title: The use of bone age for bone mineral density interpretation in a cohort of pediatric brain tumor patients.
abstract: BACKGROUND
  Skeletal bone accretion occurs throughout childhood. The integrity of this process can influence future adult bone health and the risk of osteoporosis. Although surveillance of children who are at risk of poor bone accretion is important, the most appropriate method to monitor childhood bone health has not been established. Previous investigators have proposed using bone age (BA) rather than chronological age (CA) when interpreting bone mineral density (BMD) values in children.
  
  
  OBJECTIVE
  To investigate the value of BA assessment for BMD measurement in a cohort of children at risk of poor accretion.
  
  
  METHODS
  A cohort of 163 children with brain tumors who completed both a BMD assessment (quantitative computed tomography, QCT) and who had a BA within a 6-month interval were identified. The difference in BMD Z-scores determined by CA and BA was determined. The impact of salient clinical features was assessed.
  
  
  RESULTS
  No significant difference between CA and BA Z-scores was detected in the overall cohort (P = 0.056). However, the scores in 18 children (all boys between the ages of 11 years and 15 years) were statistically determined to be outliers from the values in the rest of the cohort.
  
  
  CONCLUSIONS
  Interpretation of BMD with BA measurement might be appropriate and affect treatment decisions in peripubertal males.
authors.affiliation: Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA. Brannon.morris@stjude.org
authors.forename: E Brannon
authors.initials: EB
authors.lastname: Morris
authors.forename: John
authors.initials: J
authors.lastname: Shelso
authors.forename: Matthew P
authors.initials: MP
authors.lastname: Smeltzer
authors.forename: Nicole A
authors.initials: NA
authors.lastname: Thomas
authors.forename: E Jane
authors.initials: EJ
authors.lastname: Karimova
authors.forename: Chin-Shang
authors.initials: CS
authors.lastname: Li
authors.forename: Thomas
authors.initials: T
authors.lastname: Merchant
authors.forename: Amar
authors.initials: A
authors.lastname: Gajjar
authors.forename: Sue C
authors.initials: SC
authors.lastname: Kaste