Bone Diseases Unit, University Hospital of Florence, Florence, Italy
| | - Davide Gatti
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | | | - Stefano Gonnelli
- Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Monica Manfredini
- Department of Neurosciences and Rehabilitation, "Carlo Poma" Hospital, ASST-Mantova, Mantova, Italy
| | - Maurizio Muratore
- O.U. of Rheumatology, "Galateo" Hospital, San Cesario di Lecce ASL-LE, Lecce, Italy.
| | - Eugenio Quarta
- O.U. of Rheumatology, "Galateo" Hospital, San Cesario di Lecce ASL-LE, Lecce, Italy
| | - Laura Quarta
- O.U. of Rheumatology, "Galateo" Hospital, San Cesario di Lecce ASL-LE, Lecce, Italy
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van den Berg P, Schweitzer DH, van Haard PMM, Geusens PP, van den Bergh JP. The use of pulse-echo ultrasound in women with a recent non-vertebral fracture to identify those without osteoporosis and/or a subclinical vertebral fracture: a pilot study. Arch Osteoporos 2020; 15:56. [PMID: 32291527 DOI: 10.1007/s11657-020-00730-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Accepted: 03/23/2020] [Indexed: 02/03/2023]
Abstract
UNLABELLED A pilot study on the use of P-EU to identify patients without osteoporosis and/or a subclinical vertebral fracture after a recently sustained non-vertebral fracture (NVF). INTRODUCTION Screening with portable devices at emergency departments or plaster rooms could be of interest to limit referrals for dual X-ray absorptiometry (DXA) and vertebral fracture assessment (VFA). We calculated the number of negative tests for osteoporosis and/or subclinical vertebral fractures (VFs) using pulse-echo ultrasonometry (P-UE) at different thresholds. PATIENTS AND METHODS In this cross-sectional study, 209 consecutive women of 50-70 years with a recent non-vertebral fracture (NVF) were studied at the Fracture Liaison Service (FLS) of one hospital. All women received DXA/VFA and P-EU (Bindex®) assessments. Various P-EU thresholds (based on the density index (DI, g/cm2)) were analyzed to calculate the best balance between true negative (indeed no osteoporosis and/or subclinical VF) and false negative tests (osteoporosis and/or subclinical VF according to DXA/VFA). RESULTS Eighty-three women had osteoporosis (40%) and 17 women at least one VF (8%). Applying the manufacturer's recommended P-EU threshold (DI 0.844 g/cm2) being their proposed cut-off for not having hip osteoporosis resulted in 77 negative tests (37%, 31% true negative and 6% false negative tests). A DI of 0.896 g/cm2 resulted in 40 negative tests (19.3%) (38 true negative (18.3%) and 2 false negative tests (1.0%)). CONCLUSION The application of P-EU enables the identification of a substantial proportion of women with recent non-vertebral fractures at the FLS who would not need a DXA/VFA referral because they had no osteoporosis and/or subclinical vertebral fractures. The most conservative P-EU threshold resulted in 18.3% true negative tests verified by DXA/VFA against 1% false negative test results.
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Affiliation(s)
- Peter van den Berg
- Department of Orthopedics and Surgery, Fracture Liaison Service, Reinier de Graaf Gasthuis, Delft, the Netherlands.
