scholarly journals The radiomorphometric indices of the mandible as a screening method for early detection of osteoporosis in postmenopausal women

2021 ◽  
Vol 45 (1) ◽  
pp. 31-37
Author(s):  
Bruno Popić ◽  
Boris Dželalija ◽  
Danijela Nujić ◽  
Andrea Milostić-Srb ◽  
Kristijan Dinjar ◽  
...  

The aim of the study was to compare radiomorphometric indices measured on panoramic radiographs: mandibular cortical width (MCW), panoramic mandibular index (PMI) and mandibular cortical index (MCI) with the densitometric values of skeletons in postmenopausal women, as well as and to determine the possibilities of their use in screening for early detection of osteoporosis in risky populations. Radiomorphometric indices were measured on panoramic radiographs of 146 postmenopausal patients, mean age 66.3 (±9.7) years, mean menopausal age 16.3 (±10.6) years. By dual energy X-ray absorptiometry (DXA) method were measured bone mineral density of the femur and the lumbar vertebrae (L1–L4). The Receiver Operating Characteristic (ROC) curve analysis was used to determine the changed densitometric finding, and to distinguish osteopenia and osteoporosis. The examinees with lower densitometric values had significantly lower MCW (3.60 mm) and PMI (0.36 mm) than those with regular densitometric values (p<0.001). The most frequent finding in patients with osteopenia was C2 stage of erosion (69.50%; p<0.001), while the C3 stage of erosion (57.40%; p<0.001) was in osteoporosis patients. When differing the normal from the changed finding of densitometry the results were: MCW – area under the curve (AUC) 0.862, sensitivity 92.04%, specificity 75.76%, resolution point ≤4.39 (p<0.001); for PMI-AUC 0.874, sensitivity 76.11%, specificity 84.85%, resolution point ≤ 0.41 (p<0.001) and for MCI-AUC 0.826, sensitivity 87.6%, specificity 69.7%, resolution point> 1 (p<0.001). For early detection of osteopenia and osteoporosis in postmenopausal women in everyday clinical practice, panoramic radiograph as a screening method can be of help.


2016 ◽  
Vol 17 (2) ◽  
pp. 138-141
Author(s):  
Samira Sharmin ◽  
Mabubul Haque ◽  
Syedur Rahman Miah ◽  
Md Mahbub Ur Rahman ◽  
Jasmine Ara Haque ◽  
...  

Objectives: Low bone mass is a common disorder in elderly population which predisposes to fracture with minimal trauma. This study was performed to find out the association between the Body Mass Index (BMI) and Bone Mineral Density (BMD) in postmenopausal women.Materials and Methods: This cross sectional study was carried out at Institute of Nuclear Medicine and Allied Sciences Comilla and Mitford, Dhaka over a period of 12 months from January 2013 to December 2013. A total 93 postmenopausal women were enrolled for this study. All postmenopausal women underwent a BMD scan of femoral neck and lumbar vertebrae using a Dual Energy X-ray Absorptiometry (DEXA). Participants were categorized into three groups according to their age and BMI. BMD were expressed base on T-score according to WHO criteria. The relation among BMI, age and BMD were assessed.Results: The results of this study showed that the mean age of the study group was 57.13±7.49 years with range of 46 to 75 years. The most postmenopausal women were in age group 55-65years. The mean BMI of the study subjects were 24.18±5.08 kg/m2 with a range of 15.62 to 36.20 kg/m2. Among 93 subjects osteopenia was greater at lumbar spine (45.2%) with T-score mean±SD-1.83±0.33 and osteoporosis at femoral neck (51.6%) with T-score mean ±SD-3.36±-0.67. Pearson’s correlation coefficient test showed inverse relationship between age and BMD both lumbar spine (r = -0.301, p = 0.003) and femoral neck (r = -0.303, p=0.003) whereas the positive relation between BMI and BMD both at lumbar spine (r=0.338, p=0.001) and femoral neck (r =0.343, p=0.001). These showed that with advancing age, BMD decreases and the risk of osteoporosis increases and with increasing BMI, BMD increases and risk of osteoporosis decreases.Conclusion: The findings of this study portrait that aging and low BMI are risk factors associated with bone loss. So preventive measure should be taken for high risk post menopausal women.Bangladesh J. Nuclear Med. 17(2): 138-141, July 2014



2015 ◽  
Vol 49 (2) ◽  
pp. 135-140 ◽  
Author(s):  
Satoshi Nagano ◽  
Yuhei Yahiro ◽  
Masahiro Yokouchi ◽  
Takao Setoguchi ◽  
Yasuhiro Ishidou ◽  
...  

