A Tri-Modality Comparison of Volumetric Bone Measure Quantification Using 1.0 Tesla Peripheral Magnetic Resonance Imaging, Peripheral Quantitative Computed Tomography and Highresolution-Peripheral Quantitative Computed Tomography Images

This comparative study of peripheral (p) QCT, high-resolution pQCT (hr-pQCT) and 1.0 Tesla pMRI technologies focused on quantifying short-term test-retest reproducibility, validity, one-year detection limit and clinical sensitivity of each modality’s derived bone measures. Select bone outcomes were evaluated from scans performed on Hamiltonian women above 50 years old and then externally validated in a population-based cohort of Canadian women 60-85 years old. In the local cohort (age: 74 ± 9 years and BMI 27.65 ± 5.74 kg/m² ), Tb.Sp measured on pMRI, Ct.Th and vBMD from pQCT showed significant correlations (r² =0.52-0.85) with hr-pQCT and yielded slopes near unity. Bland-Altman analyses revealed significant relations between magnitude of pQCT and pMRI bone outcomes (Tb.Th(-), Tb.N(+), BV/TV(-)) and level of agreement with hr-pQCT. Except for hole geometry and connectivity, short-term reproducibility was < 5% for pQCT but only BV/TV was < 5% for pMRI. The more distal slice of pQCT scans at both sites showed superior reproducibility but slightly larger change than the proximal. Coregistering repeat images and excluding those on antiresorptive therapy mildly reduced precision error and one-year change. In the local cohort, only Ct.Th and cortical vBMD associated with fragility fractures (OR: 1.09-3.28) using hr-pQCT, which was externally validated in the national cohort. Certain trabecular measures on pMRI and pQCT erred towards increased odds for fractures locally. For pQCT, these became significant in the national cohort (OR:1.04-3.81). The national reference dataset for hr-pQCT showed larger Tb.Sp and smaller Tb.N compared to Americans but age-related rates of decline in Ct.Th and BV/TV were larger in Europeans. This study demonstrated validity of pMRI and pQCT image-derived volumetric bone outcomes and a reasonable degree of shortand long-term precision error for measures derived from pQCT images but not from 1.0T pMRI. For pMRI, a shorter scan was suggested to limit motion and to reduce precision error. Performing scans more distally was recommended, but a single CT slice from pQCT was comparable to 110 slices from hr-pQCT in associations with fractures.

Year	Entry
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Year

Entry

2006

Khosla S, Riggs BL, Atkinson EJ, Oberg AL, McDaniel LJ, Holets M, .Peterson JM, Melton LJ III. Effects of sex and age on bone microstructure at the ultradistal radius: a population-based noninvasive in vivo assessment. J Bone Miner Res. January 2006;21(1):124-131.

1983

Parfitt AM, Mathews CH, Villanueva AR, Kleerekoper M, Frame B, Rao DS. Relationships between surface, volume, and thickness of iliac trabecular bone in aging and in osteoporosis: implications for the microanatomic and cellular mechanisms of bone loss. J Clin Invest. October 1983;72(4):1396-1409.

2002

Brown JP, Josse RG; Scientific Advisory Council of the Osteoporosis Society of Canada. 2002 clinical practice guidelines for the diagnosis and management of osteoporosis in Canada. Can Med Assoc J. November 12, 2002;167(suppl 10):S1-S34.

2008

Recker RR, Delmas PD, Halse J, Reid IR, Boonen S, García-Hernandez PA, Supronik J, Lewiecki EM, Ochoa L, Miller P, Hu H, Mesenbrink P, Hartl F, Gasser J, Eriksen EF. Effects of intravenous zoledronic acid once yearly on bone remodeling and bone structure. J Bone Miner Res. January 2008;23(1):6-16.

2008

Engelke K, Adams JE, Armbrecht G, Augat P, Bogado CE, Bouxsein ML, Felsenberg D, Ito M, Prevrhal S, Hans DB, Lewiecki EM. Clinical use of quantitative computed tomography and peripheral quantitative computed tomography in the management of osteoporosis in adults: the 2007 ISCD official positions. J Clin Densitom. January–March 2008;11(1):123-162.