Bone Analysis Using Trabecular Bone Score and Dual-Energy X-Ray Absorptiometry-Based 3-Dimensional Modeling in Postmenopausal Women With Primary Hyperparathyroidism

2021 ◽  
Author(s):  
Rosa Arboiro-Pinel ◽  
Ignacio Mahíllo-Fernández ◽  
Manuel Díaz-Curiel
Keyword(s):  
Primary Hyperparathyroidism ◽  
Trabecular Bone ◽  
Postmenopausal Women ◽  
Trabecular Bone Score ◽  
Dual Energy ◽  
X Ray ◽  
3 Dimensional ◽  
Dimensional Modeling

scholarly journals Bone quality, as measured by trabecular bone score, in patients with primary hyperparathyroidism

2013 ◽  
Vol 169 (2) ◽  
pp. 155-162 ◽  
Author(s):  
Cristina Eller-Vainicher ◽  
Marcello Filopanti ◽  
Serena Palmieri ◽  
Fabio Massimo Ulivieri ◽  
Valentina Morelli ◽  
...  
Keyword(s):  
Primary Hyperparathyroidism ◽  
Trabecular Bone ◽  
Bone Quality ◽  
Trabecular Bone Score ◽  
Dual Energy ◽  
Mineral Density ◽  
Texture Measurement ◽  
X Ray ◽  
Spinal Radiograph ◽  
And Gender

ObjectiveIn primary hyperparathyroidism (PHPT), vertebral fractures (VFx) occur regardless of bone mineral density (BMD) and may depend on decreased bone quality. Trabecular bone score (TBS) is a texture measurement acquired during a spinal dual-energy X-ray absorptiometry (DXA). Recently, TBS has been proposed as an index of bone micro-architecture.DesignWe studied 92 PHPT patients (74 females, age 62.1±9.7 years) and 98 control subjects. In all patients at baseline, in 20 surgically treated patients and in 10 conservatively treated patients after 24 months, TBS, spinal (lumbar spine (LS)) and femoral (total hip (TH) and femoral neck (FN)) BMD were assessed by DXA and VFx by spinal radiograph.ResultsPHPT patients had lower TBS (−2.39±1.8) and higher VFx prevalence (43.5%) than controls (−0.98±1.07 and 8.2% respectively, bothP<0.0001). TBS was associated with VFx (odds ratio 1.4, 95% CI 1.1–1.9,P=0.02), regardless of LS-BMD, age, BMI and gender, and showed a better compromise between sensitivity (75%) and specificity (61.5%) for detecting VFx than LS-BMD, TH-BMD and FN-BMD (31 and 75%, 72 and 44.2%, and 64 and 65% respectively). In surgically treated patients, TBS, LS-BMD, TH-BMD and FN-BMD increased (+47±44.8,+29.2±34.1,+49.4±48.7 and +30.2±39.3% respectively, allP<0.0001). Among patients treated conservatively, TBS decreased significantly in those (n=3) with incident VFx (−1.3±0.3) compared with those without (−0.01±0.9,P=0.048), while BMD changes were not statistically different (LS 0.3±1.2 vs −0.8±0.9 respectively,P=0.19; TH 0.4±0.8 vs −0.8±1.4 respectively,P=0.13 and FN 0.4±0.9 vs −0.8±1.4 respectively,P=0.14).ConclusionsIn PHPT, bone quality, as measured by TBS, is reduced and associated with VFx and improves after surgery.

scholarly journals Relationship between Insulin Resistance (HOMA-IR), Trabecular Bone Score (TBS), and Three-Dimensional Dual-Energy X-ray Absorptiometry (3D-DXA) in Non-Diabetic Postmenopausal Women

2020 ◽  
Vol 9 (6) ◽  
pp. 1732
Author(s):  
Francisco Campillo-Sánchez ◽  
Ricardo Usategui-Martín ◽  
Ángela Ruiz -de Temiño ◽  
Judith Gil ◽  
Marta Ruiz-Mambrilla ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Trabecular Bone ◽  
Postmenopausal Women ◽  
Trabecular Bone Score ◽  
Three Dimensional ◽  
Dual Energy ◽  
Enzyme Linked Immunosorbent Assay ◽  
Model Assessment ◽  
Mineral Density ◽  
X Ray

Background: Insulin may play a key role in bone metabolism, where the anabolic effect predominates. This study aims to analyze the relationship between insulin resistance and bone quality using the trabecular bone score (TBS) and three-dimensional dual-energy X-ray absorptiometry (3D-DXA) in non-diabetic postmenopausal women by determining cortical and trabecular compartments. Methods: A cross-sectional study was conducted in non-diabetic postmenopausal women with suspected or diagnosed osteoporosis. The inclusion criteria were no menstruation for more than 12 months and low bone mass or osteoporosis as defined by DXA. Glucose was calculated using a Hitachi 917 auto-analyzer. Insulin was determined using an enzyme-linked immunosorbent assay (EIA). Insulin resistance was estimated using a homeostasis model assessment of insulin resistance (HOMA-IR). DXA, 3D-DXA, and TBS were thus collected. Moreover, we examined bone parameters according to quartile of insulin, hemoglobin A1C (HbA1c), and HOMA-IR. Results: In this study, we included 381 postmenopausal women. Women located in quartile 4 (Q4) of HOMA-IR had higher values of volumetric bone mineral density (vBMD) but not TBS. The increase was higher in the trabecular compartment (16.4%) than in the cortical compartment (6.4%). Similar results were obtained for insulin. Analysis of the quartiles by HbA1c showed no differences in densitometry values, however women in Q4 had lower levels of TBS. After adjusting for BMI, statistical significance was maintained for TBS, insulin, HOMA-IR, and HbA1c. Conclusions: In non-diabetic postmenopausal women there was a direct relationship between insulin resistance and vBMD, whose effect is directly related to greater weight. TBS had an inverse relationship with HbA1c, insulin, and insulin resistance unrelated to weight. This might be explained by the formation of advanced glycosylation products (AGEs) in the bone matrix, which reduces bone deformation capacity and resistance, as well as increases fragility.

