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High-Resolution CT Accurately Assesses Bone Microarchitecture


 

BETHESDA, MD. — High-resolution peripheral quantitative CT is a promising technology for identifying osteoporosis-related changes in bone microarchitecture, according to results of a prospective study.

Data from the noninvasive technique suggests that the imaging procedure will provide new insight into the degradation of bone mineral architecture that occurs in osteoporosis, Stéphanie Boutroy, Ph.D., said at a meeting on bone quality.

Dr. Boutroy of France's National Institute of Health and Medical Research, Lyon, described her findings from an investigation of the scanning technique in 108 healthy premenopausal women (aged 19–45 years), 109 osteopenic, postmenopausal women (aged 52–88 years), and 33 osteoporotic, postmenopausal women (aged 61–84 years). The women were classified as osteopenic or osteoporotic based on bone mineral density (BMD) measures taken by dual x-ray absorptiometry of the femoral neck or spine.

Initially, eight healthy women underwent three separate scanning sessions within 1 month to determine the short-term reproducibility of the density and architecture parameters of the scanning protocol. In the three sessions, trabecular and cortical volumetric BMD measurements varied by only 0.5%–1.3% in each of those eight patients. Similarly, trabecular architecture values varied by 0.9%–3.1% for each patient between sessions.

When Dr. Boutroy examined the relationship between volumetric BMD and architectural parameters, she found that total density, as expected, was strongly correlated to trabecular and cortical density. Trabecular and cortical density were strongly correlated to trabecular architecture and cortical thickness.

At the distal radius, osteoporotic women had significantly lower total volumetric BMD and cortical thickness compared with osteopenic women. Osteoporotic women also had comparatively lower trabecular density, number, thickness, and separation. No differences were found in cortical density or the distribution of trabeculae between the groups, Dr. Boutroy said at the meeting, sponsored by the National Institute of Arthritis and Musculoskeletal and Skin Diseases and the American Society for Bone and Mineral Research.

At the tibia, osteoporotic women had significantly lower measurements on all parameters (total volumetric BMD, cortical and trabecular density, and trabecular number, thickness, and separation) than osteopenic women.

Dr. Boutroy said she has no financial interest in the companies that manufacture high-resolution peripheral quantitative CT devices.

This high-resolution peripheral quantitative CT scan of an osteoporotic woman's tibia shows worsening trabecular connectivity, separation, and distribution. Courtesy Dr. Stéphanie Boutroy

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