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Reproducibility of direct quantitative measures of cortical bone microarchitecture of the distal radius and tibia by HR-pQCT
Open accessAbstract
Quantitative cortical micro-architectural endpoints are important for understanding structure-function relations in the context of fracture risk and therapeutic efficacy. This technique study details new image-processing methods to automatically segment and directly quantify cortical density, geometry, and micro-architecture from HR-pQCT images of the distal radius and tibia. An automated segmentation technique was developed to identify the periosteal and endosteal margins of the distal radius and tibia, and detect intra-cortical pore space morphologically consistent with Haversian canals. The reproducibility of direct quantitative cortical bone indices based on this method was assessed in a pooled dataset of 56 subjects with two repeat acquisitions for each site. The in vivo precision error was characterized using root mean square coefficient of variation (RMSCV%) from which, the least significant change (LSC) was calculated. Bland-Altman plots were used to characterize bias in the precision estimates. The reproducibility of cortical density and cross-sectional area measures was high (RMSCV <1% and <1.5%, respectively) with good agreement between young and elder medians. The LSC for cortical porosity (Ct.Po) was somewhat smaller in the radius (0.58%) compared with the distal tibia (0.84%) and significantly different between young and elder medians in the distal tibia (LSC: 0.75% vs. 0.92%; p<0.001). The LSC for pore diameter and distribution (Po.Dm and Po.Dm.SD) ranged between 15 and 23μm. Bland-Altman analysis revealed moderate bias for integral measures of area and volume, but not density nor microarchitecture. This study indicates HR-pQCT measures of cortical bone density and architecture can be measured in vivo with high reproducibility and limited bias across a biologically relevant range of values. The results of this study provide informative data for the design of future clinical studies of bone quality.
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Cited by
Nilsson, A. G., Sundh, D., Johansson, L., Nilsson, M., Mellström, D., Rudäng, R., Zoulakis, M., Wallander, M., Darelid, A., & Lorentzon, M. (2017) · Journal of Bone and Mineral Research · doi:10.1002/jbmr.3057 · Cited by 217
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Finkelstein, J. S., Lee, H., Leder, B. Z., Burnett-Bowie, S.-A. M., Goldstein, D. W., Hahn, C. W., Hirsch, S. C., Linker, A., Perros, N., Servais, A. B., et al. (2016) · Journal of Clinical Investigation · doi:10.1172/jci84137 · Cited by 198
Sornay-Rendu, E., Boutroy, S., Vilayphiou, N., Claustrat, B., & Chapurlat, R. D. (2013) · Journal of Bone and Mineral Research · doi:10.1002/jbmr.1880 · Cited by 114
Farr, J. N., Charkoudian, N., Barnes, J. N., Monroe, D. G., McCready, L. K., Atkinson, E. J., Amin, S., Melton, L. J., Joyner, M. J., & Khosla, S. (2012) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2012-2381 · Cited by 79
Sundh, D., Rudäng, R., Zoulakis, M., Nilsson, A. G., Darelid, A., & Lorentzon, M. (2016) · Journal of Bone and Mineral Research · doi:10.1002/jbmr.2747 · Cited by 76
Metadata
- Authors
- Burghardt, A. J., Buie, H. R., Laib, A., Majumdar, S., & Boyd, S. K.
- Venue
- Bone
- Publisher
- Elsevier BV
- Published
- 2010-09
- Volume
- 47
- Issue
- 3
- Pages
- 519-528
- ISSN
- 1873-2763 (ISSN-L)
- 8756-3282
- OpenAlex
- W2014973716
- Cited by
- 459
- References
- 0
- FWCI
- 21.29
- Type
- journal article
- Language
- en
- Open access
- green
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- Burghardt, A. J., Buie, H. R., Laib, A., Majumdar, S., & Boyd, S. K. (2010). Reproducibility of direct quantitative measures of cortical bone microarchitecture of the distal radius and tibia by HR-pQCT. Bone. https://doi.org/10.1016/j.bone.2010.05.034
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