Dual-energy X-ray Absorptiometry Monitoring with Trabecular Bone Score: 2019 ISCD Official Position

2019 ◽  
Vol 22 (4) ◽  
pp. 501-505 ◽  
Author(s):  
Kelly Krohn ◽  
Elliott N. Schwartz ◽  
Yoon-Sok Chung ◽  
E. Michael Lewiecki
Keyword(s):  
Trabecular Bone ◽  
Trabecular Bone Score ◽  
Dual Energy ◽  
X Ray ◽  
Official Position

Optimizing DXA to Assess Skeletal Health: Key Concepts for Clinicians

2020 ◽  
Vol 105 (12) ◽  
pp. 3784-3791
Author(s):  
Kurt A Kennel ◽  
Jad G Sfeir ◽  
Matthew T Drake
Keyword(s):  
Fracture Risk ◽  
Trabecular Bone ◽  
Trabecular Bone Score ◽  
Evidence Synthesis ◽  
Dual Energy ◽  
Care Providers ◽  
Mineral Density ◽  
Skeletal Health ◽  
X Ray ◽  
Osteoporosis Care

Abstract Context The diagnosis of osteoporosis and assessment of fracture risk prior to a sentinel fracture was transformed by the widespread clinical use of dual-energy X-ray absorptiometry (DXA) for the assessment of bone mineral density (BMD). Evidence Acquisition This review is based on a collection of primary and review literature gathered from a PubMed search of “dual energy X-ray absorptiometry,” “trabecular bone score,” and “atypical femur fracture” among other keywords. PubMed searches were supplemented by the authors’ prior knowledge of the subject. Evidence Synthesis While uncertainty exists for some aspects of osteoporosis care, patient and clinician familiarity with BMD assessment for screening and monitoring is firmly established. Beyond BMD, lateral spine images obtained with DXA can diagnose osteoporosis and refine fracture risk through the detection of unrecognized vertebral fractures. In addition, analysis of DXA lumbar spine images can reflect changes in trabecular bone microarchitecture, a component of bone “quality” that predicts risk of fracture independent of BMD. Finally, monitoring of bone health by DXA may be extended to include assessment of the femoral cortices for rare but serious adverse effects associated with antiresorptive therapies. Conclusions Increasing technologic sophistication requires additional consideration for how DXA imaging is performed, interpreted and applied to patient care. As with any test, clinicians must be familiar with DXA performance, pitfalls in analysis, and interpretation within each clinical context in which DXA is applied. With this perspective, care providers will be well positioned to contribute to continuous improvement of DXA performance and, in turn, quality of osteoporosis care.

Reproducibility of trabecular bone score with different scan modes using dual-energy X-ray absorptiometry: a phantom study

2014 ◽  
Vol 44 (4) ◽  
pp. 573-576 ◽  
Author(s):  
Michele Bandirali ◽  
Giovanni Di Leo ◽  
Carmelo Messina ◽  
Maria Juana Pastor Lopez ◽  
Alessandro Mai ◽  
...  
Keyword(s):  
Trabecular Bone ◽  
Trabecular Bone Score ◽  
Dual Energy ◽  
Phantom Study ◽  
X Ray ◽  
Scan Modes

Knochenmineraldichtemessung in der klinischen Routine

2017 ◽  
Vol 42 (03) ◽  
pp. 211-216
Author(s):  
Alexander Pfeil ◽  
Gabriele Lehmann ◽  
Joachim Böttcher ◽  
Lisa Reinhardt ◽  
Peter Oelzner ◽  
...  
Keyword(s):  
Vertebral Fracture ◽  
Trabecular Bone ◽  
Trabecular Bone Score ◽  
Dual Energy ◽  
Vertebral Fracture Assessment ◽  
X Ray ◽  
Fracture Assessment

ZusammenfassungDie Osteoporose ist durch den Verlust an Knochenmineraldichte mit einem konsekutiv erhöhten Frakturrisiko gekennzeichnet. Zur Beurteilung des Frakturrisikos und der Einleitung einer medikamentösen Therapie sollte eine Knochenmineraldichtemessung durchgeführt werden. Die Dual Energy X-ray Absorptiometrie (DXA) stellt das nach den aktuellen Leitlinien empfohlene Verfahren zur Beurteilung der Knochenmineraldichte dar. Anhand des T-Scores, welcher durch eine DXA-Knochenmineraldichtemessung ermittelt wird, erfolgt die Abschätzung des Frakturrisikos, um die Notwendigkeit zur Durchführung einer medikamentösen Therapie individuell festzulegen. Die DXA bietet zudem die Möglichkeit, eine Beurteilung der Knochenstruktur unter Verwendung des Trabecular Bone Score vorzunehmen. Das Vorliegen von Wirbelkörperfrakturen kann mit dem „sogenannten“ Vertebral Fracture Assessment durch die DXA ebenfalls visualisiert werden. Als weitere Knochenmineraldichtemessverfahren konkurrieren die Quantitative Computertomografie und der Quantitative Ultraschall. Entsprechend der S3-Leitlinie „Osteoporose“ können diese Knochenmineraldichtemessverfahren allerdings die DXA-Technik nicht ersetzen und sollten nicht regelhaft zum Einsatz kommen.

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