Abstract Background. The utility of ultrasound imaging in the screening of soft-part tumours (SPTs) has been reported. We classified SPTs according to their blood flow pattern on Doppler ultrasound and re-evaluated the efficacy of this imaging modality as a screening method. Additionally, we combined Doppler ultrasound with several values to improve the diagnostic efficacy and to establish a new diagnostic tool. Patients and methods. This study included 189 cases of pathologically confirmed SPTs (122 cases of benign disease including SPTs and tumour-like lesions and 67 cases of malignant SPTs). Ultrasound imaging included evaluation of vascularity by colour Doppler. We established a scoring system to more effectively differentiate malignant from benign SPTs (ultrasound-based sarcoma screening [USS] score). Results. The mean scores in the benign and malignant groups were 1.47 ± 0.93 and 3.42 ± 1.30, respectively. Patients with malignant masses showed significantly higher USS scores than did those with benign masses (p < 1 × 10-10). The area under the curve was 0.88 by receiver operating characteristic (ROC) analysis. Based on the cut-off value (3 points) calculated by ROC curve analysis, the sensitivity and specificity for a diagnosis of malignant SPT was 85.1% and 86.9%, respectively. Conclusions. Assessment of vascularity by Doppler ultrasound alone is insufficient for differentiation between benign and malignant SPTs. Preoperative diagnosis of most SPTs is possible by combining our USS score with characteristic clinical and magnetic resonance imaging findings.



2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 676-676 ◽  
Author(s):  
T. Saarto ◽  
L. Vehmanen ◽  
C. Blomqvist ◽  
I. Elomaa

676 Background: We have previously reported that clodronate prevents bone loss in breast cancer patients (JCO 1997;15:1341, BJC 1997;75(4):602 and EJC 2001;37:2373). Here we report the 10-year follow-up data. Methods: 268 pre- (PRE) and postmenopausal (POST) node positive breast cancer patients were randomized to clodronate (CL), orally 1.6 g daily, or control groups for 3 years. PRE were treated with adjuvant chemotherapy and POST with antiestrogens (AE), tamoxifen 20 mg or toremifene 60 mg, for 3 years. The BMD of the lumbar vertebrae L1–4 (BMDLS) and femoral neck (BMDFN) was measured before the treatment and at 1, 2, 3, 5 and 10 years. 93 patients were eligible for 10-year analyses: 53 PRE and 40 POST. 132 patients had metastatic disease or died and 39 were either lost to follow-up or had to be excluded because having diseases or medications that influences bone metabolism. Results: PRE: BMDLS decreased -12.4% in the control and −8.7% in the CL group in 10 years: from 0 to 3 years −6.9 % vs. −4.2% and from 3 to 10 years −5.5% and −4.5%, respectively. BMDFN decreased −8.8% and −7.2%: from 0 to 3 years −2.9% vs. −2.6% and from 3 to 10 years −5.9% vs. −4.6%, respectively. POST: BMDLS decreased −3.0% in the AE and −1.7% in the AE+CL group in 10 years: from 0 to 3 years −1.5% vs. + 1.2% and from 3 to 10 years −1.5% vs. −2.9%, respectively. BMDFN decreased −7.7% and −6.0%: from 0 to 3 years −0.1% vs. +1.9% and from 3 to 10 years −7.6% vs. −7.9%, respectively. These differences do not reach statistical significance. At 10-years 18 patients had osteoporosis in LS and 15 in FN. Only 4 patients who had osteoporosis at 10 years had normal BMD before the therapy. Conclusions: As reported previously, clodronate prevents the bone loss during treatment in pre- and postmenopausal women. This beneficial effect seems to be maintained at least for 7 years after treatment termination in premenopausal. In postmenopausal women the effect seems to diminish within time. Due to small numbers of patients these differences are no longer statistically significant. Patients at risk of developing osteoporosis are among those who has pretreatment osteopenia i.e. baseline BMD measurement has predictive value. No significant financial relationships to disclose.



2010 ◽  
Vol 43 (3) ◽  
pp. 107 ◽  
Author(s):  
Agus Zainal Arifin ◽  
Anny Yuniarti ◽  
Lutfiani Ratna Dewi ◽  
Akira Asano ◽  
Akira Taguchi ◽  
...  