| | - Dave H Schweitzer
- Department of Internal Medicine and Endocrinology, Reinier the Graaf Gasthuis, Delft, the Netherlands
| | - Paul M M van Haard
- Department of Medical Laboratories, Association of Clinical Chemistry, Reinier the Graaf Gasthuis, Delft, the Netherlands
| | - Piet P Geusens
- Department of Internal Medicine, Subdivision Rheumatology, Maastricht University Medical Center, Maastricht, the Netherlands
- Hasselt University, Hasselt, Belgium
| | - Joop P van den Bergh
- Department of Internal Medicine, Subdivision Rheumatology, Maastricht University Medical Center, Maastricht, the Netherlands
- Hasselt University, Hasselt, Belgium
- Department of Internal Medicine, VieCuri Medical Centre Noord-Limburg and Department of Internal Medicine, Subdivision Rheumatology, Maastricht University Medical Center, Maastricht, the Netherlands
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Zopfs D, Lennartz S, Zaeske C, Merkt M, Laukamp KR, Reimer RP, Maintz D, Borggrefe J, Grosse Hokamp N. Phantomless assessment of volumetric bone mineral density using virtual non-contrast images from spectral detector computed tomography. Br J Radiol 2020; 93:20190992. [PMID: 32101453 DOI: 10.1259/bjr.20190992] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To evaluate phantomless assessment of volumetric bone mineral density (vBMD) based on virtual non-contrast images of arterial (VNCa) and venous phase (VNCv) derived from spectral detector CT in comparison to true non-contrast (TNC) images and adjusted venous phase conventional images (CIV(adjusted)). METHODS 104 consecutive patients who underwent triphasic spectral detector CT between January 2018 and April 2019 were retrospectively included. TNC, VNCa, VNCv and venous phase images (CIV) were reconstructed. vBMD was obtained by two radiologists using an FDA/CE-cleared software. Average vBMD of the first three lumbar vertebrae was determined in each reconstruction; vBMD of CIV was adjusted for contrast enhancement as suggested earlier. RESULTS vBMD values obtained from CIV(adjusted) are comparable to vBMD values derived from TNC images (91.79 ± 36.52 vs 90.16 ± 41.71 mg/cm3, p = 1.00); however, vBMD values derived from VNCa and VNCv (42.20 ± 22.50 and 41.98 ± 23.3 mg/cm3 respectively) were significantly lower as compared to vBMD values from TNC and CIV(adjusted) (all p ≤ 0.01). CONCLUSION Spectral detector CT-derived virtual non-contrast images systematically underestimate vBMD and therefore should not be used without appropriate adjustments. Adjusted venous phase images provide reliable results and may be utilized for an opportunistic BMD screening in CT examinations. ADVANCES IN KNOWLEDGE Adjustments of venous phase images facilitate opportunistic assessment of vBMD, while spectral detector CT-derived VNC images systematically underestimate vBMD.
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Affiliation(s)
- David Zopfs
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Institute for Diagnostic and Interventional Radiology, Cologne, Germany
| | - Simon Lennartz
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Institute for Diagnostic and Interventional Radiology, Cologne, Germany.,Else Kröner Forschungskolleg Clonal Evolution in Cancer, University Hospital Cologne, Weyertal 115b, 50931, Cologne, Germany.,Department of Radiology, Massachusetts General Hospital, 55 Fruit St, White 270, Boston, MA 02114, USA
| | - Charlotte Zaeske
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Institute for Diagnostic and Interventional Radiology, Cologne, Germany
| | - Martin Merkt
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Kai Roman Laukamp
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Institute for Diagnostic and Interventional Radiology, Cologne, Germany
| | - Robert Peter Reimer
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Institute for Diagnostic and Interventional Radiology, Cologne, Germany
| | - David Maintz
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Institute for Diagnostic and Interventional Radiology, Cologne, Germany
| | - Jan Borggrefe
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Institute for Diagnostic and Interventional Radiology, Cologne, Germany
| | - Nils Grosse Hokamp
