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Cortical and trabecular bone structure analysis at the distal radius—prediction of biomechanical strength by DXA and MRI

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Abstract

The purpose of this study was to investigate whether the combination of dual-energy X-ray absorptiometry (DXA)-based bone mass and magnetic resonance imaging (MRI)-based cortical and trabecular structural measures improves the prediction of radial bone strength. Thirty-eight left forearms were harvested from formalin-fixed human cadavers. Bone mineral content (BMC) and bone mineral density (BMD) of the distal radius were measured using DXA. Cortical and trabecular structural measures of the distal radius were computed in high-resolution 1.5T MR images. Cortical measures included average cortical thickness and cross-sectional area. Trabecular measures included morphometric and texture parameters. The forearms were biomechanically tested in a fall simulation to measure absolute radial bone strength (failure load). Relative radial bone strength was determined by dividing radial failure loads by age, body mass index, radius length, and average radius cross-sectional area, respectively. DXA derived BMC and BMD showed statistically significant (p < 0.05) correlations with absolute and relative radial bone strength (r ≤ 0.78). Correlation coefficients for cortical and trabecular structural measures with absolute and relative radial bone strength amounted up to r = 0.59 and r = 0.74, respectively, (p < 0.05). In combination with DXA-based bone mass, trabecular but not, cortical structural measures, added in multiple regression models significant (p < 0.05) information in predicting absolute and relative radial bone strength (up to R adj = 0.88). Thus, a combination of DXA-based bone mass and MRI-based trabecular structural measures most accurately predicted absolute and relative radial bone strength, whereas structural measures of the cortex did not provide significant additional information in combination with DXA.

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Acknowledgments

This work was supported by grants of the Deutsche Forschungsgemeinschaft (DFG LO 730/3-1 and DFG BA 4085/1-2).

Conflict of interest

All authors have no conflicts of interest.

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Authors and Affiliations

  1. Klinikum rechts der Isar, Institut für Radiologie, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany

    Thomas Baum, Melanie Kutscher, Dirk Müller, Ernst J. Rummeny & Jan S. Bauer

  2. Institut und Poliklinik für Diagnostische Radiologie, Universitätsklinikum Köln, Kerpener Str. 62, 50937, Cologne, Germany

    Dirk Müller

  3. Max-Planck-Institut für extraterrestrische Physik, Giessenbachstr. 1, 85748, Garching, Germany

    Christoph Räth

  4. Institute of Anatomy and Musculoskeletal Research, Paracelsus Medical University Salzburg, Strubergasse 21, 5020, Salzburg, Austria

    Felix Eckstein & Eva-Maria Lochmüller

  5. Musculoskeletal and Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Suite 350, San Francisco, CA, 94107, USA

    Thomas M. Link

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  1. Thomas Baum
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  2. Melanie Kutscher
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Correspondence to Thomas Baum.

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Baum, T., Kutscher, M., Müller, D. et al. Cortical and trabecular bone structure analysis at the distal radius—prediction of biomechanical strength by DXA and MRI. J Bone Miner Metab 31, 212–221 (2013). https://doi.org/10.1007/s00774-012-0407-8

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  • DOI: https://doi.org/10.1007/s00774-012-0407-8

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