Multi‐detector row CT imaging of vertebral microstructure for evaluation of fracture risk

Ito, Masako; Ikeda, Kyoji; Nishiguchi, Masahiko; Shindo, Hiroyuki; Uetani, Masataka; Hosoi, Takayuki; Orimo, Hajime

Affiliations

¹Department of Radiology, Nagasaki University School of Medicine, Nagasaki, Japan

²Department of Bone and Joint Disease, The Research Institute, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan

³Department of Orthopedic Surgery, Japan Ekisai‐kai Nagasaki Hospital, Nagasaki, Japan

⁴Department of Orthopedic Surgery, Nagasaki University School of Medicine, Nagasaki, Japan

⁵Department of Internal Medicine, Tokyo Metropolitan Institute of Gerontology and Geriatric Hospital, Tokyo, Japan

⁶Health Science University, Tokyo, Japan

Abstract and keywords

We applied MDCT for in vivo evaluation of the microarchitecture of human vertebrae. Microstructure parameters, such as structure model index, Euler's number, and bone volume fraction, revealed higher relative risk for prevalent vertebral fracture than did BMD obtained by DXA. Thus, microstructure analysis by MDCT, together with simultaneously obtained volumetric BMD values, is useful for clinical assessment of fracture risk.

Introduction: BMD measurement by DXA alone has limitations in predicting fracture, and methods for clinical assessment of bone quality, such as microstructure, are awaited. This study was undertaken to examine the applicability of multidetector row CT (MDCT) for in vivo evaluation of trabecular microstructure.

Materials and Methods: Optimal conditions for MDCT scanning were determined at a spatial resolution of 250 × 250 × 500 μm, using μCT data of excised human vertebra specimens as a reference. We analyzed the trabecular microstructure of the vertebrae of 82 postmenopausal women (55‐76 years old), including 39 women with and 43 without a recent vertebral fracture.

Results: Microstructure indices obtained by MDCT scanning revealed higher relative risk for prevalent vertebral fracture (OR: 16.0 for structure model index, 13.6 for bone volume fraction, and 13.1 for Euler's number) than did spinal BMD obtained by DXA (OR: 4.8). MDCT could also provide volumetric BMD data, which had higher diagnostic value (OR: 12.7) than did DXA.

Conclusion: Vertebral microarchitecture can be visualized by MDCT, and microstructure parameters obtained by MDCT, together with volumetric BMD, provided better diagnostic performance for assessing fracture risk than DXA measurement.

Keywords: osteoporosis; fracture; CT; microstructure

Links

DOI: 10.1359/JBMR.050610

PubMed: 16160740

WoS: 000232062900013

History

Received: 2005-02-16

Revised: 2005-06-04

Accepted: 2005-06-16

Online: 2005-06-20

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