Update on imaging-based measurement of bone mineral density and quality

wbldb

Link, Thomas M.¹; Kazakia, Galateia¹

Update on imaging-based measurement of bone mineral density and quality

Curr Rheumatol Rep. April 9, 2020;22(5):5

©2020 Springer Science+Business Media, LLC, part of Springer Nature

Affiliations

¹Department of Radiology, University of California, 400 Parnassus Ave, A-367, San Francisco, CA 94143, USA
Abstract and keywords

Purpose of Review: Patients with inflammatory arthropathies have a high rate of fragility fractures. Diagnostic assessment and monitoring of bone density and quality are therefore critically important. Here, we review standard and advanced techniques to measure bone density and quality, specifically focusing on patients with inflammatory arthropathies.

Recent Findings: Current standard procedures are dual-energy X-ray absorptiometry (DXA) and quantitative computed tomography (QCT). DXA-based newer methods include trabecular bone score (TBS) and vertebral fracture assessment (VFA). More advanced imaging methods to measure bone quality include high-resolution peripheral quantitative computed tomography (HR-pQCT) as well as multi-detector CT (MD-CT) and magnetic resonance imaging (MRI). Quantitative ultrasound has shown promise but is not standard to assess bone fragility.

Summary: While there are limitations, DXA remains the standard technique to measure density in patients with rheumatological disorders. Newer modalities to measure bone quality may allow better characterization of bone fragility but currently are not standard of care procedures.

Keywords: Osteoporosis; Bone fragility; Inflammatory arthropathies; Bone mineral density; Bone quality; DXA
Links

DOI: 10.1007/s11926-020-00892-w

PubMed: 32270332

WoS: 000524859400001
History

Online: 2020-04-09

Cited Works (27)