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Institute for Diagnostic and Interventional Radiology, Cologne, Germany
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Hayashi Y, Ito M, Imanishi Y, Watanabe K, Matsumoto K, Arai Y, Honda K. Use of experimental phantoms to determine the accuracy and reliability of mandibular cortical width measurements by panoramic radiography and cone-beam computed tomography. J Oral Sci 2020; 62:303-307. [DOI: 10.2334/josnusd.19-0307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Yusuke Hayashi
- Department of Oral and Maxillofacial Radiology, Nihon University School of Dentistry
| | - Motohiro Ito
- Department of Oral and Maxillofacial Radiology, Nihon University School of Dentistry
| | - Yusuke Imanishi
- Department of Oral and Maxillofacial Radiology, Nihon University School of Dentistry
| | - Kenichiro Watanabe
- Department of Oral and Maxillofacial Radiology, Nihon University School of Dentistry
| | - Kunihito Matsumoto
- Department of Oral and Maxillofacial Radiology, Nihon University School of Dentistry
| | - Yoshinori Arai
- Department of Oral and Maxillofacial Radiology, Nihon University School of Dentistry
| | - Kazuya Honda
- Department of Oral and Maxillofacial Radiology, Nihon University School of Dentistry
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Malekzadeh M, Asadi M, Abbasi-Rad S, Abolghasemi J, Hamidi Z, Talebi M, Shiran MB, Saligheh Rad H. MDCT-QCT, QUS, and DXA in healthy adults: An intermodality comparison. Med J Islam Repub Iran 2019; 33:156. [PMID: 32280662 PMCID: PMC7137819 DOI: 10.34171/mjiri.33.156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Indexed: 11/05/2022] Open
Abstract
Background: Cortical deceleration is the main reason for bone loss at peripheral sites. It was suggested that when peripheral bones were assessed for osteoporosis, management and therapy can be administered early. The main aim of this study was to assess the relationships between the central and peripheral measurements at different skeleton bone sites (spine, femur, forearm, tibia, and calcaneus) with available modalities: DXA, QUS, and MDCT-QCT. Methods: The volunteers recruited in this study did not have any history or evidence of metabolic bone disease. Blood test and DXA measurements were used as inclusion criteria to select 40 healthy participants. The selected volunteers underwent 3 imaging modalities: QCT, DXA, and QUS. DXA-based measurements were made on 3 sites, including spine, femur, and forearm. QCT and QUS measurements were done for distal of tibia and calcaneus bones, respectively. The extracted parameters from the 3 modalities were analyzed using a bivariate (Pearson) correlation (r) in statistical software. Results: The results showed moderate to good correlations between spongy bones in central and peripheral sites from all the modalities. However, there was no correlation between MDCT measures and central bone values. According to correlations between different peripheral sits, aBMD of 33% radius and trabecular vBMD in 38% distal tibia showed weak but significant relationship between peripheral bones (r=-0.342, p=0.044). Conclusion: The findings demonstrated how bones in central and peripheral sites were correlated. Multimodality imaging was used in this group of healthy volunteers. Also, it was found that QCT-based MDCT needs more optimization and requires further investigations.
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Affiliation(s)
- Malakeh Malekzadeh
- Medical Physics Department, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mojgan Asadi
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahrokh Abbasi-Rad
- Quantitative Medical Imaging Systems Group, Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Tehran, Iran
- Medical Physics and Biomedical Engineering Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Jamileh Abolghasemi
- Department of Biostatistics, School of public health, Iran University of Medical Sciences, Tehran, Iran
| | - Zohreh Hamidi
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahsa Talebi
- Quantitative Medical Imaging Systems Group, Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Tehran, Iran
- Medical Physics and Biomedical Engineering Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Bagher Shiran
