In vivo assessment of trabecular bone microarchitecture by high-resolution peripheral quantitative computed tomography.
BACKGROUND
Assessment of trabecular microarchitecture may enhance the prediction of fracture risk and improve monitoring of treatment response. A new high-resolution peripheral quantitative computed tomography (HR-pQCT) system permits in vivo assessment of trabecular architecture and volumetric bone mineral density (BMD) at the distal radius and tibia with a voxel size of 82 microm3.


OBJECTIVE
We determined the short-term reproducibility of this device by measuring 15 healthy volunteers three times each. We compared HR-pQCT measurements in 108 healthy premenopausal, 113 postmenopausal osteopenic, and 35 postmenopausal osteoporotic women. Furthermore, we compared values in postmenopausal osteopenic women with (n = 35) and without previous fracture history (n = 78).


METHODS
We conducted a cross-sectional study in a private clinical research center.


METHODS
We took HR-pQCT measurements of the radius and tibia. Femoral neck and spine BMD were measured in postmenopausal women by dual-energy x-ray absorptiometry.


RESULTS
Precision of HR-pQCT measurements was 0.7-1.5% for total, trabecular, and cortical densities and 2.5-4.4% for trabecular architecture. Postmenopausal women had lower density, trabecular number, and cortical thickness than premenopausal women (P < 0.001) at both radius and tibia. Osteoporotic women had lower density, cortical thickness, and increased trabecular separation than osteopenic women (P < 0.01) at both sites. Furthermore, although spine and hip BMD were similar, fractured osteopenic women had lower trabecular density and more heterogeneous trabecular distribution (P < 0.02) at the radius compared with unfractured osteopenic women.


CONCLUSIONS
HR-pQCT appears promising to assess bone density and microarchitecture at peripheral sites in terms of reproducibility and ability to detect age- and disease-related changes.
Boutroy
Stephanie
S
INSERM Unit 403, and Claude Bernard University of Lyon, France.
Bouxsein
Mary L
ML
Munoz
Francoise
F
Delmas
Pierre D
PD
D015502:Absorptiometry, Photon; D000328:Adult; D000375:Aging / Q000378:metabolism; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000150:complications / Q000000981:diagnostic imaging / Q000378:metabolism; D003430:Cross-Sectional Studies; D005260:Female; D005272:Femur Neck / Q000000981:diagnostic imaging / Q000378:metabolism; D050723:Fractures, Bone / Q000209:etiology; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000378:metabolism; D006801:Humans; D008499:Medical Records; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000000981:diagnostic imaging / Q000378:metabolism; D017698:Postmenopause; D017697:Premenopause; D011884:Radius / Q000000981:diagnostic imaging* / Q000378:metabolism; D015203:Reproducibility of Results; D013131:Spine / Q000000981:diagnostic imaging / Q000378:metabolism; D013977:Tibia / Q000000981:diagnostic imaging* / Q000378:metabolism; D014057:Tomography, X-Ray Computed / Q000379:methods*