Trabecular bone score: a noninvasive analytical method based upon the dxa image

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Silva, Barbara C.¹; Leslie, William D.²; Resch, Heinrich³; Lamy, Olivier⁴; Lesnyak, Olga⁵; Binkley, Neil⁶; McCloskey, Eugene V.⁷; Kanis, John A.⁸; Bilezikian, John P.¹

Trabecular bone score: a noninvasive analytical method based upon the dxa image

J Bone Miner Res. March 2014;29(3):518-530

©2014 American Society for Bone and Mineral Research

Affiliations

¹Metabolic Bone Diseases Unit, Division of Endocrinology, Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, USA

²Department of Medicine, University of Manitoba, Winnipeg, Canada

³Medical Department II, St. Vincent Hospital Vienna, Academic Teaching Hospital of the Medical University Vienna, Vienna, Austria

⁴Center of Bone Diseases, Lausanne University Hospital, Lausanne, Switzerland

⁵Department of Family Medicine, Ural State Medical Academy, Yekaterinburg, Russian Federation

⁶Osteoporosis Clinical Research Program, University of Wisconsin, Madison, WI, USA

⁷University of Sheffield, Metabolic Bone Centre, Northern General Hospital, Sheffield, United Kingdom

⁸WHO Collaborating Centre for Metabolic Bone Diseases, University of Sheffield, Shefﬁeld, United Kingdom
Abstract and keywords

The trabecular bone score (TBS) is a gray-level textural metric that can be extracted from the two-dimensional lumbar spine dual-energy X-ray absorptiometry (DXA) image. TBS is related to bone microarchitecture and provides skeletal information that is not captured from the standard bone mineral density (BMD) measurement. Based on experimental variograms of the projected DXA image, TBS has the potential to discern differences between DXA scans that show similar BMD measurements. An elevated TBS value correlates with better skeletal microstructure; a low TBS value correlates with weaker skeletal microstructure. Lumbar spine TBS has been evaluated in cross-sectional and longitudinal studies. The following conclusions are based upon publications reviewed in this article: 1) TBS gives lower values in postmenopausal women and in men with previous fragility fractures than their nonfractured counterparts; 2) TBS is complementary to data available by lumbar spine DXA measurements; 3) TBS results are lower in women who have sustained a fragility fracture but in whom DXA does not indicate osteoporosis or even osteopenia; 4) TBS predicts fracture risk as well as lumbar spine BMD measurements in postmenopausal women; 5) efficacious therapies for osteoporosis differ in the extent to which they influence the TBS; 6) TBS is associated with fracture risk in individuals with conditions related to reduced bone mass or bone quality. Based on these data, lumbar spine TBS holds promise as an emerging technology that could well become a valuable clinical tool in the diagnosis of osteoporosis and in fracture risk assessment.

Keywords: TRABECULAR BONE SCORE; OSTEOPOROSIS; FRACTURE RISK; BONE MINERAL DENSITY; MICROARCHITECTURE
Links

DOI: 10.1002/jbmr.2176

PubMed: 24443324

WoS: 000331458700002

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