Background: Mandibular bone on panoramic radiographs has been proven to be useful for identifying postmenopausal women with low skeletal bone mineral density. One of the important parts of mandibular bone is trabecular bone. Trabecular bone architecture is one of the factors that governs bone strength and may be categorized as a contributor to bone quality. Purpose: The purposes of this study were to develop a computer-aided system for measuring trabecular bone line strength on panoramic radiographs in identifying postmenopausal women with osteoporosis and to clarify the diagnostic efficacy of the system. Methods: Reduction and expansion of trabecular bone sample images using a two level Gaussian pyramid for removing noises and small segments were first introduced. Then, line strength at each pixel was calculated based on its existence on the trabecular bone with emphasizes line segment which has similar orientation with the root of tooth. The density was measured with respect to line strength of segment structure which has similar orientation with the root of tooth, either on the left and the right in the mandibular bone. Number of pixels in the line segment area was compared with a threshold value to determine whether normal or osteoporosis. Results: From experiment on 100 data, the accuracy of 88%, sensitivity of 92%, and specificity of 86.7% were achieved. Conclusion: The computer-aided system of trabecular bone analysis may be useful for detecting osteoporosis using panoramic radiographs.Latar belakang: Tulang mandibula pada panoramik radiografi telah banyak diteliti dan terbukti mampu digunakan untuk mengidentifikasi wanita pasca menopause dengan menggunakan bone mineral density rendah. Salah satu bagian tulang mandibula yang penting adalah tulang trabekula. Arsitektur tulang trabekula merupakan salah satu dari faktor-faktor yang mempengaruhi kekuatan tulang dan dapat digolongkan sebagai kontributor bagi kualitas tulang. Tujuan: Penelitian ini bertujuan untuk membangun sebuah sistem dengan bantuan komputer untuk mengukur kekuatan garis pada tulang trabekula dan menggunakannya untuk mendeteksi osteoporosis pada wanita postmenopause. Metode: Dilakukan sampling pada sebagian tulang mandibular yang menghasilkan sebuah sampel citra. Sampel citra ini selanjutnya diperbaiki dari derau (noise) dengan menggunakan piramida Gaussian dua level. Kekuatan garis pada tiap piksel dihitung berdasarkan orientasi segmen garis tulang trabekula yang sejajar dengan akar gigi. Setelah dilakukan binerisasi, luasan segmen yang dihasilkan dihitung dan dibandingkan dengan sebuah nilai ambang. Bila luasan melebihi nilai threshold maka dikategorikan sebagai normal. Sebaliknya bila luasan dibawah nilai threshold, dikategorikan sebagai osteoporosis. Hasil: Berdasarkan eksperimen terhadap 100 data, sistem mampu mencapai akurasi identifikasi sebesar 88%, sensitivitas 92%, dan spesifisitas 86,7%. Kesimpulan: Sistem analisa trabecular bone dengan bantuan komputer ini dapat digunakan oleh para dokter gigi untuk mendeteksi osteoporosis menggunakan panoramik radiografi.



2016 ◽  
Vol 21 (1) ◽  
pp. 151-157 ◽  
Author(s):  
Olja Grgić ◽  
Branka Kovačev-Zavišić ◽  
Tanja Veljović ◽  
Jovanka Novaković-Paro ◽  
Tatjana Maravić ◽  
...  


2017 ◽  
Vol 11 (1) ◽  
pp. 350-359 ◽  
Author(s):  
Shambulingappa Pallagatti ◽  
Priyanka Parnami ◽  
Soheyl Sheikh ◽  
Deepak Gupta

Objective:It is a well-known fact that osteoporosis affects the people with old age and remains unnoticeable until the patient presents with fracture. Various studies in the literature reveal that panoramic radiographs may prove to be beneficial in the detection of Osteoporosis in patients. Henceforth this present study was aimed to validate the use of Klemetti Index (KI) on panoramic radiographs so as to detect osteoporosis in the patients at an early stage.Methods:60 postmenopausal women were selected. A panoramic radiograph was taken to grade their mandibular cortex on the basis of Klemetti Index. All the panoramic radiographs were evaluated by 5 different Oral Medicine and Radiology specialists. Later all the patients were subjected to dual energy X-ray absorptimetry (DEXA) scan for bone mineral density evaluation. The results were evaluated statistically.Results:The average accuracy of the five observers to demonstrate normal bone, osteopenia and osteoporosis when compared to DEXA scan was 58.08%, 63.3% and 64.74% respectively. The observations of the 5 observers on the basis of KI were not statistically different from the BMD evaluation done with the help of DEXA Scan.Conclusion:Panoramic radiographs can be used as a screening tool for the evaluation as well as early detection of osteoporosis with the usage of Klemetti Index.



