Improvements in imaging technology and image processing techniques have made it possible to extend clinical osteoporosis research beyond bone mineral density into indices of bone structure. These techniques range from estimates made on relatively crude imaging technologies, such as DXA and radiographic imaging, to more sophisticated approaches based on images from volumetric CT acquisitions. These measures range from estimates of sectional strength estimates from cross-sections through the femoral neck and indices of apparent cortical thickness and volume, to finite element modeling methods which take into account the full 3D information on the bone geometry and material properties to estimate the whole bone strength. Although the resolution of CT scanners has improved greatly due to the introduction of multidetector systems, the images are still not of sufficient quality directly to assess trabecular microstructure and cortical thickness. To this end, microCT has become available for high-resolution scanning of bone specimens and live animals and high-resolution devices such as the XtremeCT HR-PQCT device have been developed for estimates of trabecular texture and cortical structure at peripheral skeletal sites.
