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Discrimination of Contributing Factors to Bone Fragility Using vQCT In Vivo

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Advanced Bioimaging Technologies in Assessment of the Quality of Bone and Scaffold Materials

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Abstract

The most serious manifestations of osteoporosis are proximal femoral fractures, affecting over 250,000 elderly in the United States each year and 890,000 in the European Union in the year 2000 alone. The impact on public health and the resultant cost to the health care system highlight the urgency to identify those parameters significant to accurately predict bone quality and fracture risk at the proximal femur. Determinations of the proximal femur are employed to illustrate relevant applications of vQCT with the potential to be extrapolated to other skeletal sites and the research and development of novel biomaterials that could contribute to the restoration or improvement of bone function. We explain the underpinning of parameters for bone mass, BMD, and bone geometry, as well as the structural indices discriminated by vQCT. We further clarify the benefit of sub-regional analysis (trochanteric region separate from femoral neck region) and of compartmental analysis (cortical bone separate from trabecular bone). In order to gain insight into how these factors contribute to bone fragility, we show how vQCT information combined with finite element modeling (FEM) information, a structural analysis tool, allows for estimation of fracture load under various loading conditions including impact from a fall. We typify unique results obtained from studies on aging, drugs with bone impact, and spaceflight, which is difficult to reveal in vivo without vQCT. We show in vivo how aging results in heterogeneous effects in the trochanteric and femoral neck region and how the impact of long-term spaceflight differs between trabecular and cortical bone. We suggest future directions for vQCT, such as the improvement of accuracy and precision for longitudinal studies, the FEM analysis integration into individual patient evaluation for in vivo assessment of simulated fracture conditions, and the development of additional variables for enhancement of bone fragility evaluations.

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Authors and Affiliations

  1. Department of Radiology, University of California San Francisco, 185 Berry Street, Suite 350, San Francisco, CA, 94143-0946, USA

    Margarita Meta, Ying Lu & Thomas F. Lang

  2. Department of Orthopedic Surgery, University of California, Irvine, California

    Joyce H. Keyak

Authors
  1. Margarita Meta
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  2. Ying Lu
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  3. Joyce H. Keyak
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  4. Thomas F. Lang
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Corresponding author

Correspondence to Margarita Meta .

Editor information

Editors and Affiliations

  1. Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China

    Ling Qin (Professor) & Kwok Sui Leung (Professor of Department of Orthopaedics & Traumatology) (Professor) &  (Professor of Department of Orthopaedics & Traumatology)

  2. University of California, San Francisco

    Harry K. Genant (Professor Emeritus, Chairman Emeritus and Board of Directors) (Professor Emeritus, Chairman Emeritus and Board of Directors)

  3. Synarc, Inc, USA

    Harry K. Genant (Professor Emeritus, Chairman Emeritus and Board of Directors) (Professor Emeritus, Chairman Emeritus and Board of Directors)

  4. Department of Radiology and Organ Imaging, The Chinese University of Hong Kong, Hong Kong SAR, China

    James F. Griffith

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Meta, M., Lu, Y., Keyak, J.H., Lang, T.F. (2007). Discrimination of Contributing Factors to Bone Fragility Using vQCT In Vivo. In: Qin, L., Genant, H.K., Griffith, J.F., Leung, K.S. (eds) Advanced Bioimaging Technologies in Assessment of the Quality of Bone and Scaffold Materials. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-45456-4_26

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  • DOI: https://doi.org/10.1007/978-3-540-45456-4_26

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-45454-0

  • Online ISBN: 978-3-540-45456-4

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