Year	Entry
2012	Pialat JB, Burghardt AJ, Sode M, Link TM, Majumdar S. Visual grading of motion induced image degradation in high resolution peripheral computed tomography: impact of image quality on measures of bone density and micro-architecture. Bone. January 2012;50(1):111-118.
2001	Wehrli FW, Gomberg BR, Saha PK, Song HK, Hwang SN, Snyder PJ. Digital topological analysis of in vivo magnetic resonance microimages of trabecular bone reveals structural implications of osteoporosis. J Bone Miner Res. October 2001;16(8):1520-1531.
1999	Majumdar S, Link TM, Augat P, Lin JC, Newitt D, Lan NE, Genant HK. Trabecular bone architecture in the distal radius using magnetic resonance imaging in subjects with fractures of the proximal femur. Osteoporos Int. 1999;10(3):231-239.
2005	Boutroy S, Bouxsein ML, Munoz F, Delmas PD. In vivo assessment of trabecular bone microarchitecture by high-resolution peripheral quantitative computed tomography. J Clin Endocrinol Metab. December 2005;90(12):6508-6515.
1998	Link TM, Majumdar S, Lin JC, Newitt D, Augat P, Ouyang X, Mathur A, Genant HK. A comparative study of trabecular bone properties in the spine and femur using high resolution mri and ct. J Bone Miner Res. January 1998;13(1):122-132.
2017	Sornay‐Rendu E, Boutroy S, Duboeuf F, Chapurlat RD. Bone microarchitecture assessed by HR‐pQCT as predictor of fracture risk in postmenopausal women: the OFELY study. J Bone Miner Res. June 2017;32(6):1243-1251.
2008	MacNeil JA, Boyd SK. Improved reproducibility of high-resolution peripheral quantitative computed tomography for measurement of bone quality. Med Eng Phys. July 2008;30(6):792-799.
2014	Silva BC, Leslie WD, Resch H, Lamy O, Lesnyak O, Binkley N, McCloskey EV, Kanis JA, Bilezikian JP. Trabecular bone score: a noninvasive analytical method based upon the dxa image. J Bone Miner Res. March 2014;29(3):518-530.
2008	Techawiboonwong A, Song HK, Leonard MB, Wehrli FW. Cortical bone water: in vivo quantification with ultrashort echo-time MR imaging. Radiology. September 2008;248(3):824-833.
2017	Kroker A, Zhu Y, Manske SL, Barber R, Mohtadi N, Boyd SK. Quantitative in vivo assessment of bone microarchitecture in the human knee using HR-pQCT. Bone. April 2017;97:43-48.
2010	Burghardt AJ, Buie HR, Laib A, Majumdar S, Boyd SK. Reproducibility of direct quantitative measures of cortical bone microarchitecture of the distal radius and tibia by HR-pQCT. Bone. September 2010;47(3):519-528.
2013	Nishiyama KK, Macdonald HM, Hanley DA, Boyd SK. Women with previous fragility fractures can be classified based on bone microarchitecture and finite element analysis measured with HR-pQCT. Osteoporos Int. May 2013;24(5):1733-1740.
1998	Link TM, Majumdar S, Augat P, Lin JC, Newitt D, Lu Y, Lane NE, Genant HK. In vivo high resolution MRI of the calcaneus: differences in trabecular structure in osteoporosis patients. J Bone Miner Res. July 1998;13(7):1175-1182.
2019	Samelson EJ, Broe KE, Xu H, Yang L, Boyd S, Biver E, Szulc P, Adachi J, Amin S, Atkinson E, Berger C, Burt L, Chapurlat R, Chevalley T, Ferrari S, Goltzman D, Hanley DA, Hannan MT, Khosla S, Liu C-T, Lorentzon M, Mellstrom D, Merle B, Nethander M, Rizzoli R, Sornay-Rendu E, Van Rietbergen B, Sundh D, Wong AKO, Ohlsson C, Demissie S, Kiel DP, Bouxsein ML. Cortical and trabecular bone microarchitecture as an independent predictor of incident fracture risk in older women and men in the Bone Microarchitecture International Consortium (BoMIC): a prospective study. Lancet Diabetes Endocrinol. January 2019;7(1):34-43.
2004	Siris ES, Chen Y-T, Abbott TA, Barrett-Connor E, Miller PD, Wehren LE, Berger ML. Bone mineral density thresholds for pharmacological intervention to prevent fractures. Arch Intern Med. May 24, 2004;164(10):1108-1112.
2016	McCloskey EV, Odén A, Harvey NC, Leslie WD, Hans D, Johansson H, Barkmann R, Boutroy S, Brown J, Chapurlat R, Elders PJM, Fujita Y, Glüer C-C, Goltzman D, Iki M, Karlsson M, Kindmark A, Kotowicz M, Kurumatani N, Kwok T, Lamy O, Leung J, Lippuner K, Ljunggren Ö, Lorentzon M, Mellström D, Merlijn T, Oei L, Ohlsson C, Pasco JA, Rivadeneira F, Rosengren B, Sornay-Rendu E, Szulc P, Tamaki J, Kanis JA. A meta-analysis of trabecular bone score in fracture risk prediction and its relationship to FRAX. J Bone Miner Res. May 2016;31(5):940-948.
2018	Chiba K, Okazaki N, Kurogi A, Isobe Y, Yonekura A, Tomita M, Osaki M. Precision of second-generation high-resolution peripheral quantitative computed tomography: intra- and intertester reproducibilities and factors involved in the reproducibility of cortical porosity. J Clin Densitom. April–June 2018;21(2):295-302.
2005	Ito M, Ikeda K, Nishiguchi M, Shindo H, Uetani M, Hosoi T, Orimo H. Multi‐detector row CT imaging of vertebral microstructure for evaluation of fracture risk. J Bone Miner Res. October 2005;20(10):1828-1836.
2011	Hans D, Barthe N, Boutroy S, Pothuaud L, Winzenrieth R, Krieg M-A. Correlations between trabecular bone score, measured using anteroposterior dual-energy x-ray absorptiometry acquisition, and 3-dimensional parameters of bone microarchitecture: an experimental study on human cadaver vertebrae. J Clin Densitom. July 1, 2011;14(3):302-312.
2003	Black DM, Greenspan SL, Ensrud KE, Palermo L, McGowan JA, Lang TF, Garnero P, Bouxsein ML, Bilezikian JP, Rosen CJ; PaTH Study Investigators. The effects of parathyroid hormone and alendronate alone or in combination in postmenopausal osteoporosis. NEJM. September 25, 2003;349(13):1207-1215.
2009	Kanis JA, Oden A, Johansson H, Borgström F, Ström O, McCloskey E. FRAX^® and its applications to clinical practice. Bone. May 2009;44(5):734-743.
2008	Kanis JA, Johnell O, Oden A, Johansson H, McCloskey E. FRAX™ and the assessment of fracture probability in men and women from the UK. Osteoporos Int. April 2008;19(4):385-397.
2008	Kazakia GJ, Hyun B, Burghardt AJ, Krug R, Newitt DC, de Papp AE, Link TM, Majumdar S. In vivo determination of bone structure in postmenopausal women: a comparison of MR‐pQCT and high‐field MR imaging. J Bone Miner Res. 2008;23(4):463-474.
1998	Majumdar S, Kothari M, Augat P, Newitt DC, Link TM, Lin JC, Lang T, Lu Y, Genant HK. High-resolution magnetic resonance imaging: three-dimensional trabecular bone architecture and biomechanical properties. Bone. May 1998;22(5):445-454.
2002	Kanis JA. Diagnosis of osteoporosis and assessment of fracture risk. Lancet. June 1, 2002;359(9321):1929-1936.
2010	Sode M, Burghardt AJ, Kazakia GJ, Link TM, Majumdar S. Regional variations of gender-specific and age-related differences in trabecular bone structure of the distal radius and tibia. Bone. June 2010;46(6):1652-1660.
2017	Humbert L, Martelli Y, Fonollà R, Steghöfer M, Di Gregorio S, Malouf J, Romera J, del Río Barquero LM. 3D-DXA: assessing the femoral shape, the trabecular macrostructure and the cortex in 3D from DXA images. IEEE Trans Med Imaging. January 2017;36(1):27-39.

Cited By (3)

Year	Entry
2021	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. February 2021;143:115786.
2023	Jones BC, Wehrli FW, Kamona N, Deshpande RS, Vu B-TD, Song HK, Lee H, Grewal RK, Chan TJ, Witschey WR, MacLean MT, Josselyn NJ, Iyer SK, al Mukaddam M, Snyder PJ, Rajapakse CS. Automated, calibration-free quantification of cortical bone porosity and geometry in postmenopausal osteoporosis from ultrashort echo time MRI and deep learning. Bone. June 2023;171:116743.
2022	Sollmann N, Löffler MT, Husseini ME, Sekuboyina A, Dieckmeyer M, Rühling S, Zimmer C, Menze B, Joseph GB, Baum T, Kirschke JS. Automated opportunistic osteoporosis screening in routine computed tomography of the spine: comparison with dedicated quantitative CT. J Bone Miner Res. July 2022;37(7):1287-1296.