- Medical Physics Department, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Finetech in Medicine Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Saligheh Rad
- Quantitative Medical Imaging Systems Group, Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Tehran, Iran
- Medical Physics and Biomedical Engineering Department, Tehran University of Medical Sciences, Tehran, Iran
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Recine F, Bongiovanni A, Foca F, Mercatali L, Fausti V, Calpona S, Riva N, De Vita A, Liverani C, Spadazzi C, Miserocchi G, Di Menna G, Gurrieri L, Cocchi C, Debonis SA, Vespignani R, Ibrahim T. BOne HEalth ManagEment in Patients with Early Breast Cancer: A Retrospective Italian Osteoncology Center "Real-Life" Experience (BOHEME Study). J Clin Med 2019; 8:jcm8111894. [PMID: 31698876 PMCID: PMC6912302 DOI: 10.3390/jcm8111894] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 10/16/2019] [Accepted: 11/04/2019] [Indexed: 12/12/2022] Open
Abstract
Background: We assessed the real-life clinical impact of bone health management in patients with breast cancer (BC) receiving adjuvant endocrine therapy at an Italian Osteoncology Center. Methods: Pre- and post-menopausal women undergoing adjuvant endocrine therapy for early-stage BC who came to our institute for their first bone health evaluation from January 2011 to June 2016 were considered in this retrospective observational study. Results: 1125 pre- and post-menopausal early-stage BC patients (209 and 916, respectively) were evaluated. Median age was 61 years (range 26–88). In the pre-menopausal group, spinal x-ray revealed that 10 patients (4.7%) had a morphometric vertebral fracture. Higher age (OR: 1.14; 95% CI: 1.01–1.29) and bone mineral density (BMD) ≤ −2.5 (OR: 14.45; 95% CI: 1.70–122.67) were associated with a higher risk of bone fracture. The overall frequency of bone fracture was 17.6% (n = 161) in post-menopausal patients and a lower risk for bone fractures was associated with tamoxifen or other treatments (OR: 0.25; 95% CI: 0.12–0.53), presence of back pain (OR: 1.65; 95% CI: 1.16–2.36), lower BMD (OR: 2.09 in patients with T-score ≤ 2.5; 95% CI: 1.21–3.59) and lower vitamin D levels (OR: 1.57 in patients with ≤ 10 ng/mL; 95% CI: 1.05–2.34) in univariate analysis. Conclusion: Our findings confirm that bone health management should be an integral part of long-term cancer care.
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Affiliation(s)
- Federica Recine
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (A.B.); (L.M.); (V.F.); (S.C.); (N.R.); (A.D.V.); (C.L.); (C.S.); (G.M.); (G.D.M.); (L.G.); (C.C.); (S.A.D.); (T.I.)
- Correspondence: ; Tel.: +39-0543-739140; Fax: +39-0543-739151
| | - Alberto Bongiovanni
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (A.B.); (L.M.); (V.F.); (S.C.); (N.R.); (A.D.V.); (C.L.); (C.S.); (G.M.); (G.D.M.); (L.G.); (C.C.); (S.A.D.); (T.I.)
| | - Flavia Foca
- Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy;
| | - Laura Mercatali
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (A.B.); (L.M.); (V.F.); (S.C.); (N.R.); (A.D.V.); (C.L.); (C.S.); (G.M.); (G.D.M.); (L.G.); (C.C.); (S.A.D.); (T.I.)
| | - Valentina Fausti
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (A.B.); (L.M.); (V.F.); (S.C.); (N.R.); (A.D.V.); (C.L.); (C.S.); (G.M.); (G.D.M.); (L.G.); (C.C.); (S.A.D.); (T.I.)
| | - Sebastiano Calpona
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (A.B.); (L.M.); (V.F.); (S.C.); (N.R.); (A.D.V.); (C.L.); (C.S.); (G.M.); (G.D.M.); (L.G.); (C.C.); (S.A.D.); (T.I.)
| | - Nada Riva
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (A.B.); (L.M.); (V.F.); (S.C.); (N.R.); (A.D.V.); (C.L.); (C.S.); (G.M.); (G.D.M.); (L.G.); (C.C.); (S.A.D.); (T.I.)
| | - Alessandro De Vita
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (A.B.); (L.M.); (V.F.); (S.C.); (N.R.); (A.D.V.); (C.L.); (C.S.); (G.M.); (G.D.M.); (L.G.); (C.C.); (S.A.D.); (T.I.)
| | - Chiara Liverani
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (A.B.); (L.M.); (V.F.); (S.C.); (N.R.); (A.D.V.); (C.L.); (C.S.); (G.M.); (G.D.M.); (L.G.); (C.C.); (S.A.D.); (T.I.)
| | - Chiara Spadazzi
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (A.B.); (L.M.); (V.F.); (S.C.); (N.R.); (A.D.V.); (C.L.); (C.S.); (G.M.); (G.D.M.); (L.G.); (C.C.); (S.A.D.); (T.I.)
