scholarly journals Phantomless assessment of volumetric bone mineral density using virtual non-contrast images from spectral detector computed tomography

2020 ◽  
Vol 93 (1109) ◽  
pp. 20190992 ◽  
Author(s):  
David Zopfs ◽  
Simon Lennartz ◽  
Charlotte Zaeske ◽  
Martin Merkt ◽  
Kai Roman Laukamp ◽  
...  

Objective: To evaluate phantomless assessment of volumetric bone mineral density (vBMD) based on virtual non-contrast images of arterial (VNCa) and venous phase (VNCv) derived from spectral detector CT in comparison to true non-contrast (TNC) images and adjusted venous phase conventional images (CIV(adjusted)). Methods: 104 consecutive patients who underwent triphasic spectral detector CT between January 2018 and April 2019 were retrospectively included. TNC, VNCa, VNCv and venous phase images (CIV) were reconstructed. vBMD was obtained by two radiologists using an FDA/CE-cleared software. Average vBMD of the first three lumbar vertebrae was determined in each reconstruction; vBMD of CIV was adjusted for contrast enhancement as suggested earlier. Results: vBMD values obtained from CIV(adjusted) are comparable to vBMD values derived from TNC images (91.79 ± 36.52 vs 90.16 ± 41.71 mg/cm3, p = 1.00); however, vBMD values derived from VNCa and VNCv (42.20 ± 22.50 and 41.98 ± 23.3 mg/cm3 respectively) were significantly lower as compared to vBMD values from TNC and CIV(adjusted) (all p ≤ 0.01). Conclusion: Spectral detector CT-derived virtual non-contrast images systematically underestimate vBMD and therefore should not be used without appropriate adjustments. Adjusted venous phase images provide reliable results and may be utilized for an opportunistic BMD screening in CT examinations. Advances in knowledge: Adjustments of venous phase images facilitate opportunistic assessment of vBMD, while spectral detector CT-derived VNC images systematically underestimate vBMD.

2020 ◽  
Vol 73 (1) ◽  
pp. 91-94
Author(s):  
Nazar M. Kostyshyn ◽  
Liubov P. Kostyshyn ◽  
Mechyslav R. Gzhegotskyi

The aim of investigation was to study the structural and functional conditions of cortical and trabecular layers of lumbar vertebrae L1-L5 in different age groups. Materials and methods: In order to assess BMD of the lumbar vertebrae 102 people18 to 75 years old was examined. Study of bone mineral density cortical and trabecular layer of lumbar vertebrae (L1-L5) performed by computed tomography in Hounsfield Units (HU) in terms of standard deviation (SD). Results: The results of computed tomography showed a direct relationship of bone mineral density of lumbar vertebrae with age of examined persons. Osteoporosis and osteopenia was registered in 15% of men and 30% women in middle adulthood, in late adulthood – 35% and 50% respectively. During early old age osteopenia and osteoporosis are observed in 37,5% and 25% of men and 26% and 64% women. Osteoporosis in the middle old age has been reported in 50% of men and 75% of women Conclusions: Results of the study showed a direct link between mineral density, age and gender. The middle adulthood age period was characterized by the highest mineral mass compared with the other age periods. Then there is a loss of bone mass throughout life, and with the onset of aging osteopenia and osteoporosis are recorded. It was investigated that in the early old age, loss of bone mass is mainly observed in female.


2012 ◽  
Vol 39 (6) ◽  
pp. 1215-1220 ◽  
Author(s):  
SYMEON TOURNIS ◽  
VASILIOS SAMDANIS ◽  
SAVAS PSARELIS ◽  
CHRYSA LIAKOU ◽  
JULIA ANTONIOU ◽  
...  

Objective.To investigate the effect of rheumatoid arthritis (RA) on volumetric bone mineral density (vBMD) and bone geometry in postmenopausal women treated with bisphosphonates.Methods.Fifty-three postmenopausal women with RA and 87 control subjects, comparable in terms of age, body mass index, and years since menopause, underwent peripheral quantitative computed tomography (pQCT) of the nondominant tibia.Results.At 4% (trabecular site), trabecular bone mineral content (BMC) and vBMD (p < 0.001) were lower in the RA group, while trabecular area was comparable. At 38% (cortical site), cortical BMC (p < 0.01), area (p < 0.05), and thickness (p < 0.001) were lower in the RA group, whereas vBMD was comparable. Endosteal circumference was higher (p < 0.05), whereas periosteal circumference was comparable, indicating cancellization of cortical bone. In the RA group, muscle area was lower (p < 0.001), while at 14% polar stress strength index was significantly lower (p < 0.01) in patients with RA, indicating impairment of bone mechanical properties.Conclusion.RA is associated with negative effects on both cortical and cancellous bone in postmenopausal women treated with bisphosphonates. Cortical geometric properties are also adversely affected mainly by increased endosteal circumference, whereas trabecular geometric properties are generally preserved.


