scholarly journals Bone Microstructure Changes due to Once-/Twice-Weekly Teriparatide Administration: A Report of Five Cases Using High-Resolution Peripheral Quantitative Computed Tomography

2021 ◽  
Author(s):  
Manabu Tsukamoto ◽  
Nobukazu Okimoto ◽  
Miyuki Mori ◽  
Toru Yoshioka ◽  
Kei Asano ◽  
...  
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Quantitative Computed Tomography ◽  
Peripheral Quantitative Computed Tomography ◽  
Lumbar Bone Mineral Density ◽  
Bone Microstructure ◽  
Anabolic Effect ◽  
Mineral Density ◽  
Weekly Administration ◽  
Average Change

Abstract This study was conducted with the aim of presenting cases in which high-resolution peripheral quantitative computed tomography (HR-pQCT) was used to investigate changes in bone microstructure due to once-weekly/twice-weekly administration of teriparatide (TPTD). Of osteoporosis patients who participated in a non-inferiority trial (TWICE study: once-weekly vs twice-weekly TPTD) with lumbar bone mineral density (BMD) as the primary endpoint, five cases scanned by HR-pQCT before TPTD administration were analyzed. Two cases were given once-weekly TPTD, three were given twice-weekly TPD, and HR-pQCT was repeated after 48 weeks. A sufficient anabolic effect of once-weekly/twice-weekly TPTD on the trabecular and cortical bone at the tibia was obtained. In addition, the average change in cortical porosity (Ct.Po) was only 0.3% in the tibia and 0.2% in the radius. These findings indicate that once-weekly and twice-weekly TPTD can be expected to improve bone microstructure, and the increase in Ct.Po may be suppressed.

Bone Evaluation by High-Resolution Peripheral Quantitative Computed Tomography in Patients With Adrenal Incidentaloma

2020 ◽  
Vol 105 (8) ◽  
pp. e2726-e2737
Author(s):  
Aline Barbosa Moraes ◽  
Marcela Pessoa de Paula ◽  
Francisco de Paula Paranhos-Neto ◽  
Emanuela Mello Ribeiro Cavalari ◽  
Felipe Fernandes Cordeiro de Morais ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Bone Mineral Density ◽  
High Resolution ◽  
Distal Radius ◽  
Bone Mineral ◽  
Quantitative Computed Tomography ◽  
Adrenal Incidentaloma ◽  
Peripheral Quantitative Computed Tomography ◽  
Mineral Density ◽  
X Ray

Abstract Context Data regarding high-resolution peripheral quantitative computed tomography (HR-pQCT) in patients with adrenal incidentaloma (AI) are unknown. Purpose To evaluate the areal bone mineral density (aBMD), microstructure, and fractures in patients with nonfunctioning AI (NFAI) and autonomous cortisol secretion (ACS). Methods We evaluated 45 patients with NFAI (1 mg dexamethasone suppression test [DST] ≤1.8 µg/dL) and 30 patients with ACS (1 mg DST 1.9-5.0 µg/dL). aBMD was measured using dual-energy X-ray absorptiometry; vertebral fracture by spine X-ray; and bone geometry, volumetric bone mineral density (vBMD), and microstructure by HR-pQCT. Results Patients with ACS showed lower aBMD values at the spine, femoral neck, and radius 33% than those with NFAI. Osteoporosis was frequent in both groups: NFAI (64.9%) and ACS (75%). Parameters at the distal radius by HR-pQCT were decreased in patients with ACS compared to those with NFAI: trabecular vBMD (Tb.vBMD, P = 0.03), inner zone of the trabecular region (Inn.Tb.vBMD, P = 0.01), the bone volume/tissue volume ratio (BV/TV, P = 0.03) and trabecular thickness (P = 0.04). As consequence, a higher ratio of the outer zone of the trabecular region/inner zone vBMD (Meta/Inn.vBMD, P = 0.003) was observed. A correlation between the cortisol levels after 1 mg DST and Meta/Inn.vBMD ratio was found (r = 0.29; P = 0.01). The fracture frequency was 73.7% in patients with ACS vs 55.6% in patients with NFAI (P = 0.24). Conclusion Our findings point to an association between trabecular bone microarchitectural derangement at the distal radius and ACS. Our data suggest that AI have a negative impact on bone when assessed by HR-pQCT, probably associated to subclinical hypercortisolism.