2021 ◽  
pp. 030089162110149
Author(s):  
Dragan Trivanovic ◽  
Stjepko Plestina ◽  
Lorena Honovic ◽  
Renata Dobrila-Dintinjana ◽  
Jelena Vlasic Tanaskovic ◽  
...  

Background: Gastric cancer (GC) is the eighth most common cause of cancer deaths in Croatia and one of the most common causes of cancer deaths worldwide. A reliable diagnostic tool for the early detection of GC is essential. Objective: We previously suggested a pepsinogen test method to reduce the mortality from GC by allowing early detection. Here, we report an updated analysis from a prospective single-center clinical study to evaluate the sensitivity and specificity of the pepsinogen test method and to determine whether this test can be used as a part of routine laboratory assessment of high-risk patients. Methods: We present mature data of the pepsinogen test method in the Croatian population after a median follow-up of 36 months. Statistical analyses were performed using a Mann-Whitney U test, multiple logistic regression, and receiver operating characteristics (ROC) to evaluate the predictive power of the assayed biomarkers. Results: Of the 116 patients, 25 patients had GC and 91 demonstrated a nonmalignant pathology based on tissue biopsy. Cutoff values were pepsinogen I ⩽70 and pepsinogen I/II ratio ⩽3.0. Using ROC curve analysis, the accuracy, sensitivity, specificity, positive predictive value, and negative predictive value were determined to be 87.22%, 78.12%, 90.10%, 71.43%, and 92.86%, respectively, for the diagnosis of GC. The area under the curve was 0.700 (95% confidence interval 0.57–0.83). Conclusion: Pepsinogen tests are valuable for screening a population in need of further diagnosis and could help to avoid unnecessary invasive endoscopic procedures.



2020 ◽  
Vol 24 (1) ◽  
Author(s):  
Aline Nagai ◽  
Lucas Morita ◽  
Luciana Munhoz ◽  
Emiko Arita

Objective: The objective of this study was to evaluate mandibular osteoporotic alterations in patients with HIV infection in comparison to non-HIV-infected patients using panoramic radiographs. Material and Methods: 26 HIV-infected patients and 142 non-HIV-infected patients (control group) were included in this study. Panoramic radiographs of the participants were assessed considering mandibular cortical index (MCI). Non-parametric comparisons between groups were performed, using Mann-Whitney test, at a level significance level of p= 0.05. Results: HIV-infected patients presented lower bone mineral density (BMD) at mandible, assessed by MCI in panoramic radiographs when compared to non-HIV-infected patients. The medication intake of HIV-infected patients was highly heterogeneous and could not be associated to the low BMD presented in the mandibular cortex. Conclusions:  HIV-infected patients may present lower mandibular BMD than non-HIV-infected patients.   Keywords Panoramic radiograph; osteoporosis; bone mineral density; HIV.



Author(s):  
Agus Zainal Arifin ◽  
◽  
Akira Asano ◽  
Akira Taguchi ◽  
Takashi Nakamoto ◽  
...  

A thin or eroded cortex of the mandible detected on dental panoramic radiographs is independently associated with low skeletal bone mineral density (BMD) or osteoporosis in postmenopausal women. The purposes of this study were to develop new computer-aided diagnosis system that combines these two panoramic measures by using fuzzy neural networks (FNN) for identifying postmenopausal women with osteoporosis. Dental panoramic radiographs of 100 postmenopausal women who visited our clinic and had BMD assessments at the lumbar spine and the femoral neck were used in this study. Mandibular cortical width and shape were measured by computer-aided systems and used as the inputs. This system partitioned the input space into a set of subspaces using a novel fuzzy thresholding and constructed the fuzzy inference system incorporated with multi layer perceptron neural network. Our results show that the combination of cortical width and shape by using FNN can be used for the identification of postmenopausal women with osteoporosis in dental clinic. Dentists may identify postmenopausal women accurately by using the new FNN based system and refer them to medical professional for BMD testing.



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