Medicina ◽  
2020 ◽  
Vol 56 (10) ◽  
pp. 518
Author(s):  
Witold Krupski ◽  
Joanna Kruk-Bachonko ◽  
Marcin R. Tatara

Background and Objectives: During osteopetrosis course, impaired bone remodeling induces skeletal osteosclerosis and abnormally dense bones, which, however, are brittle and susceptible to low-energy fractures. In this study, radiological evaluation and densitometric measurements of several bones of the skeleton in one of the oldest patients in the world suffering from osteopetrosis was presented. Materials and Methods: Volumetric bone mineral density measurements of the examined bones in an 80-year-old man were performed using two different quantitative computed tomography techniques. Results: The obtained results show higher values of the volumetric bone mineral density of the trabecular bone in lumbar spine than in the cortical bone compartment. T-score and Z-score in this patient reached values of 27–28 and 31–32, respectively. Conclusions: The obtained densitometric data may serve for further diagnostic purposes of osteopetrosis. As documented, the severity of the osteosclerotic changes of bones were higher in this patient than in most other described cases. Moreover, radiological signs diagnosed in this patient were characteristic for all types of osteopetrosis making this case very uncommon.


2005 ◽  
Vol 46 (3) ◽  
pp. 269-275 ◽  
Author(s):  
G. Guglielmi ◽  
I. Floriani ◽  
V. Torri ◽  
J. Li ◽  
C. van Kuijk ◽  
...  

Purpose: To evaluate the impact of degenerative changes due to osteoarthritis (OA) at the spine on volumetric bone mineral density (BMD) as measured by volumetric quantitative computed tomography (vQCT). Material and Methods: Eighty‐four elderly women (mean age 73±6 years), comprising 33 with vertebral fractures assessed by radiographs and 51 without vertebral fractures, were studied. Trabecular, cortical, and integral BMD were examined at the spine and hip using a helical CT scanner and were compared to dual X‐ray absorptiometry (DXA) measurements at the same sites. OA changes visible on the radiographs were categorized into two grades according to severity. Differences in BMD measures obtained in the two groups of patients defined by OA grade using the described radiologic methods were compared using analysis of variance. Standardized difference (effect sizes) was also compared between radiologic methods. Results: Spinal trabecular BMD did not differ significantly between OA grade 0 and OA grade 1. Spinal cortical and integral BMD measures showed statistically significant differences, as did the lumbar spine DXA BMD measurement (13%, P = 0.02). The QCT measurements at the hip were also higher in OA 1 subjects. Femoral trabecular BMD was 13–15% higher in OA grade 1 subjects than in OA grade 0 subjects. The cortical BMD measures in the CT_TOT_FEM and CT_TROCH ROI's were also higher in the OA 1 subjects. The integral QCT BMD measures in the hip showed difference between grades OA 1 and 0. The DXA measurements in the neck and trochanter ROI's showed smaller differences (9 and 11%, respectively). There were no statistically significant differences in bone size. Conclusion: There is no evidence supporting that trabecular BMD measurements by QCT are influenced by OA. Instead, degenerative changes have an effect on both cortical and integral QCT, and on DXA at the lumbar spine and the hip. For subjects with established OA, assessment of BMD by volumetric QCT may be suggested.


2012 ◽  
Vol 57 (No. 12) ◽  
pp. 573-580 ◽  
Author(s):  
A. Charuta ◽  
R.G. Cooper ◽  
M. Pierzchała ◽  
J.O. Horbańczuk

Changes in the volumetric bone mineral density (vBMD) and bone mineral content (BMC) of tibiotarsal bones of growing turkeys as affected by birds&rsquo; age, sex, and within-the-bone location, respectively, were determined by computed tomography. The research was performed on 165 heavy-type BIG 6 turkeys reared between weeks (wk) 3&ndash;16 of age. The computed tomography (pQCT) measurement, conducted at 18&nbsp;and 50% of the bone length, comprised a bone fragment which was 0.07 mm thick for the compact and the spongious substance collectively. It should be noted that the diaphyses of the tibiotarsal bones in turkeys (580 mg/cm<sup>3</sup>) had greater vBMD than the proximal metaphyses (300 mg/cm<sup>3</sup>), (P &le; 0.001). BMC was higher in metaphyses for both sexes. Significant differences between the BMC of the metaphyses and the diaphyses were observed in males and females at wk 3 (P &le; 0.01), 6 (P &le; 0.05), and 9 (P &le; 0.001), and at wk 3 (P &le; 0.05) and 12 (P &le; 0.01), respectively. vBMD in the diaphyses gradually attenuated with age for both sexes, from 688 mg/cm<sup>3</sup> (wk 3) to 532 mg/cm<sup>3</sup> (wk 16). vBMD of the metaphyses was constant in females, but in males it achieved maximum values of 350 mg/cm<sup>3 </sup>at wk 6 and 12 and minimum of 260 mg/cm<sup>3 </sup>at wk 9 and 16. Correlations between body weight (BW) and vBMD of the diaphyses were observed in males (r = &ndash;0.85, P &le; 0.001) and females (r = &ndash;0.52, P &le; 0.01). It can be concluded that vBMD loss in diaphyses diminished bone-breaking strength leading in investigated turkeys to deformities and bone fractures.


