Best Practice & Research Clinical Endocrinology & Metabolism
5Bone mass and architecture determination: state of the art
Section snippets
Bone, bone mass and bone density
Mineralized bone tissue is composed of type-I collagen fibres (∼40% by volume) interspersed with calcium hydroxyapatite crystals (∼45% by volume). The remaining volume (∼15%) is composed of water bound to collagen or free. Bone marrow is composed of vessel sinusoids, and a variable amount of haematopoietic and fatty tissue. As opposed to isotropic tissue, which is identical in all directions, bone tissue is anisotropic and changes from one direction to another depending on functional
Determination of bone macro-architecture
Bone macro-architecture refers to overall bone geometry and covers such aspects as bone shape and size. Bone macrostructure can be assessed by radiography, DXA, QCT, peripheral QCT (pQCT) or magnetic resonance imaging (MRI), and is an important contributor to bone strength. A strong association has been reported between proximal femoral geometry and postmenopausal fracture12, 13, while biomechanical testing has shown that a combination of bone density and femoral geometry is more predictive of
Determination of bone micro-architecture
Only high-resolution techniques can depict micro-architecture. Techniques used to assess micro-architecture include CT-based (micro-CT, high-resolution pQCT, pQCT and multidetector CT) and MR-based (micro-MR, high-resolution clinical MR) techniques as well as radiography (fractal analysis). The accuracy of micro-architecture determination depends heavily on spatial resolution as well as analytical methods. Following image acquisition, addition steps may include region-of-interest extraction,
Dual x-ray absorptiometry (DXA)
Dual x-ray absorptiometry, as the name implies, measures the relative tissue absorption of a dual-energy x-ray spectrum. The dual-energy spectrum is produced in one of two ways: either a cerium filter is applied to absorb the mid-energy spectrum waves of an x-ray beam yielding effective energies of 40 and 70 keV, or a dual-energy x-ray source is utilized rapidly switching between low (∼70 kVp) and high (∼140 kVp) tube potentials.26
DXA is a projectional imaging technique which measures areal
Summary
Bone mineral density is the best single surrogate marker of bone strength and, for the immediate future, bone strength will continued to assessed most widely by DXA. There are, however, many aspects to bone strength beyond those evaluated by DXA. Currently, the increasing research use of high-resolution imaging to assess bone strength is limited by cost, availability, consensus regarding analytical standards, and irradiation limitations. These new techniques may become much more widely adopted
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Cited by (102)
Finite element analysis informed variable selection for femoral fracture risk prediction
2021, Journal of the Mechanical Behavior of Biomedical MaterialsUpper Extremity Fragility Fractures
2021, Journal of Hand SurgeryEvaluation of the capability of the simulated dual energy X-ray absorptiometry-based two-dimensional finite element models for predicting vertebral failure loads
2019, Medical Engineering and PhysicsCitation Excerpt :In addition, only approximately 50% of the variability in the vertebral failure load can be predicted by these BMD measurements, which cannot provide information about bone microarchitecture and BMD distribution [4–6]. By contrast, DXA can be used routinely and frequently because of its low radiation dose and low cost [7]. However, the aBMD obtained from DXA does not contain information about the material microarchitecture or any mechanical properties of the bone tissues.
Subchondral tibial bone texture predicts the incidence of radiographic knee osteoarthritis: data from the Osteoarthritis Initiative
2017, Osteoarthritis and CartilageCitation Excerpt :Second, the bifractal aspect of the TBT was arbitrarily chosen and delimited in this study according to empirical observation of the variograms. However, the cut-off at 500 μm corresponds to the breaking point in scale range between the trabecular thickness (100–300 μm) and the trabecular separation (200–2000 μm)52. This observation has been reported in several studies focusing on the TBT15,17,38 and might confirm the need to differentiate the process occurring at different scales in bone remodeling.