High-resolution Peripheral Quantitative Computed Tomography Imaging in the Assessment of Periarticular Bone of Metacarpophalangeal and Wrist Joints

2016 ◽  
Vol 43 (10) ◽  
pp. 1921-1934 ◽  
Author(s):  
Sujay Nagaraj ◽  
Stephanie Finzel ◽  
Kathryn S. Stok ◽  
Cheryl Barnabe ◽  
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Bone Microarchitecture ◽  
Image Interpretation ◽  
Quantitative Computed Tomography ◽  
High Sensitivity ◽  
Peripheral Quantitative Computed Tomography ◽  
Joint Space ◽  
Mineral Density ◽  
Wrist Joints

Objective.To synthesize descriptions of periarticular findings at the metacarpophalangeal (MCP) and wrist joints in different types of arthritis and in the normal state imaged by high-resolution peripheral quantitative computed tomography (HR-pQCT); to assemble the literature reporting on the ability of HR-pQCT to detect findings relative to other imaging modalities; and to collate results on the reproducibility of image interpretation.Methods.A systematic literature review was performed using terms for HR-pQCT and MCP or wrist joints using medical literature databases and conference abstracts. Any study describing predefined pathology findings, comparison to another radiographic technique, or a measure of reproducibility was included with no limitation by disease state.Results.We identified 44 studies meeting inclusion criteria from the 1901 articles identified by our search. All 44 reported on pathology findings, including erosions (n = 31), bone microarchitecture (n = 10) and bone mineral density (n = 10) variables, joint space evaluation (n = 7), or osteophyte characterization (n = 7). Seventeen of the studies compared HR-pQCT findings to either plain radiography (n = 9), ultrasound (n = 4), magnetic resonance imaging (n = 5), or microcomputed tomography (n = 2), with HR-pQCT having high sensitivity for erosion detection. Twenty-four studies included an assessment of reproducibility with good to excellent metrics, and highlighting the critical importance of positioning when assessing joint space variables.Conclusion.Despite high sensitivity for erosion detection and good reproducibility, more research is required to determine where HR-pQCT can be applied to enhance our understanding of periarticular bone changes in a variety of arthritis conditions.

scholarly journals Bone microstructural changes revealed by high-resolution peripheral quantitative computed tomography imaging and elevated DKK1 and MIP-1α levels in patients with MGUS

Blood ◽  
2011 ◽  
Vol 118 (25) ◽  
pp. 6529-6534 ◽  
Author(s):  
Alvin C. Ng ◽  
Sundeep Khosla ◽  
Natthinee Charatcharoenwitthaya ◽  
Shaji K. Kumar ◽  
Sara J. Achenbach ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Bone Mineral Density ◽  
High Resolution ◽  
Bone Mineral ◽  
Quantitative Computed Tomography ◽  
Peripheral Quantitative Computed Tomography ◽  
Areal Bone Mineral Density ◽  
Mineral Density ◽  
Trabecular Thickness ◽  
Increased Risk

Abstract Recent population-based studies demonstrate an increased fracture risk with monoclonal gammopathy of undetermined significance (MGUS). The etiology of this increased risk remains unclear, however, because areal bone mineral density (aBMD) measurements by dual-energy x-ray absorptiometry cannot assess bone microstructural properties critical to determining bone quality and strength. To better define the skeletal effects of MGUS, we performed aBMD and high-resolution peripheral quantitative computed tomography volumetric bone mineral density (vBMD) measurements in 50 MGUS patients (20 females, 30 males; mean ± SEM age, 70.5 ± 1.4 years) and 100 matched control subjects. Relative to controls, MGUS patients had decreased aBMD at the femoral neck (P = .05) and total femur (P < .05) but no differences at other sites. In contrast, high-resolution peripheral quantitative computed tomography showed markedly diminished cortical thickness (P < .05) and increased endocortical area (P < .01). Average vBMD (P < .01), cortical vBMD (P < .001), and trabecular thickness (P < .01) were all significantly decreased in MGUS patients, suggestive of impaired bone formation. Serum levels of the Wnt pathway inhibitor Dickkopf-related protein 1 (P < .001) and osteoclast-activating factor MIP-1α (P < .05) also were significantly elevated in MGUS patients. Our data provide the first evidence of altered bone microstructure in MGUS and suggest that cytokines elevated in osteolytic myeloma also may be associated with bone loss in MGUS.

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