2006 ◽  
Vol 91 (5) ◽  
pp. 1748-1753 ◽  
Author(s):  
Ioannis Charopoulos ◽  
Symeon Tournis ◽  
George Trovas ◽  
Panagiota Raptou ◽  
Philippos Kaldrymides ◽  
...  

Context: Primary hyperparathyroidism (PH) is characterized by inappropriate PTH elevation with or without hypercalcemia. Bone disease involves catabolic action at cortical sites, whereas cancellous sites and geometry might be relatively preserved. Objective: Our objective was to examine the effect of PH on quantitative and qualitative bone characteristics using peripheral quantitative computed tomography at the tibia in postmenopausal women with PH and healthy controls. Design and Setting: We conducted a cross-sectional study at a tertiary referral center. Patients: Fifty-two postmenopausal women with PH and 56 healthy controls, comparable for age and anthropometric measures, participated. Intervention: There was no intervention. Main Outcome Measure: We assessed volumetric bone mineral density (vBMD), bone mineral content (BMC), cortical thickness, cortical and trabecular area, peri- and endosteal circumference, and polar stress strength index assessed by peripheral quantitative computed tomography of the left tibia at 4% (cancellous), 14% (transition zone), and 38% (cortical) from the distal end. Results: At 4%, there was a significant decrease of trabecular BMC and vBMD (P &lt; 0.001), effect particularly evident in hypercalcemic patients, whereas trabecular area was comparable. At 38%, cortical BMC (P &lt; 0.01), vBMD (P &lt; 0.01), area (P &lt; 0.05), and thickness (P &lt; 0.001) were reduced in the PH group, particularly in hypercalcemic patients. Endosteal circumference increased (P &lt; 0.001), whereas periosteal circumference was comparable, indicating cancellization of cortical bone. At 14%, polar stress strength index was significantly decreased (P &lt; 0.01) in hypercalcemic patients, indicating impairment of bone mechanical properties. Conclusions: Normocalcemic PH is characterized by catabolic actions at both cortical and cancellous sites (38 and 4%, respectively), an effect accentuated in hypercalcemic patients. Cortical geometric properties are adversely affected even in normocalcemic patients, whereas trabecular properties are generally preserved.


2020 ◽  
Vol 14 (3) ◽  
pp. 265-272
Author(s):  
Atsushi Ikeura ◽  
Taketoshi Kushida ◽  
Kenichi Oe ◽  
Yoshihisa Kotani ◽  
Muneharu Ando ◽  
...  

Study Design: Biomechanical study.Purpose: To assess the correlation between the computed tomography (CT) values of the pedicle screw path and screw pull-out strength.Overview of Literature: The correlation between pedicle screw pull-out strength and bone mineral density has been well established. In addition, several reports have demonstrated a correlation between bone mineral density and CT values. However, no previous biomechanical studies investigated the correlation between CT values and pedicle screw pull-out strength.Methods: Sixty fresh-frozen lumbar vertebrae from 6-month-old pigs were used. Before screw insertion, the CT values of the screw path were obtained for each sample. Specimens were then randomly divided into three equal groups. Each group had one of three pedicle screws inserted: 4.0-mm LEGACY (4.0-LEG), 4.5-mm LEGACY (4.5-LEG), or 4.5-mm SOLERA (4.5-SOL) (all from Medtronic Sofamor Danek Inc., Memphis, TN, USA). Each screw had a consistent 30-mm thread length. Axial pull-out testing was performed at a rate of 1.0 mm/min. Correlations between the CT values and pedicle screw pull-out strength were evaluated using Pearson’s correlation coefficient analysis.Results: The correlation coefficients between the CT values of the screw path and pedicle screw pull-out strength for the 4.0-LEG, 4.5-LEG, and 4.5-SOL groups were 0.836 (<i>p</i> <0.001), 0.780 (<i>p</i> <0.001), and 0.873 (<i>p</i> <0.001), respectively. Greater CT values were associated with greater screw pull-out strength.Conclusions: The CT values of the screw path were strongly positively correlated with pedicle screw pull-out strength, regardless of the screw type and diameter, suggesting that the CT values could be clinically useful for predicting pedicle screw pull-out strength.


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