Advances in imaging approaches to fracture risk evaluation.
Fragility fractures are a growing problem worldwide, and current methods for diagnosing osteoporosis do not always identify individuals who require treatment to prevent a fracture and may misidentify those not a risk. Traditionally, fracture risk is assessed using dual-energy X-ray absorptiometry, which provides measurements of areal bone mineral density at sites prone to fracture. Recent advances in imaging show promise in adding new information that could improve the prediction of fracture risk in the clinic. As reviewed herein, advances in quantitative computed tomography (QCT) predict hip and vertebral body strength; high-resolution HR-peripheral QCT (HR-pQCT) and micromagnetic resonance imaging assess the microarchitecture of trabecular bone; quantitative ultrasound measures the modulus or tissue stiffness of cortical bone; and quantitative ultrashort echo-time MRI methods quantify the concentrations of bound water and pore water in cortical bone, which reflect a variety of mechanical properties of bone. Each of these technologies provides unique characteristics of bone and may improve fracture risk diagnoses and reduce prevalence of fractures by helping to guide treatment decisions.
Biomedical Engineering, Vanderbilt University, Nashville, TN; Vanderbilt University Institute of Imaging Science, Nashville, TN.
Mary Kate
MK
Manhard
Biomedical Engineering, Vanderbilt University, Nashville, TN; Vanderbilt University Institute of Imaging Science, Nashville, TN; Orthopaedic Surgery and Rehabilitation, Vanderbilt University, Nashville, TN; Tennessee Valley Healthcare System, Department of Veterans Affairs, Nashville, TN; Center for Bone Biology, Vanderbilt University Medical Center, Nashville, TN.
Jeffry S
JS
Nyman
Biomedical Engineering, Vanderbilt University, Nashville, TN; Vanderbilt University Institute of Imaging Science, Nashville, TN; Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN; Electrical Engineering, Vanderbilt University, Nashville, TN. Electronic address: mark.does@vanderbilt.edu.
Mark D
MD
Does
D000818:Animals; D003952:Diagnostic Imaging / Q000379:methods*; D050723:Fractures, Bone / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D006801:Humans; D008279:Magnetic Resonance Imaging; D018570:Risk Assessment; D014057:Tomography, X-Ray Computed