title: Trabecular bone score: perspectives of an imaging technology coming of age.
abstract: The trabecular bone score (TBS) is a new method to describe skeletal microarchitecture from the dual energy X-ray absorptiometry (DXA) image of the lumbar spine. While TBS is not a direct physical measurement of trabecular microarchitecture, it correlates with micro-computed tomography (µCT) measures of bone volume fraction, connectivity density, trabecular number, and trabecular separation, and with vertebral mechanical behavior in ex vivo studies. In human subjects, TBS has been shown to be associated with trabecular microarchitecture and bone strength by high resolution peripheral quantitative computed tomography (HRpQCT). Cross-sectional and prospective studies, involving a large number of subjects, have both shown that TBS is associated with vertebral, femoral neck, and other types of osteoporotic fractures in postmenopausal women. Data in men, while much less extensive, show similar findings. TBS is also associated with fragility fractures in subjects with secondary causes of osteoporosis, and preliminary data suggest that TBS might improve fracture prediction when incorporated in the fracture risk assessment system known as FRAX. In this article, we review recent advances that have helped to establish this new imaging technology.
authors.affiliation: Medical School, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.
authors.forename: Barbara C
authors.initials: BC
authors.lastname: Silva
authors.affiliation: Division of Endocrinology, Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, United States.
authors.forename: John P
authors.initials: JP
authors.lastname: Bilezikian
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods* / Q000639:trends; D015519:Bone Density; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D001842:Bone and Bones / Q000033:anatomy & histology* / Q000502:physiology*; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging*; D008297:Male; D015663:Osteoporosis, Postmenopausal / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D058866:Osteoporotic Fractures / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control; D017698:Postmenopause / Q000502:physiology; D012307:Risk Factors
chemical_list: D050071:Bone Density Conservation Agents