| | - Giacomo Miserocchi
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (A.B.); (L.M.); (V.F.); (S.C.); (N.R.); (A.D.V.); (C.L.); (C.S.); (G.M.); (G.D.M.); (L.G.); (C.C.); (S.A.D.); (T.I.)
| | - Giandomenico Di Menna
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (A.B.); (L.M.); (V.F.); (S.C.); (N.R.); (A.D.V.); (C.L.); (C.S.); (G.M.); (G.D.M.); (L.G.); (C.C.); (S.A.D.); (T.I.)
| | - Lorena Gurrieri
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (A.B.); (L.M.); (V.F.); (S.C.); (N.R.); (A.D.V.); (C.L.); (C.S.); (G.M.); (G.D.M.); (L.G.); (C.C.); (S.A.D.); (T.I.)
| | - Claudia Cocchi
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (A.B.); (L.M.); (V.F.); (S.C.); (N.R.); (A.D.V.); (C.L.); (C.S.); (G.M.); (G.D.M.); (L.G.); (C.C.); (S.A.D.); (T.I.)
| | - Silvia Angela Debonis
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (A.B.); (L.M.); (V.F.); (S.C.); (N.R.); (A.D.V.); (C.L.); (C.S.); (G.M.); (G.D.M.); (L.G.); (C.C.); (S.A.D.); (T.I.)
| | - Roberto Vespignani
- IT Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy;
| | - Toni Ibrahim
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (A.B.); (L.M.); (V.F.); (S.C.); (N.R.); (A.D.V.); (C.L.); (C.S.); (G.M.); (G.D.M.); (L.G.); (C.C.); (S.A.D.); (T.I.)
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Yousfi L, Houam L, Boukrouche A, Lespessailles E, Ros F, Jennane R. Texture Analysis and Genetic Algorithms for Osteoporosis Diagnosis. INT J PATTERN RECOGN 2019. [DOI: 10.1142/s0218001420570025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Early diagnosis of osteoporosis can efficiently predict fracture risk. There is a great demand to prevent this disease. The goal of this study was to distinguish osteoporotic cases from healthy controls on 2D bone radiograph images, using texture analysis and genetic algorithms (GAs). Gray Level Co-occurrence Matrix (GLCM), Run length Matrix (RLM) and Binarized Statistical Image Features (BSIF) were used for texture analysis. Features are numerous and parameter-dependent. The related experts can pick out the useful input features for the classifier. It however remains a difficult task and may be inefficient or even harmful as the data pattern is not clear. In this paper, GAs were used to optimize the two parameters of the co-occurrence matrix (distance parameter or pixel separation, orientation or direction) and the number of gray levels used in the preprocessing quantification step. GAs were also used to select the best combination of features extracted from GLCM and RLM matrices. Experiments were conducted on two populations composed of Osteoporotic Patients and Control Subjects. Results show that GAs combined with GLCM and BSIF features can improve the classification rates (ACC = 87.50%) obtained using GLCM (ACC = 77.8%) alone.
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Affiliation(s)
- Laatra Yousfi
- Laboratory of Inverse Problems, Modeling, Information and Systems (PI:MIS), University 8 Mai 1945 Guelma, Algeria
- Department of Electrical Engineering, University of Tebessa, Tebessa, Algeria
| | - Lotfi Houam
- Department of Electrical Engineering, University of Tebessa, Tebessa, Algeria
| | - Abdelhani Boukrouche
- Laboratory of PI:MIS, Department of Electronic and Telecommunications University of Guelma, BP 401, 24000 Guelma, Algeria
| | - Eric Lespessailles
- Laboratory I3MTO EA 4708, University of Orleans, CHR Orléans, 45032 Orleans, France
| | - Frédéric Ros
- Laboratory PRISME, University of Orleans, 12 rue de Blois, 45067 Orleans, France
| | - Rachid Jennane
- Laboratory I3MTO EA 4708, University of Orleans, CHR Orléans, 45032 Orleans, France
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