title: A Trimodality Comparison of Volumetric Bone Imaging Technologies. Part III: SD, SEE, LSC Association With Fragility Fractures.
abstract: Part II of this 3-part series demonstrated 1-yr precision, standard error of the estimate, and 1-yr least significant change for volumetric bone outcomes determined using peripheral (p) quantitative computed tomography (QCT) and peripheral magnetic resonance imaging (pMRI) modalities in vivo. However, no clinically relevant outcomes have been linked to these measures of change. This study examined 97 women with mean age of 75 ± 9 yr and body mass index of 26.84 ± 4.77 kg/m(2), demonstrating a lack of association between fragility fractures and standard deviation, least significant change and standard error of the estimate-based unit differences in volumetric bone outcomes derived from both pMRI and pQCT. Only cortical volumetric bone mineral density and cortical thickness derived from high-resolution pQCT images were associated with an increased odds for fractures. The same measures obtained by pQCT erred toward significance. Despite the smaller 1-yr and short-term precision error for measures at the tibia vs the radius, the associations with fractures observed at the radius were larger than at the tibia for high-resolution pQCT. Unit differences in cortical thickness and cortical volumetric bone mineral density able to yield a 50% increase in odds for fractures were quantified here and suggested as a reference for future power computations.
authors.affiliation: Department of Medicine, McMaster University, Hamilton, ON, Canada. Electronic address: wongko@mcmaster.ca.
authors.forename: Andy K O
authors.initials: AK
authors.lastname: Wong
authors.affiliation: Department of Medicine, McMaster University, Hamilton, ON, Canada.
authors.forename: Karen A
authors.initials: KA
authors.lastname: Beattie
authors.affiliation: Health Sciences, McMaster University, Hamilton, ON, Canada.
authors.forename: Kevin K H
authors.initials: KK
authors.lastname: Min
authors.affiliation: Department of Medicine, University Health Network, Toronto, ON, Canada.
authors.forename: Zamir
authors.initials: Z
authors.lastname: Merali
authors.affiliation: Department of Nuclear Medicine, Hamilton Health Sciences, Hamilton, ON, Canada.
authors.forename: Colin E
authors.initials: CE
authors.lastname: Webber
authors.affiliation: Department of Nuclear Medicine, McMaster University, Hamilton, ON, Canada.
authors.forename: Christopher L
authors.initials: CL
authors.lastname: Gordon
authors.affiliation: Division of Geriatrics, Hamilton Health Sciences, Hamilton, ON, Canada.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Papaioannou
authors.affiliation: Osteoporosis Program, University Health Network, Toronto, ON, Canada.
authors.forename: Angela M W
authors.initials: AM
authors.lastname: Cheung
authors.affiliation: Department of Medicine, McMaster University, Hamilton, ON, Canada.
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Adachi
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D015519:Bone Density; D015331:Cohort Studies; D005260:Female; D050723:Fractures, Bone / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D016017:Odds Ratio; D010024:Osteoporosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology*; D011884:Radius; D012680:Sensitivity and Specificity; D013977:Tibia; D014057:Tomography, X-Ray Computed
keywords: Clinical sensitivity; fragility fractures; least significant change; pMRI; pQCT